The first thing to do after a medical error, with Anthony Orsini, D.O.
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Anthony Orsini, D.O., says most physicians were never trained for the conversation that follows a medical error, and how they handle it often decides whether the case ends in court.
Fewer than half of physicians know the exact steps to take when a medical error occurs, according to a survey cited by Anthony Orsini, D.O. That gap, he argues, is where malpractice claims begin.
Orsini, a neonatologist, founder of The Orsini Way and a member of the Medical Economics editorial advisory board, joins Medical Economics Managing Editor Todd Shryock to walk through the mistakes physicians make most often in a disclosure conversation: staying silent, getting defensive instead of transparent, retreating into medical jargon and letting body language contradict every empathetic word in the room.
He explains why speculating about a cause before the review is finished is the worst move a physician can make, what the University of Michigan's shift away from deny-and-defend did to claims and liability costs, and why even a harmless error has to be disclosed.
Don't miss the first episode of Conversations that Matter, with Anthony Orsini, D.O.: https://www.medicaleconomics.com/view/do-you-struggle-with-difficult-patient-conversations-
Music Credits:
Ambient Jazz by AurbanniAudio - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com
Editor's note: Episode timestamps and transcript produced using artificial intelligence (AI) tools.
0:00 – 0:26 | Cold open Orsini on why the most empathetic words in the world fail when a physician's posture contradicts them.
0:26 – 2:00 | Introduction Austin Littrell introduces the episode, the guest and the debut of Orsini's new Medical Economics series.
2:00 – 2:35 | Meet Dr. Anthony Orsini Todd Shryock introduces Orsini and The Orsini Way.
2:35 – 7:27 | The most common disclosure mistakes Failing to disclose at all, getting defensive rather than transparent, retreating into medical jargon and ignoring nonverbal communication. Orsini cites a study finding fewer than half of physicians know the steps to take after an error.
7:27 – 9:59 | Why speculating is the worst thing you can do The brain reads nonverbal cues before words, an angry family is a normal response, and naming a cause before the review is finished routinely turns out to be wrong.
9:59 – 13:33 | What families actually want to hear Orsini says 39 states now have full or partial apology laws, and that in role-play training physicians more often over-claim fault than dodge it. A morphine dosing example shows why errors are almost always a process breakdown.
13:33 – 15:28 | The data behind transparency Orsini walks through the University of Michigan findings on claims, liability costs and time to resolution after the system moved away from deny-and-defend.
15:28 – 18:02 | Can body language be taught? Videotaped role play, the "long sitter" posture, and why a relaxed stance that builds rapport in a routine visit destroys credibility in a disclosure.
18:02 – 18:55 | P2 Management Minute Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.
18:55 – 21:56 | Does every error get disclosed? Yes, Orsini says, and he tells the story of a minor morphine overdose a hospital chose not to report, and what happened when the mother found out anyway.
21:56 – 24:22 | Who should deliver the news Why the physician should lead the disclosure rather than risk management or legal counsel, and how the pre-disclosure meeting should work.
24:22 – 27:11 | Be prepared before it happens Why physicians avoid training for medical errors, what resources exist for practices outside a hospital system, and Orsini's closing message.
27:11 – 27:28 | Closing thoughts and outro