Admitting fault can be a difficult endeavour — perhaps Elton John said it best when he sang, “Sorry Seems to Be the Hardest Word.”

For those of us in the dental profession, whose training and practice often entails striving for perfection, errors in patient treatment can cause personal challenges, along with concerns about our professional reputations and, in extreme cases, our liability. Does the act of apologizing for our mistakes and/or professional misgivings help or hinder our relationships with our patients? And what, if any, are the legal repercussions of admitting fault through an apology?

Mistakes are a part of the human experience. It’s important to acknowledge errors — even those we think are small, misconstrued, or, in some cases, wrong. In a Harvard Health Publishing article titled, “The art of a heartfelt apology,” Dr. Ronald Siegel states, “To preserve or re-establish connections with other people, you have to let go of concerns about right and wrong and try instead to understand the other person’s experience.”

Indeed, denying, diminishing, or completely disregarding a patient’s concerns can cause small issues to snowball into something out of your control. In fact, experience tells us that dissatisfied patients are likely to share their story with more people as compared to those who are happy with their treatment. In the age of social media, this can have a big impact on our professional reputation, even in cases where it is unwarranted.

When we are made aware of a patient’s dissatisfaction with the treatment we have provided or mistakes/errors we have been made (which can be real or perceived), our first action is to hear the patient out. It is important to truly listen to their complaint, without interruption and with empathy. Often, simply listening and offering a genuine apology helps the patient feel seen and heard and can resolve the matter at hand.

What entails a genuine apology? To paraphrase the article cited above, Dr. Aaron Lazare, an apology expert, says this includes four elements:

• Acknowledge the offense. It is important to take responsibility for your actions. Avoid using vague or evasive language, or wording your apology in a way that minimizes the offense or is defensive and confrontational. Never use the wording, “I’m sorry, but…”
• Explain what happened. Be mindful to explain how the error may have occurred without excusing it. Focus here on your own actions and not the feelings of the offended patient.
• Express remorse. If you regret the error or feel ashamed or humiliated, let the patient know. The patient will feel more at ease knowing you are on their side.
• Offer to make amends. Your willingness to fix the error will go a long way in establishing a more trusting and open relationship. Be sure to take the time to both ask and listen to the patient in what they think the solution to the problem may be. It could turn out to be an easier fix than you had anticipated.

While apologies are hard enough with those we love and care for, patient apologies may harbour the unwanted layer of admitting legal fault. If we apologize to our patients, are we setting ourselves up for complaints to be raised against us and risking our license? Are we exposing ourselves to legal reprisal from our patients?

The Apology Act, established in Nova Scotia in 2008, should provide professionals with more confidence when offering atonement. The Act states that an apology, “means an expression of sympathy or regret, a statement that one is sorry, or any other words or actions indicating contrition or commiseration, whether or not the words or actions admit or imply an admission of fault in connection with the matter to which the words or actions relate.”

Further, “an apology made by or on behalf of a person in connection with any matter:

• does not constitute an express or implied admission of fault or liability by the person in connection with that matter;
• does not constitute a confirmation of a cause of action or acknowledgment of a claim in relation to that matter for the purpose of the Limitations of Actions Act;
• notwithstanding any wording to the contrary in any contract of insurance or any other enactment or law, does not void, impair, or otherwise affect any insurance coverage that is or, but for the apology, would be available to the person in connection with that matter; and
• may not be taken into account in any determination of fault or liability in connection with that matter.”

In simpler terms, the Department of Health and Wellness states, “a healthcare worker’s apology to a patient or family member cannot be used as evidence in legal proceedings to establish fault or liability. Instead, an apology is a sign of compassion and empathy.”

Mistakes are an integral part of human nature and apologies should be, too. Being able to offer a sincere apology helps foster personal growth and can expand our emotional intelligence, leading to healthier and more productive relationships with not only others, but ourselves, as well.