Letters to the Editor

Revealing a Medication Error

Am Fam Physician. 2000 Jul 15;62(2):315.

to the editor: The “Curbside Consultation” piece1 about revealing a medication error was good, but I disagree with the author's opinion that the discussion with a patient should simply end with the query, “Do you have any questions for me?”

In 1971, Dr. Fred Rehfeldt, a senior neurosurgeon who taught in our family practice program, gave me some good advice. He told me that if I ever made a significant mistake and as soon as I realized it, I should go straight to the patient (or family), say I had made a mistake and what it had caused, that I would set it right or, if preferred, summon a doctor I trusted to do so, and that I would pay the second doctor's fee and any hospital expenses related to the mistake.

The neurosurgeon said, “Don't go on about how sorry you are; just let them know you made an honest mistake and you'll do whatever you can to make it right. I've done this several times—and I've made some big mistakes—and I've never once had it backfire on me.”

About 10 years later I did that very thing—the only time in my career. I don't remember now what happened clinically. The part I remember was the strongly positive reaction by the patient's family. They not only kept me on the case, but the word went all around the little farm town about what a fine fellow I was. I learned many lessons from that, but the strongest one was the clear and strong feeling of rightness in dealing honestly with the patient's family.

Dr. Rehfeldt, may he rest in peace, was absolutely right.

REFERENCE

1. Brazeau C. Disclosing the truth about a medical error [Curbside Consultation]. Am Fam Physician. 1999;60:1013–14.

in reply: I thank Dr. Daugherty for his reply. His comment about doing all he can “to make it right” brings up the issue of compensation. It is unfortunate that malpractice litigation is often viewed as the only way to compensate a patient for medical mistakes. In a poignant article,1 Dr. David Hilfiker recounts some of his own mistakes and states, “Rather than establish a ‘patient compensation fund’ (similar to worker's compensation), we insist that the doctor be sued . . . judged guilty.”

Another article2 points out that our health care system has unrealistically relied on “individual error-free performance enforced by punishment” and that error prevention can best occur in a culture of “error recognition, accountability, honesty and rapid and fair settlement for injuries.”

Need litigation be the main option? Could recognition of errors and fair compensation for injuries both be accepted as an inherent part of our medical system?

REFERENCES

1. Hilfiker D. Facing our mistakes. N Engl J Med. 1984;310:118–22.

2. Leape LL, Woods DD, Hatlie MJ, Kizer KW, Schroeder SA, Lundberg GD. Promoting patient safety by preventing medical error. JAMA. 1998;280:1444–7.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article