Hospitals and physicians use disclosure-and-resolution programs to disclose adverse events that affected patients and their families, apologize for the events, and offer compensation if necessary, according to Becker’s Hospital Review. Despite recent attention to this approach for medical malpractice, a new study found that patients’ reactions to compensation offers are complex, as some patients believe the offers are merely strategic methods for health staff and institutions to avoid lawsuits.

Researchers conducted an online survey to see how people would react to 16 different scenarios involving medical errors, errors disclosures or apologies, and compensation offers. In an effort to see how patients would react to different compensation packages compared with an explanation and an apology alone, researchers randomly sent one of 16 scenarios to about 3,250 respondents.

The scenarios depicted either diagnostic or surgical errors, disclosure or apology and one of four compensation offers. Compensation offers included no compensation; waiver of medical expenses only; reimbursements for out-of-pocket expenses up to $25,000 and loss of time up to $5,000; and compensation of economic losses as well as pain and suffering.

Results showed that even in scenarios where the patients were offered generous compensation, the majority of respondents were not satisfied. In scenarios where patients were offered generous compensation, almost 60 percent of patients felt like they should have been offered more and viewed the efforts as motivated by self-interest. Eight-one percent of the group that received full compensation and 71 percent of all the respondents believed the primary reason behind the compensation offer was to avoid a malpractice suit. Furthermore, a strong majority of respondents said they would likely change physicians because of the error.

Although many respondents claimed that they would accept the compensation, they also noted that they would seek legal advise. The study authors note how the disclosure-and-resolution approach generates complex responses and how health institutions can improve the method: “Creating a clear separation between disclosure conversations and compensation offers may help avoid perceptions that both disclosures and offers are merely strategic behaviors, rather than ethical acts and gestures of goodwill.”