Responding to serious medical error in general practice-consequences for the GPs involved: analysis of 75 cases from Germany

Objectives. GPs' recollections about their 'most serious errors in treatment' and about the consequences for themselves. Does it make a difference, who (else) contributed to the error, or to its discovery or disclosure? Methods. Anonymous questionnaire study concerning the 'three most serious errors in your career as a GP'. The participating doctors were given an operational definition of 'serious error'. They applied a special recall technique, using patient-induced associations to bring to mind former 'serious errors'. The recall method and the semi-structured 25-item questionnaire used were developed and piloted by the authors. The items were analysed quantitatively and by qualitative content analysis. Setting. General practices in the North Rhine region in Germany: 32 GPs anonymously reported about 75 'most serious errors'. Results. In more than half of the cases analysed, other people contributed considerably to the GPs' serious errors. Most of the errors were discovered and disclosed to the patient by doctors: either by the GPs themselves, or by colleagues. A lot of GPs suffered loss of reputation and loss of patients. However, the number of patients staying with their GP clearly exceeded the number leaving their GP, depending on who else contributed to the error, who discovered it and who disclosed it to the patient. Conclusions. The majority of patients still trusted their GP after a serious error, especially if the GP was not the only one who contributed to the error and if the GP played an active role in the discovery and disclosure or the error.