#on/apology | #on/risk | #ACRMPain | #note/idea *How to be sorry for what happened without taking responsibility for parts that you aren't responsible for.* This reminds me of [[Listening to Understand]], ensuring that you are understanding so you can be [[Making Meaning]] with the patient. You can understand what happened from their experience. It's kind of like [[We see the world in stories]], ensuring you hear their story is the best way to align with them. [[truth seeking to allow emergent properties]] of the conversation. Don't be fixed with solving for an outcome, only seek to understand the experience. This is a process involving: - [[preparing the way]]: getting yourself ready for the conversation by choosing a successful location, a positioning, managing your [[Safety]], ensuring you have the time and space for the difficult conversation to be protected. - [[listening is a conversational procedure]] - hear what they understand - apologize for their experience "I'm so sorry for what you are going through" - don't assign blame - don't tell them you know facts yet - endorse a thorough investigation - ensure you will stay with the patient as their provider if they are willing to keep you - Offer a second opinion, acknowledge a possible lost of trust - Focus on the immediate patient care plan - follow-up - get the help you need for yourself - keep the patient informed of the investigation, or hand that off directly - document facts in the chart why does it matter? Medical errors have significant [[second order effects]], with the care givers being impacted by the error In 2012, Massachusetts adopted its version of a medical malpractice apology law. It makes apologies concerning medical "unexpected outcomes" inadmissible at a malpractice trial. However, the law does include a caveat. During the civil litigation if either the doctor or the defense expert witness is questioned under oath makes a contradictory or inconsistent statement about "the facts or opinions" of the mistake or error, then the previously made apology is admissible. This essentially means that the law says if a doctor apologized to the family for an error made on the operating table, if that doctor later says no error occurred, then the apology is admissible to show liability.   [I'm Sorry, but Massachusetts Has Two Apology Laws?!](https://dedicatedlawyer.blogspot.com/2019/03/im-sorry-but-massachusetts-has-two.html) [Several States Protect Physicians Who Apologize, But Be Careful](https://www.acepnow.com/article/several-states-protect-physicians-who-apologize-but-be-careful/?singlepage=1&theme=print-friendly) ## Sources Several States Protect Physicians Who Apologize, But Be Careful. (n.d.). _ACEP Now_. Retrieved October 31, 2022, from [https://www.acepnow.com/article/several-states-protect-physicians-who-apologize-but-be-careful/](https://www.acepnow.com/article/several-states-protect-physicians-who-apologize-but-be-careful/) Esq, S. P. M. (2019, March 10). The Dedicated Lawyer: I’m Sorry, but Massachusetts Has Two Apology Laws?! _The Dedicated Lawyer_. Retrieved October 31, 2022, from [https://dedicatedlawyer.blogspot.com/2019/03/im-sorry-but-massachusetts-has-two.html](https://dedicatedlawyer.blogspot.com/2019/03/im-sorry-but-massachusetts-has-two.html)