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Apologies in Medicine

Only 2% of patient harm problems get reported accurately.* Apologies are made for only a tiny percentage of that 2%.

Medicine gets a lot of mileage out of the apologies it makes, but they are the equivalent of what it would be like if Exxon planted a palm tree on the bow of every super tanker claiming it was helping global warming.

The biggest problem might be the extent to which medicine believes its own spin.

If you get your information from health care professionals, and from the lucky few who got an apology, you would hear good things about apology programs. You could get the impression that it is another example of health care putting the well-being of everyone else ahead of their own interests in a good faith effort to solve the problems.

They are not that. They are spin covering up a pernicious reality. Only a hanful of injured patients receive an apology. Almost none of the rest even are recognized as patients with injuries, but instead are dismissed as cranks with frivolous grievances. Try getting treatment for injuries when you have been so labeled.

Medicine continually promotes as great strides initiatives that are marginal at best. Patient advocates hear the promotion and report having "heard some very positive stories about medical apologies." We hear positive stories about people winning lotteries too. But just as a lottery winner is a rare exception, so is someone who gets an apology. 93% of injured patients cannot even become a statistic, cannot get any record made of what happened to them, cannot get their injuries treated, often cannot even find out who their caregivers were, and get labeled as problem patients, a label that follows them interfering with routine treatment in the future. Most of the other 7% of injured patients do not fare much better.

We hear good things about apologies because medicine, besides having figured out ways to make apology programs serve its own interests at the expense of patients, spins great public relations out of it. The rest of us need to be wiser than to fall for it.

For further information about how "sorry" can be the opposite of what it seems, see this article on another site that explains the history of medical apology programs and how medicine designs them to subvert the goals one would expect them to have, while still promoting spin that results in even patient advocates reporting that they have heard good things about them.

I'd like there to be more apologies in medicine. Even though they are rare, they can be a good thing in those rare cases, but only if there is some way to check on them to prevent them from becoming yet another bad thing. There needs to be something like Community Patient Agencies and State Patients Boards to keep patients from falling for spin and subversive goals. As long as there is no one to enable patients to be wiser, medicine can get away with murder and the only thing patients will hear is positive things.


*2% rate of accurate reporting
According to a Health & Human Services report, summarized and linked to at this link, 93% of adverse events never get into any record anywhere and the 7% that do are inaccurate 63% of the time leaving only a rate of 2% of accurate reporting. The rest are never acknowledged, let alone apologized for.

Of the 2% of injured patients who are recognized as such, how many receive an apology? Some fraction of 1%? Perhaps .0001%? It is some small number like that. What's .0001% of 2%? Your odds of getting killed in a fatal car crash on the way to the hospital probably are greater than your odds of getting an apology if you are injured by your health care. And when you do receive one, it may thwart your ability to be compensated as you could have been without one.