Does saying ‘sorry’ make you a better doctor?
Key Takeaways
Everyone makes mistakes—including doctors.
On a hectic day at an outpatient clinic, I needed to catch up—and my patient wait times were increasing. I remember this particularly busy day because I had to send four patients to the ER to rule out myocardial infarctions.
I was finally about to see my last patient an hour after her appointment time. As soon as I entered the room, she gave me a tongue-lashing about being late and how unprofessional that was. She said she would never come to this office again.
I was so worn down, exhausted, and stressed that my knee-jerk reaction was to say, “That’s fine. You can go elsewhere. It’s not my fault that I’m running behind, but I needed to give each one of my patients the proper time and care today.”
My mistake
Unfortunately, I forgot to ask my office staff to communicate with my waiting room full of patients that I was running late, explain why, and give them the option to reschedule. That was my mistake and where I was in the wrong.
I stood there in silence for what felt like an eternity, took a deep breath, and then apologized for making her wait. I explained that I was running late because I was overbooked, had a few very sick patients, and always tried to take the needed time to examine patients and address their concerns.
I spent about 30 minutes with her during her visit, answering her questions and changing her diabetes regimen. At the end of the visit, I again said I was sorry for my tardiness.
She thanked me and apologized for being harsh. She then complimented me on my bedside manner and told me it was worth the wait, and of course, she would be back in 3 months for a follow-up visit.
The pros and cons of apologizing
"If we want to be better doctors, we should apologize for our mistakes."
— Kristen Fuller, MD
An apology is a characteristic of kindness and humility that shows we care for our patients—and ourselves. But sometimes, saying “sorry” can be a sign of low confidence or a way to ask for permission, and in these cases, an apology may do more harm than good.
A learning opportunity
We can always make room for growth and learning opportunities when we correct past mistakes, even if we must humble ourselves and admit our failures.
"Physicians are not perfect. We get angry. We make mistakes, and sometimes we need to learn the hard way from them."
— Kristen Fuller, MD
Apologies can help to mend old wounds, whether they are inflicted intentionally or unintentionally. It can also go a long way in enhancing a patient’s quality of life.
Out of your control
Although apologies are essential when you make a mistake, apologizing for something outside your control can place the blame on you when it’s not your fault.
For example, suppose a procedure is taking longer than anticipated because you are paying attention to detail, making sure your work is solid, and taking great care of your patient. In that case, you shouldn't have to apologize for “taking too long.”
Instead, you can explain to the patient and their family that the procedure took longer than anticipated because you wanted to ensure that your patient was safe.
In an outpatient setting, you can send a nurse or an office staff member out into the waiting room to give them an appropriate explanation of why the procedure is taking longer than anticipated. You can also do this when running late in outpatient clinics.
When ‘sorry’ is used as a crutch
In an article published by KevinMD, Theresa Hsiao, DO, explained that an apology can be a crutch, especially for female physicians who may feel marginalized and powerless.[]
"For any woman in a position of power, there is a constant struggle to delicately give orders without offending anyone."
— Theresa Hsiao, DO, KevinMD
“This is especially so for women in medicine who constantly face the dilemma of balancing femininity and assertiveness,” Dr. Hsaio continued. “One tip of the scale in either direction causes them to lose credibility. Soft-spoken becomes unsure and incompetent, assertiveness is seen as ‘bitchy’ and hard to work with. Because of this fear, there is a blatant overuse of comfort words such as ‘sorry.’”
Maybe we are not sorry for asking a question but instead trying to be polite or not to come off as harsh. In these situations, “sorry” is often used as a crutch to ask for something politely or to appear nicer when making a request.
Saying “I’m sorry” when you are not in the wrong can potentially cripple your self-confidence and may cause your patients and co-workers to question your competence. When we apologize to our patients or colleagues, we must take a step back and ask why we are doing so.
"Are we apologizing because we were in the wrong, or because we don’t want to step on anyone’s toes and be assertive?"
— Kristen Fuller, MD
Legal implications
Do we put ourselves at legal risk for legal action such as malpractice suits if we apologize to patients?
“In theory, telling a patient about an error may make patients more likely to pursue litigation,” wrote the authors of an analysis published by The Journal of the American Academy of Psychiatry and the Law.[] “In practice, however, bad outcomes alone are typically not reason enough for patients or their families to file malpractice claims.”
The authors found that malpractice suits are often related to “bad feelings evoked.” Such feelings may be due to the patient’s perception of the physician’s communication skills. Those who seem unavailable, insensitive, or critical are more likely to be sued. Patients are also more likely to pursue legal action to get the information they feel the doctor is withholding.
Some states have also enacted legal protections for physicians who apologize. These typically are one of two types of law—full or partial apology laws. Full apology laws “protect statements that are consistent with the definition of an apology, ie, an expression of regret and a disclosure of error,” while “partial apology laws protect expressions of regret only, without any protection given to error disclosure.”
According to the analysis, as of October 2020, nine states had implemented full apology laws, while 31 states had partial laws in place.
Further research found that these laws “have increased physician apologies, expedited claim resolution, and decreased the number of and payments for malpractice claims.”[][]
While patient reactions to apologies can be unpredictable and there is no ironclad way to prevent legal action, the installation of apology laws—as well as the goodwill that such admissions typically generate—seem to indicate that saying “I’m sorry” to patients may come with minimal legal risk.
Read Next: I made a medical mistake I'll never forgetEach week in our "Real Talk" series, mental health advocate Kristen Fuller, MD, shares straight talk about situations that affect the mental and emotional health of today's healthcare providers. Each column offers key insights to help you navigate these challenging experiences. We invite you to submit a topic you'd like to see covered.