Sorry really can be hard to say. Dr Catherine Wills considers what makes a genuine apology.

I was the victim of a medical error while I was a medical student being treated in my own hospital.

The doctor who became aware of the error – which left me bed-bound for days and scarred for years – offered me a half-hearted expression of regret but would not tell the doctor who had made the mistake, for fear of upsetting them. I was too shocked, too junior, too powerless to object. I knew it was wrong at the time and I still feel cross about it, all these years later.

Hopefully you’ve never been victim of a medical error, but can you think of a time when someone let you down? The hurt, the anger, the loss of trust? And can you remember how it felt when that person offered you a genuine apology in which they recognised what they had done wrong, took ownership and expressed regret and determination not to let it happen again?

If you’ve ever been in that situation, you’ll already understand the power of a genuine apology.

Not an admission of guilt

We all make mistakes in our careers; responding properly to errors is a key professional skill that will help you maintain good, trusting relationships with patients and colleagues. The professional duty of candour requires healthcare professionals to be open and honest when something goes wrong that ‘causes (or has the potential to cause) harm or distress’. This includes offering an explanation and apology that might sound fairly straightforward to do, but can be really challenging in practice.

Our members often call us with worries about what they can say when something has gone wrong. Will saying sorry open them up to a claim for negligence? Make them vulnerable in a GMC investigation? What about recognition of all the other problems that contributed to what happened – for example, the flawed system that made errors almost inevitable? It can feel unfair to be the one who has to say sorry.

Taking ownership of the error and saying sorry will not open you up to criticism – in fact, it’s the opposite.

Saying sorry is not an admission of legal liability in clinical negligence. The GMC guidance makes it clear that doctors are not expected to take personal responsibility for things that aren’t their fault, and the patient has the right to receive an apology from the ‘most appropriate team member’ – which will often be your supervising consultant when you work in a hospital team.

What makes a good apology

Below are a few things to remember about how to offer a genuine apology to patients.

Don’t panic. Be open and honest and never try to cover anything up or amend records.

Get support. It can be hard to recognise that we need help, but it can make all the difference. Reach out to your supervisor or senior colleagues who may have been there before.

Don’t delay. Putting something right shouldn’t have to wait. And an apology is much more powerful when it is made voluntarily, in a timely way.

Take responsibility and be specific. It takes strength to say sorry in a way that takes ownership of the error. For example: ‘I am sorry, I should have looked up the result and made the referral myself’ is much more powerful than a vague and distant apology, such as ‘I am sorry mistakes were made’.

Avoid ifs and buts – or anything else that dilutes your apology. Imagine you’re the one receiving the apology. You’re furious and upset about what happened. Would it make you feel any better if the person apologising said: ‘I am sorry if you feel upset, but I can assure you no lasting harm was done’?

Show empathy. Again, try to put yourself in the position of the person you’re saying sorry to. Empathy can go a long way and shows you understand the impact on the patient – for instance: ‘I am sorry this happened – I know it means it’ll be harder for you to get a referral, which is hugely frustrating.’

Don’t deflect blame or minimise what happened. It can reflect badly on you to describe something as a ‘mistake’ if it was a deliberate act that you know was wrong. And if you’re saying sorry for doing something wrong that you know is commonly done by other people, focus on yourself rather than normalising the behaviour.

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If the worst happens and you find yourself referred to the GMC, it’s worth remembering that decision-makers will be looking at whether your responses have demonstrated genuine insight and apology, and whether you have put things right (in other words, remediated).

So while ‘sorry’ can be a tough word to say, taking ownership of the error and saying sorry will not open you up to criticism – in fact, it’s the opposite.

Despite this, it can still be hard to do, so please contact us for support and guidance whenever something goes wrong – no matter what it is.

This page was correct at publication on 17/01/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.