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Does honesty erode trust? Discordant public & professional perceptions on transparency of medical errors

Zivan Beer1, Nurit Guttman, PhD2, and Mayer Brezis, MD MPH1. (1) Center for Quality, Safety & Data, Hadassah-Hebrew University Hospital, POB 12000, Box 53, Jerusalem, Israel, 97226777110, brezis@vms.huji.ac.il, (2) Department of Communication, Tel-Aviv University, Tel-Aviv, 69978, Israel

Background: Increasingly there is a demand to report performance data and medical negligence in healthcare. The issue is hotly debated. One argument is it should be avoided because it may erode trust in physicians and their institutions.

Objective: To examine public and physicians’ attitudes toward transparency in healthcare.

Methods: Phone survey of a representative sample of the Israeli public (n=570); 115 face-to-face interview of physicians in 3 major teaching hospitals (2 from Israel, 1 from USA). Respondents were asked about their views regarding the predicted effects of a transparency policy upon public image of hospitals and doctors. Physicians were told about the views of the public.

Findings: The majority of the public indicated that disclosing mistakes and performance data would enhance the image of hospitals that adopt such a policy. By contrast, a majority of physicians predicted that such a disclosure would damage the image of the hospital (p<0.001) (American and Israeli physicians had similar distribution of opinions). Both the public and physicians thought that disclosure of individual mistakes between doctors and patients would enhance the doctor’s image but the public thought that few or none of the doctors in fact disclose errors, whereas both Israeli and American physicians felt disclosure was common (p<0.001).

Conclusions: Public and physicians' views are in discord regarding the extent to which physicians actually disclose mistakes to their patients. The public and physicians also strongly differ in their beliefs regarding the value of the potential contribution of the practice of transparency in health care to trust in physicians and the image of the hospital.

Learning Objectives:

Keywords: Communication, Quality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Research and the Public Interest

The 132nd Annual Meeting (November 6-10, 2004) of APHA