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- Presentation
Best Practices for Disclosing Medical Errors
Description
The presentation reviews best practices for disclosing medical errors and explains that a medical error is a failed action or wrong action that does not achieve the intended result. It distinguishes serious errors, minor errors, and near misses, and emphasizes the immediate steps after an error: prevent further harm, minimize suffering, preserve evidence, avoid altering records, inform the patient and family, and document accurately. The speakers note that medical errors are common and have major consequences for patients and physicians, including malpractice risk and significant financial liability. In dermatology, common errors include assessment problems such as biopsy mix-ups or missed follow-up of results, and intervention errors such as wrong-site surgery or incorrect diagnosis. The talk defines disclosure as honest communication with the patient or family that acknowledges the error, explains what happened and why, describes the impact, and outlines how recurrence will be prevented. It highlights that attitudes toward disclosure have improved over time and that most physicians now say they would disclose an error. The presentation explains why disclosure matters: patients want to know, it may reduce litigation, and it aligns with ethical principles of autonomy, nonmaleficence, beneficence, and justice. Finally, it discusses barriers to disclosure, especially fear of litigation, shame, knowledge gaps, institutional culture, and limited time.
View moreConclusions
- Medical errors are common and can range from near misses to serious events, so the first response should be to prevent further harm, protect evidence, inform the patient, and document accurately.
- In dermatology, the most frequent serious and common errors involve assessment problems such as biopsy mix-ups and delayed responses to results, as well as intervention errors like wrong-site surgery and misdiagnosis.
- Procedural mistakes are the most common basis for dermatology malpractice claims, but diagnostic errors tend to produce the largest payouts.
- Patients generally want to be told when an error occurs, and disclosure is supported by ethical principles including autonomy, nonmaleficence, beneficence, and justice.
- Although physicians increasingly endorse disclosure, there remains a gap between believing in disclosure and actually carrying it out in practice.
- Fear of litigation is the most common barrier to disclosure, but knowledge gaps, shame, institutional culture, and time pressure also make disclosure difficult.
- The presentation implies that normalizing and teaching disclosure can improve patient trust, reduce litigation risk, and support physicians in handling these events more effectively.
- Watson AJ, Redbord K, Taylor JS, Shippy A, Kostecki J, Swerlick R. Medical error in dermatology practice: development of a classification system to drive priority setting in patient safety efforts. J Am Acad Dermatol. 2013 May;68(5):729-37.#10.1016/j.jaad.2012.10.058
- Kornmehl H, et al. JAMA Dermatology article on medical errors and litigation in dermatology (citation referenced on slide).
- Hobgood C, Peck CR, Gilbert B, Chappell K, Zou B. Medical errors—what and when: what do patients want to know? Acad Emerg Med. 2002;9(11):1156–61.#10.1111/j.1553-2712.2002.tb01570.x