Do Harm Severity and Incident Apparentness Influence Physicians’ Willingness to Disclose Medical Errors and Adverse Events to Patients and Their Families?

Garavalia, Lesley

2021-08

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Title

Do Harm Severity and Incident Apparentness Influence Physicians’ Willingness to Disclose Medical Errors and Adverse Events to Patients and Their Families?

Authors

Garavalia, Lesley

Published Date

2021-08

Type

Thesis or Dissertation

Abstract

This study examines how harm severity and apparentness influence physicians’ willingness to disclose medical errors and adverse events to patients and their families using a cross-sectional, mixed-mode study design. A simple random sample of 1,565 physicians was selected from a list of licensed Minnesota physicians provided by the Minnesota Board of Medical Practice. In total, 341 physicians had only a postal address on file. The remaining 1,224 physicians had both a postal and email address on file, so they were randomly assigned to one of four modes of survey administration: mail-only, mail-web, web-mail, and web-only. Afterwards, all physicians were randomly assigned to receive one of the Disclosure of Medical Errors or Disclosure of Adverse Events Surveys. All data was collected between November of 2017 and February of 2018.The overall response rate was 18% ( n = 292), and there was not a statistically significant difference in the response rate across survey modes. Most respondents were non-Hispanic (98%), white (89%), and male (69%). On average, respondents reported that they are likely to disclose medical errors (x ̅=7.47;sd=1.56) and adverse events ((x ̅=9.04;sd=1.14) to patients and their families. Across all model specifications, the probability of physicians being highly likely to disclose medical errors and adverse events is high, regardless of harm severity and malpractice risk. As apparentness increases so does the probability that physicians will be highly likely to disclose medical errors (not readily apparent: 0.66, somewhat apparent: 0.72, readily apparent: 0.95; p < 0.001) and adverse events (not readily apparent: 0.59, somewhat apparent: 0.67, readily apparent: 0.93; p < 0.001). While physicians reported being likely to disclose medical errors and adverse events, they may not disclose when faced with a situation that warrants disclosure. Future research should examine whether physicians’ actions align with their beliefs as well as whether the information they provide to patients during disclosure conversations is meetings patients’ informational needs.

Keywords

Attitudes of Physicians

Medical Jurisprudence

Description

University of Minnesota Ph.D. dissertation. August 2021. Major: Health Services Research, Policy and Administration. Advisor: Todd Rockwood. 1 computer file (PDF); viii, 262 pages pages.

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Garavalia, Lesley. (2021). Do Harm Severity and Incident Apparentness Influence Physicians’ Willingness to Disclose Medical Errors and Adverse Events to Patients and Their Families?. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/224964.

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