Sorry may be the hardest word to say when things go wrong, but health practitioners need to see making genuine apology as a strength, health law practitioner Dr Marie Bismark says.
As a registered medical practitioner herself, Dr Bismark said she could recognise the absolutely devastating feeling which practitioners had when they made mistakes.
They went to work to help people and felt ashamed when things went wrong and someone was hurt.
However, apologies needed to be genuine or they could escalate the situation.
Sometimes apologies were made in such a way that they could demean patients or make them feel they were being unreasonable, such as: "I'm sorry if you found my manner unacceptable. You are the only patient to complain in 20 years."
Often such apologies were a deflection of responsibility, implying the victim was in the wrong.
Non-apologies could also offer explanations which were dishonest, arrogant, manipulative or an insult to the intelligence of the patient or the family.
Dr Bismark warned against practitioners rushing in to say sorry and that it was all their fault.
Often, in a hospital setting, it might not be all their fault, but a series of events which had led to the harm.
It was important all of those involved with a harmful event made sure they discussed the event and that the families of patients got consistent messages.
It could lead to further mistrust if various members of the medical team gave pieces of conflicting information before the event had been analysed.
While the pseudo-apology could do more harm than good, heartfelt expressions of sympathy and sincere apologies could have profound healing effects for all parties, Dr Bismark said.
Although doctors feared the arrival of a letter from Health and Disability Commissioner Ron Paterson, it was clear from his experience that if "people do the right thing very early on" patients were much more likely to have complaints resolved.
Investigation of events was also a good chance to learn from what happened.
Dr Bismark, who addressed the Royal New Zealand College of General Practitioners conference in Wellington this week, on the power of apology, said some of those most interested in her views on the issue were people who were involved in training medical students and keen to equip the next generation with skills in that area.
She noted that while many health practitioners were still uncomfortable about apologies, she likened it to similar discomfort some years ago about informed consent.
But that had now become accepted as a standard part of the health-care relationship.
• Apology defined
An authentic apology after a medical mishap should:
> Recognise the event that caused harm.
> Express regret and sympathy.
> Acknowledge responsibility once the facts are fully understood.
> Involve effective reparation, which may include measures to protect others from similar harm.
> Opportunity for those involved to meet again after a time of reflection.
-- Dr Marie Bismark, health law practitioner
