Menu Close
  • Clinical
    • In the Literature
    • Key Clinical Questions
    • Interpreting Diagnostic Tests
    • Coding Corner
    • Clinical
    • Clinical Guidelines
    • COVID-19
    • POCUS
  • Practice Management
    • Quality
    • Public Policy
    • How We Did It
    • Key Operational Question
    • Technology
    • Practice Management
  • Diversity
  • Career
    • Leadership
    • Education
    • Movers and Shakers
    • Career
    • Learning Portal
    • The Hospital Leader Blog
  • Pediatrics
  • HM Voices
    • Commentary
    • In Your Eyes
    • In Your Words
  • SHM Resources
    • Society of Hospital Medicine
    • Journal of Hospital Medicine
    • SHM Career Center
    • SHM Converge
    • Join SHM
    • Converge Coverage
    • SIG Spotlight
    • Chapter Spotlight
    • #JHM Chat
  • Industry Content
    • Patient Monitoring with Tech
An Official Publication of
  • Clinical
    • In the Literature
    • Key Clinical Questions
    • Interpreting Diagnostic Tests
    • Coding Corner
    • Clinical
    • Clinical Guidelines
    • COVID-19
    • POCUS
  • Practice Management
    • Quality
    • Public Policy
    • How We Did It
    • Key Operational Question
    • Technology
    • Practice Management
  • Diversity
  • Career
    • Leadership
    • Education
    • Movers and Shakers
    • Career
    • Learning Portal
    • The Hospital Leader Blog
  • Pediatrics
  • HM Voices
    • Commentary
    • In Your Eyes
    • In Your Words
  • SHM Resources
    • Society of Hospital Medicine
    • Journal of Hospital Medicine
    • SHM Career Center
    • SHM Converge
    • Join SHM
    • Converge Coverage
    • SIG Spotlight
    • Chapter Spotlight
    • #JHM Chat
  • Industry Content
    • Patient Monitoring with Tech

The Power of “Sorry”

Like many people, we like to sing while secure in the anonymity of our cars. This morning, one of us was wailing along with Elton John as he sang “Sorry Seems to Be the Hardest Word”:

It’s sad, so sad

Why can’t we talk it over

Oh, it seems to me

That sorry seems to be the hardest word.

That verse frames a critical legal question physicians regularly encounter: how to communicate with patients after an unexpected outcome. More precisely, should a physician apologize to a patient who suffers complications because of that physician’s treatment?

Traditionally, after a patient suffered a complication, defense lawyers were reluctant to allow the physician to express apologies or regret. The defense lawyer feared the apology would be treated as an “admission against interest.” In other words, the defense lawyer wanted to prevent a plaintiff’s lawyer from someday arguing that the physician’s apology was an admission of negligence or wrongdoing.

But the lawyer’s strategy fails. The patient wants the physician to apologize for an error. In fact, the patient distrusts a physician who does not admit errors.

‘‘Although a physician may wish to tell a patient when he has made a mistake, lawyers often order doctors to say nothing,’’ wrote University of Florida law professor Jonathan R. Cohen in the Southern California Law Review.1 “The physician’s silence may then trigger the patient’s anger. This alienation may then prompt the patient to sue.”

Apology Statutes

States with apology laws: Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Missouri, Montana, New Hampshire, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, and Wyoming.

These observations are consistent with studies demonstrating that patients are far less to sue when provided with a full explanation and apology.2

Certainly no physician wants to make a statement that a plaintiff’s lawyer will use against him in court. But the same physician rationally wants to take any steps that might prevent the patient from feeling as though he or she needs to consult with a plaintiff’s lawyer. So, what’s a physician to do when caught between the hospital’s lawsuit-fearing attorney and a patient who expects his doctor to communicate with her honestly and forthrightly?

Fortunately, several state legislatures have recognized this tension and passed legislation that encourages physicians to apologize without facing the prospect that a plaintiff’s lawyer will argue that the physician apologized only because he knew he did something wrong. An example best illustrates how such “I’m sorry” statutes work.

Dr. Smith is treating a 22-year-old patient, John Elway, for a fractured fibula. Dr. Smith sees no signs of neurological compromise while the patient is in a cast. After the cast is removed, it appears the patient has lost function in the leg because the cast was too tight. The patient was a star college athlete who was expected to be drafted into the NFL, but now likely won’t be drafted. Dr. Smith tells the patient: “It’s my fault this happened. I’m really sorry that I didn’t pick up on this sooner.”

Does Dr. Smith’s statement come into evidence in court? Does part of it? The answers probably depend upon which state’s apology statute is applied. Massachusetts was one of the first states to pass an apology statute. It reads:

Statements, writings, or benevolent gestures expressing sympathy or a general sense of benevolence relating to the pain, suffering or death of a person involved in an accident and made to the person or to the family of such a person shall be inadmissible as evidence of an admission of liability in a civil action.

  • The Power of “Sorry”

    October 1, 2007

  • Is P4P Paying off?

    October 1, 2007

  • 1

    Group Growth

    October 1, 2007

  • 1

    When Discharge Fails

    October 1, 2007

  • 1

    Stress Ulcer Agents

    October 1, 2007

  • In the Literature

    October 1, 2007

  • 1

    The Life of a Task Force

    October 1, 2007

  • Psychiatric hospitalists diagnose, treat mental illness

    October 1, 2007

  • Flexibility Is Key

    October 1, 2007

  • Hyphenate Hospitalists

    October 1, 2007

1 … 905 906 907 908 909 … 962
  • About The Hospitalist
  • Contact Us
  • The Editors
  • Editorial Board
  • Authors
  • Publishing Opportunities
  • Subscribe
  • Advertise
fa-facebookfa-linkedinfa-instagramfa-youtube-playfa-commentfa-envelopefa-rss
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies.
    ISSN 1553-085X
  • Privacy Policy
  • Terms and Conditions
  • SHM’s DE&I Statement
  • Cookie Preferences