I'm Sorry
Bridging the Gap
Dr. Barnett, who practices hospital medicine part-time along with his major focus in addiction medicine, was formerly the director of the UNM hospitalist team. He explains that one of the primary reasons hospitalists may need to apologize to patients is that the hospitalist and patient have no prior relationship that could serve as a foundation for interpreting each other’s behavior.8
He believes apologizing for the delays and inconveniences that happen in the hospital “can help bridge the relationship gap in hospital medicine. Because what people believe about their primary care physicians is that they know and care about them,” he says. “To minimize their anxiety about you, show them that you do care about them by getting to know them well, and apology is the one of the best ways of doing that.”
When asked to elaborate what he means by “getting to know them well,” Dr. Barnett says, “I might tell someone, ‘I’d like to get to know you better; what can you tell me about yourself that would help bring me up to speed?’” It’s open-ended, he says, and you let the patient choose the topic. “Most people will say something. … It’s empathic inquiry with really good reflective listening; that is probably the simplest way of summarizing what it takes.”
Dr. Barnett suggests this kind of inquiry can mitigate the gaps in relationships that may lead to misunderstandings, edgy situations, and errors that may later call for apology. He recommends asking or saying some of the following to patients:
- What do you know about your illness?
- What do you believe about your illness?
- What are your feelings, values, beliefs, and preferences about/for your treatment?
- What can you tell me about your experiences in the hospital?
For patients who have been ill many times and have had a lot of medical experience, you could ask:
- Could you tell me about your doctors?
- What do you like about doctors?
- What don’t you like about your doctors?
These questions can help you discern who they are as a patient, and it gives patients the opportunity to be candid with you.
“It’s not about finding information that’s embarrassing or critical to your predecessor physicians, but it allows you to not make the same mistakes inadvertently,” says Dr. Barnett, who considers it concrete information. “I want them to have good medical care. I don’t want to make them unhappy. I want to avoid pitfalls. I think the two of us—the patient and I—should avoid pitfalls together.”
Asking the patient in a straightforward way what they want and don’t want gives the patient an opportunity to give the physician advice on how to stay out of trouble with them.
