06/08/2011 08:24 am ET Updated Aug 08, 2011

Why Doctors Should Disclose Their Mistakes

If the staff at a restaurant found out that cleaning fluid had gotten mixed into the food you ate, would you want to know?

If your car caught on fire, would you want to know that it was because your mechanic had left some wires crossed the day before?

If your doctor had caused you some harm, would you want to know about it?

I'd suspect that the answer to all of these questions is "of course." But historically, when doctors have harmed patients in some way, they didn't always volunteer this information. These days, though, in an era of Wikileaks, video surveillance cameras and consumer protections, it's hard for organizations and individuals to keep secrets, even if they want to.

Doctors and hospitals are finding that when they make a mistake, sharing the information with the patient isn't just the right thing and the smart thing -- it can be a money-saving thing. A new story from American Medical News -- published by the American Medical Association -- discusses a report from the insurance broker Lockton that analyzed the financial impact of disclosing medical errors.

The report looked at programs and studies regarding error disclosure that dated back to 1987 -- an era when the prevailing attitude towards handling errors was more "deny and defend," according to the report's author.

One health system that launched a disclosure program saw their annual lawsuits drop from 38.7 to 17 and the average cost per lawsuit decline from $406,000 to $228,000. And as the author points out, the reason for disclosing errors isn't to save money. It's to keep patients safe. I'd say another important reason -- if not the most crucial one -- is because it's simply the right thing to do.

Doctors and patients have a special relationship that requires honesty. We expect patients to expose parts of their body to doctors that they would never show a stranger; to discuss their drug use and sex lives and all manner of other personal information; and to faithfully follow the directions that their doctors prescribe.

But this honesty must go both ways. In return for this openness on the patient's side, why shouldn't the provider be expected to follow the same code?

We've moved away from many of the ways of thinking about the doctor-patient relationship that dominated during the 1980s and before. The public no longer sees doctors as all-mighty, all-knowing and infallible ... and they shouldn't. Doctors are human. They get tired. They make hundreds of decisions every day and not every one can be perfect. Mistakes happen, just like they happen to you in your everyday life. Perhaps an honest acknowledgment of errors, along with an apology, can put the patient in the mindset of understanding and forgiveness rather than litigation.

Opening up lines of communication about patients' health -- both when things are going well and when things have regrettably gone awry -- can only improve doctor-patient communication. Will announcing an error that otherwise would have gone undiscovered cause financial harm to some doctors? Perhaps. Is it still supporting the greater good? Signs point to yes.

As the report's author concludes, "We do know disclosure of medical errors has been
increasingly accepted and expected by caregivers, patients and others with an interest in patient safety, and that almost all agree disclosure is the right thing to do."

And along the way, such openness may help lower costs to the health care system, which is something we should all be concerned about.