Specialists Encounter Many Barriers to Disclosing Pre-Referral Errors, Study Says

May 16, 2018 | Strategic Insights for Health System


​When specialists identify errors that occurred earlier at other providers, they struggle with whether to provide disclosure, according to a study in the June 2018 issue of the Annals of Surgery. The authors conducted semi-structured interviews with cancer specialists at two cancer centers to determine their attitudes regarding disclosure of prereferral errors, whether and how they disclose these errors, and the barriers to disclosure. The errors included errors of diagnosis, staging, and treatment resulting in adverse events ranging from decreased quality of life to premature death. The interviews revealed three principal findings: the majority of specialists are skeptical that disclosure provides benefits to patients; disclosure practices varied, but most respondents provided partial or no disclosure unless it was needed to justify further therapy; and there are numerous barriers to full disclosure. The primary reason for the skepticism regarding disclosure was that it created unnecessary anxiety for patients.

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