MARCH 2008


Saying sorry can solve a host of problems

New laws make apologizing to patients safe. What you need to know

Apology protection laws across Canada

British Columbia Canada's first Apology Act passed in April 2006 - but only after the law's sponsor found himself forced to apologize to opposition members of the legislature for calling their motion to delay a vote on the bill "sick," "reprehensible" and dishonourable.

Saskatchewan Apology protection was added to the Evidence Amendment Act in May 2007.

Manitoba Dr Jon Gerrard's Apology Act was passed as in November 2007 and came into force last month after a 90-day waiting period.

Yukon Legislation proposed in April 2007 by Liberal MLA Don Inverarity hasn't yet been put to a vote. "I don't think it will see the light of day," he told NRM in a recent interview.

Last month, Manitoba Liberal leader Dr Jon Gerrard was visited by a cancer patient in his office. "There had been some problems that, from the descriptions I've had, would be classed as medical errors," he says.

The patient was a lawyer and "very cognizant of the issues," as Dr Gerrard puts it. But, to his surprise, she hadn't come to complain or ask for help. Instead, she had come to thank him for sponsoring the Apology Act, the new legislation that came into force in Manitoba in early February. "She was suddenly getting 'sorry' and explanations for why the errors happened," he says proudly. "She was very grateful and pleased."

On February 8, Manitoba became the third province to enact apology protection legislation (see the box below for a run-down of other provinces' laws). Physicians now have a guarantee they can say "I'm sorry" without having to worry their apology might later be introduced as evidence of their guilt in court.

American and Australian evidence on doctors' apologies show improved patient satisfaction, a decrease in repeat errors and reduced cost and frequency of malpractice settlements. In many cases, patients and families just wanted an apology, an admission of responsibility if it was appropriate, and a reasonable offer of compensation.

After implementing an apology policy in 2002, University of Michigan hospitals cut their annual legal costs from $3 million to $1 million and saw 50% fewer lawsuits and threats to sue. The Canadian Medical Protective Association (CMPA) says it's too soon to say whether Canadian apology laws have had a similar effect.

So is this an idea that you can use in your practice?

Absolutely, says Doug Wojciezsak, the Illinois-based author of Sorry Works!, an apology strategy book published in January. He got involved in the apology business after his brother died as the result of a medical error in 1998; the family never heard the word sorry from doctors. A disclosure and apology policy, as he calls it, can work for you even if you don't practise in one of the provinces where apology protection legislation has been passed.

"These apology laws are really legal nothings," he claims. "It's been okay all along to say sorry." According to lawyers quoted in Sorry Works!, a well-documented apology is hard for the prosecution to beat. After all, what malpractice lawyer wants to draw attention to the defendant's contrition, honesty and good will? In fact, the CMPA says its advice to doctors doesn't change whether or not their province has apology legislation: if a thorough investigation determines you messed up, you should apologize.

"It's a 180 in thinking," says Mr Wojciezsak. "I tell doctors, 'For god's sake, learn about legal strategy.' They think it's the error that kills them in court, but it's not. It's the cover-up." His advice? Set up a disclosure and apology policy in your practice, clinic or hospital. His book, which is available online at and includes a CME test on apologizing, offers a five-step process for developing a policy of your own.



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