An apology can often go a long way in resolving a complaint or avoiding one in the first place.

Unfortunately things do go wrong in dental care and sometimes patients are dissatisfied, disappointed or upset with the care that they have received. Dental Protection advises members that an apology is not an admission of liability; rather, it is an acknowledgement that something has gone wrong and a way of expressing empathy.

APOLOGISING CAN AVOID AND RESOLVE COMPLAINTS

Contrary to popular belief, apologies tend to prevent formal complaints rather than actually cause them. An apology and an explanation can provide reassurance to a patient and is often all the patient is looking for. When patients are aggrieved, or feel that they have been harmed by treatment,it is important for the professional person to acknowledge those feelings and to express regret for what has happened – irrespective of where any fault might lie. The lack of an apology in these situations is one of the reasons why patients take complaints further. 

Concerns about the consequences of speaking up mean that members of the dental team sometimes hesitate to act when things go wrong. The desire to seem infallible,coupled with a fear of recrimination, can stifle an open approach to errors. As a result, a natural apology and explanation to patients can be lost. However, an apology can reassure your patient that you understand their situation.

WHEN SHOULD AN APOLOGY TYPICALLY BE OFFERED?

An apology should be offered as soon as it becomes apparent that an adverse incident has occurred (regardless of fault) or if the patient is unhappy with their care or some aspect of their account. It is important that patients receive a meaningful and timely apology. It may be some time before all the facts are understood, including perhaps the reasons why and how the events occurred. However, this consideration should not delay a prompt apology.

The culture within a clinical setting should allow dentists the freedom to apologise. It is ethically and professionally the right thing to do – irrespective of the cause.

WHAT IS AN ‘APPROPRIATE’ APOLOGY?

An apology is appropriate when a patient has suffered harm from their dental care or experienced disappointment. It should be tailored to the situation to reflect the patient’s perception of the issue.

For example, ‘I am sorry this happened to you’is an expression of empathy, rather than, ‘I am sorry I caused this to happen to you and it’s my fault...’

Providing context can ensure all parties understand the purpose of the apology. Ownership should also be taken by a senior clinician. Fundamentally, an apology should be offered willingly, and not perceived to have been given reluctantly.

WIDER BENEFITS

Dental Protection would always advocate a full and objective review of an adverse event,with the patient being informed about any resulting learning points. A commitment should be made to understand and learn from what has happened in a blame-free manner,to reduce the likelihood of it reoccurring and happening to someone else. Most importantly the patient will understand what happened,receive an apology and get recognition of the distress they feel.

The Dental Protection workshop ‘Mastering Adverse Outcomes’ gives you the tools to successfully communicate with your patients should they experience an adverse outcome during their care. Find out more at dentalprotection.org.

Hong Kong was the first region in Asia to enact apology legislation when the Apology Bill was passed into law by the Legislative Council in July 2018.

HOW HAS THE LAW CHANGED?

This new legislation seeks to encourage the making of apologies, with a view to preventing the escalation of disputes and facilitating their amicable resolution. It marks a departure from previous legislation, where officials and individuals were often reluctant to deliver a prompt apology for fear of possible legal liabilities.

Under the law, an apology or expression of regret or sympathy (oral, written or by conduct) will not be admissible as evidence to determine fault or liability in civil and other non-criminal proceedings, subject to certain exemptions.

WHEN DOES THE APOLOGY LEGISLATION APPLY?

The apology legislation will apply to an apology made on or after the start date of the legislation, regardless of whether the matter or the applicable proceeding began before, on or after that date. The applicable proceedings include: judicial, arbitral, administrative,disciplinary and regulatory proceedings.

The apology legislation does not apply to:

• an apology made in a document filed or submitted in applicable proceedings• an apology made in a testimony, submission or similar oral statement given at a hearing of applicable proceedings
• an apology adduced as evidence inapplicable proceedings by, or with the consent of, the person who made it.

To see a copy of the legislation, visit goo.gl/CDcx6P