Disclosure of medical errors: what factors influence how patients respond?

J Gen Intern Med. 2006 Jul;21(7):704-10. doi: 10.1111/j.1525-1497.2006.00465.x.


Background: Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited.

Objective: This study sought to determine whether full disclosure, an existing positive physician-patient relationship, an offer to waive associated costs, and the severity of the clinical outcome influenced patients' responses to medical errors.

Participants: Four hundred and seven health plan members participated in a randomized experiment in which they viewed video depictions of medical error and disclosure.

Design: Subjects were randomly assigned to experimental condition. Conditions varied in type of medication error, level of disclosure, reference to a prior positive physician-patient relationship, an offer to waive costs, and clinical outcome.

Measures: Self-reported likelihood of changing physicians and of seeking legal advice; satisfaction, trust, and emotional response.

Results: Nondisclosure increased the likelihood of changing physicians, and reduced satisfaction and trust in both error conditions. Nondisclosure increased the likelihood of seeking legal advice and was associated with a more negative emotional response in the missed allergy error condition, but did not have a statistically significant impact on seeking legal advice or emotional response in the monitoring error condition. Neither the existence of a positive relationship nor an offer to waive costs had a statistically significant impact.

Conclusions: This study provides evidence that full disclosure is likely to have a positive effect or no effect on how patients respond to medical errors. The clinical outcome also influences patients' responses. The impact of an existing positive physician-patient relationship, or of waiving costs associated with the error remains uncertain.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Health*
  • Health Maintenance Organizations
  • Humans
  • Malpractice / legislation & jurisprudence
  • Massachusetts
  • Medical Errors*
  • Patient Satisfaction*
  • Physician-Patient Relations*
  • Truth Disclosure*
  • Video Recording