Is “My Bad” Ever a Good Idea?

The expression “my bad” has evolved from basketball slang to contemporary vernacular for “I’m sorry, my fault.” From Wall Street to the White House to NASA, individuals utter this instant apology to quickly acknowledge their fault without dwelling on it or diverting attention from everyone’s primary focus. If the blunder isn’t too damaging—if it doesn’t have a drastic or long-term affect—then this form of “mea culpa” serves to demonstrate character and can actually help build our trust with the person willing to take responsibility for his or her miscue.

So, is there any place for “my bad” in health care?

For a mistake that harms or seriously inconveniences a patient, the answer is “no.” Those circumstances need to be properly addressed by the individuals involved. That is a skill physicians need to learn and practice. Disclosure and apology is best handled by individuals with training, experience, and a thorough understanding of the proper clinical, regulatory, and legal protocols.

But what about a near miss, a minor misunderstanding, or an inconvenience that doesn’t inflict bodily harm? Could a sincere “my bad” (or a non-slang equivalent) help your long-term relationship with that patient and someday help you avoid an allegation of malpractice?

Perhaps.

Poor communication between providers and patients pervades allegations of malpractice. Analysis of 19,000 malpractice cases in the CRICO Strategies’ Comparative Benchmarking System shows that 24% of claims and suits asserted from 2007–2011 involved specific incidences of inadequate communication between providers and their patients. The attorneys and defendants and jurors who hear malpractice claimants’ accountings of their interactions know that the problem is even more prevalent, and often subtle.

Patients factor their communication experience into the overall quality of their care. Those angered by unfortunate circumstances will latch on to minor slights and seemingly benign exchanges as evidence of a pattern of indifference or incompetence. They will share their recollections with their attorneys and, if possible, a jury. When they prevail, malpractice cases citing poor physician-patient rapport are a hit to one’s reputation and the insurer’s bottom line (average indemnity paid=$390,000).

A legacy of poor communication is not a good starting point for a clinician whose patient experiences an adverse event. On the other hand, a history and reputation of good communication, built from the ground up on even seemingly insignificant exchanges, works in your favor across all interactions with your patients. Will being nice and apologizing for the lack of parking or the chilly air conditioning exempt you ever from being sued? No. But it seems like a good way to build a foundation of trust and rapport that might enable you to diffuse a more difficult situation in the future.

Additional Reading

• Difficult Patient-Physician Relationships and the Risk of Medical Malpractice Litigation
• Communication gaffes: a root cause of malpractice claims
• Good Bedside Manners Make a Difference
• 
  Communication Factors in Malpractice Cases