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Attorney's Advice on When and How to Apologize

Question: One of my patients believes I aggravated a previous injury during a chiropractic adjustment. Should I apologize to the patient?

Answer: There is a growing sense that offering a patient apology is the compassionate thing to do and may even help avoid a malpractice allegation. However, many doctors are unsure whether it’s a good idea. In this video, malpractice defense attorney Victoria Vance shares her perspective.

Victoria explains that apologies should be approached thoughtfully and managed with the following questions in mind.

  1. Why would you want to apologize? Research and evidence show that a properly managed communication and explanation to the patient about an outcome can actually help reinforce the trusting relationship you have with your patient. It will also reduce the risk of potential claims or litigation.
  1. What does the law allow? State rules in most jurisdictions in the U.S. speak to the issue of whether a doctor can apologize to a patient and how to do that properly. Be familiar with the rules about what you can say and how to say it, as they vary by state. Some state rules permit statements of condolence, sympathy, bereavement or support for a patient, and those statements would not come into evidence. Some states, however, will allow statements of fault or admissions of liability to be used against you.
  1. When should you apologize? The time to make a patient apology is when you have credible information that is knowledgeable and well-informed. Saying something too soon, when your information may be incomplete or inaccurate or may need to be retracted, is not helpful. It may actually be viewed suspiciously by your patient.
  1. How should you apologize to the patient? Invite the patient and the patient’s family members to your office when you have time to answer their questions honestly. A big part of that conversation is actually not talking at all—but actively and empathetically listening to hear their concerns. Answer their questions to the best of your ability and sincerely and honestly, but only with information you know is accurate. When the meeting is concluded, document the interaction while you remember what you said and the assurances you provided.

Keep in mind that the patient or family members may wish to videotape or record the conversation. Feel comfortable in saying “yes” to show that you’re confident in what you’re going to say and having the conversation memorialized.

If you're unsure about how to proceed, call the NCMIC Claims Advice Hotline at 800-242-4052. A professional claims representative can talk you through the many issues involved with your specific situation. A claim file will not be opened unless a request for damages has already been put in writing.

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