Apologizing for humiliations in medical practice

Lazare commentary says doctors who apologize heal their colleagues, themselves

By Sandra Gray

UMass Medical School Communications

April 15, 2011
a.lazare 
  Aaron Lazare, MD

Physicians’ ability to apologize to each other and to other members of the care team should be considered a vital skill for clinical excellence, according to Aaron Lazare, MD, an internationally renowned expert on shame, humiliation and apology. In a commentary published in the April 2011 edition ofChest, the journal of the American College of Chest Physicians, Dr. Lazare, professor of psychiatry and chancellor and deanemeritus at UMass Medical School, suggested that doctors who apologize for behavior that offends other care team members can further benefit patients with improved quality of care. 

In “Apologizing for Humiliations in Medical Practice,” Lazare compiled the most comprehensive listing to date of the healing forces of apology, based on empirical data from surveys of 355 subjects that asked what an offended party seeks in an apology, and the magnitude of the importance of each of these desires. With the restoration of dignity in response to humiliation emerging as one of the most important functions of apologies, the Chest paper puts together, perhaps for the first time, the relationship between apology as a way to restore dignity, and restoring dignity as the key to alleviating humiliation. “A humiliated treatment team member is unable to function at optimal capacity,” Lazare explained. “Apology is not only a strategic issue, it is a moral issue—apologizing for any offensive behavior is the right thing to do.”

Co-editor of The Medical Interview, a seminal textbook published in 1994, Lazare is credited with initiating an entirely new sphere of scholarly activity on the subject of shame and humiliation in medical encounters, and the healing process of apology and forgiveness. In 2004, he published On Apology, one of the first full-length books to examine the integral components of effective and sincere apologies. “I love this subject because it is so important,” he said, noting the troubling prevalence of humiliating behavior like bullying in contemporary youth culture.

“The interpersonal skills necessary for offering effective and meaningful apologies can be learned,” Lazare concluded. “Addressing the destructive outcome of humiliations with effective apologies will improve relationships between medical staff and patients as well as among the medical staff itself, resulting in improved morale and enhanced quality of patient care.” 

Learn more at http://chestjournal.chestpubs.org/content/139/4/746.abstract