Physicians are encouraged to disclose medical errors to patients, which often requires close collaboration between physicians and risk managers. An anonymous national survey of 2,988 health care facility-based risk managers was conducted between November 2004 and March 2005, and results were compared with those of a previous survey (conducted between July 2003 and March 2004) of 1,311 medical physicians in Washington and Missouri. Both surveys included an error disclosure scenario for an obvious and a less obvious error with scripted response options.
More risk managers than physicians were aware that an error-reporting system was present at their hospital (81% versus 39%) and believed that mechanisms to inform physicians about errors in their hospital were adequate (51% versus 17%). More risk managers than physicians strongly agreed that serious errors should be disclosed to patients (70% versus 49%). Across both error scenarios, risk managers were more likely than physicians to definitely recommend that the error be disclosed (76% versus 50%) and to provide full details about how the error would be prevented in the future (62% versus 51%). However, physicians were more likely than risk managers to provide a full apology recognizing the harm caused by the error (39% versus 21%).
Risk managers have more favorable attitudes about disclosing errors to patients compared with physicians but are less supportive of providing a full apology. These differences may create conflicts between risk managers and physicians regarding disclosure. Health care institutions should promote greater collaboration between these two key participants in disclosure conversations.