3 in 10 doctors fear being blamed or facing legal action after admitting mistakes

Three in 10 doctors are worried about the repercussions of admitting to clinical errors, including facing legal action, a Medical Defence Union (MDU) survey has found.

GP consultation
(Photo: sturti/Getty Images)

Despite this, the survey of 411 doctors – around a quarter of which were GPs – found that 99% of doctors were open and honest with patients when things went wrong with their care.

However, 30% of doctors had concerns about admitting errors, such as being blamed, facing legal action, or a negative patient reaction.

The duty of candour, which was introduced in England in 2014 and Scotland in 2018, requires organisations to be open and honest with patients if they experience harm after an incident.

Just over half of respondents (55%) said that their organisation’s approach to learning from mistakes had improved since the statutory duty of care was introduced – although 16% said that they felt the place where they worked needed to improve on this.

Duty of candour

Half of the doctors said medication errors were the most common incident involving the legal duty of candour, followed by a delayed diagnosis or referral (24%) and a surgical complication (24%).

One doctor responding to the poll said: ‘Honesty is a virtue. People don't want perfection but they want honesty. At the same time increasing complexity of medicine means the likelihood of things going wrong has increased. This creates a problem for the doctor faced with the duty of candour – they can be blamed for a systemic problem.’

Another said: ‘Patients are aware that complications do happen in spite of giving special care. So we should be open and honest. Documentation is equally important.’

MDU head of professional standards and liaison Dr Michael Devlin said: ‘Our survey shows that being open and honest with patients when things go wrong is second nature among medical professionals. This is welcome news, even though recent cases have shown there is still work to do in improving transparency.

‘Apologising meaningfully and explaining fully and promptly what has happened is vital for maintaining trust and respect, which is at the heart of the doctor-patient relationship. 

Open learning culture

‘A significant minority of MDU members still have concerns about admitting errors because they fear being blamed, the risk of litigation or how patients might respond. It’s important to realise that apologising for errors is not an admission of legal liability for what has happened but an acknowledgement that something could have gone better.

He added:  ‘We need to ensure no obstacles get in the way of the move towards a more open and learning culture – regulators and employers need to ensure there is a proportionate response to how they deal with individuals when mistakes are made.’

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