Lisa M Reisch1, Carolyn D Prouty2, Joann G Elmore3, Thomas H Gallagher1. 1. Department of Medicine, University of Washington, Seattle, WA, USA. 2. The Evergreen State College, Olympia, WA, USA. 3. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: jelmore@mednet.ucla.edu.
Abstract
OBJECTIVE: To gain understanding of breast cancer care providers' attitudes regarding communicating with patients about diagnostic errors, to inform interventions to improve patient- provider discussions. METHODS: Focus groups were held in three U.S. states involving 41 breast cancer care providers from a variety of specialties. Discussions focused on providers' experiences with potential errors in breast cancer diagnosis, communication with patients following three hypothetical diagnostic vignettes, and suggestions for how and why diagnostic errors in breast cancer care should be communicated. Transcripts were qualitatively analyzed. RESULTS: Providers were more willing to inform breast cancer patients of a diagnostic error when they felt it would be helpful, when they felt responsible for the error, when they were less concerned about litigation, and when the patient asked directly. CONCLUSIONS: Breast cancer care providers experience several challenges when considering whether to inform a patient about diagnostic errors. A better understanding of patients' preferences for open communication, combined with customized tools and training, could increase clinicians' comfort with these difficult discussions. PRACTICE IMPLICATIONS: Providers gave suggestions to facilitate discussions about diagnostic errors when these events occur, including themes of education, honesty, and optimism.
OBJECTIVE: To gain understanding of breast cancer care providers' attitudes regarding communicating with patients about diagnostic errors, to inform interventions to improve patient- provider discussions. METHODS: Focus groups were held in three U.S. states involving 41 breast cancer care providers from a variety of specialties. Discussions focused on providers' experiences with potential errors in breast cancer diagnosis, communication with patients following three hypothetical diagnostic vignettes, and suggestions for how and why diagnostic errors in breast cancer care should be communicated. Transcripts were qualitatively analyzed. RESULTS: Providers were more willing to inform breast cancerpatients of a diagnostic error when they felt it would be helpful, when they felt responsible for the error, when they were less concerned about litigation, and when the patient asked directly. CONCLUSIONS:Breast cancer care providers experience several challenges when considering whether to inform a patient about diagnostic errors. A better understanding of patients' preferences for open communication, combined with customized tools and training, could increase clinicians' comfort with these difficult discussions. PRACTICE IMPLICATIONS: Providers gave suggestions to facilitate discussions about diagnostic errors when these events occur, including themes of education, honesty, and optimism.