“I won’t say I’m sorry if it’s not my fault.” (“And by the way, don’t script me!”)

December 9, 2009

The other day I received a note from someone with a copy of a letter sent to him by a staff member regarding a conversation with a patient who was upset with the care she had received. The note basically read, “I won’t say I’m sorry if I didn’t do anything wrong. And I won’t use tools that have been provided because I don’t want to be scripted.”

I am sure many of you are thinking of some “key words” you would like to use right now! But instead, let’s attempt to help this person see the value of handling a complaint in a value-driven manner. I’ll address his concerns one point at a time:

Point #1: “I won’t say I’m sorry if I’m not at fault.” Saying you are sorry does not have to mean you’re admitting a mistake. It is fine to say, “I am sorry we are not meeting your expectations.” This does not mean that you or anyone else did something wrong.

The Fire Starter Publishing book “I’m Sorry to Hear That…” Real-Life Responses to Patients’ 101 Most Common Complaints About Health Care (by Susan Keane Baker and Leslie Bank) offers numerous examples of ways to say you’re sorry. The main goal is to get patient care back on track.

When I was president of a hospital, I wanted to help the patients and families get to the point in which they followed the treatment plan and worked with the staff, not against them. So when a patient complained, I would say, for example, “I am sorry you are disappointed,” or, “I am sorry we’re not meeting your expectations.” I followed this up with, “What would you like us to do?” Probably 95 percent of the time, it was something that could be done.

Sure, there were times when an issue was not able to be resolved. But most of the time things got back on track. In fact, our litigation all but disappeared—and much of the credit was due to those simple words.

Point #2: “I will not be scripted.” We prefer to use the term “key words” instead of “script.” (It seems healthcare people can be so upset with the word “script” that they miss the outcome.) Whatever you call it, scripting works. The goal is to use words, phrases, actions, tools, and techniques to help the situation and to achieve the best possible outcome.

Parents love scripting: “Say please,” “Say excuse me,” “Say thank you.” Spouses also use key words: “I love you,” “Thank you,” and “Let me get that.”

In healthcare we use scripts—or key words—with patients all the time. “Press this button if you need anything,” “Tell me if this hurts,” and “Let me know if you have questions.”

During each patient visit, physicians use the phrase, “Can I answer any questions?” When I ask them why, they say that it lets patients know they are interested and that there is time to ask questions. It also reduces calls back to the office. I believe that when the reasons why are correctly explained to them—and when they understand there’s a way to do it without admitting error—people don’t have a problem with saying sorry. (Of course, if it is an error, we need to say it is and fix it as best we can.) I also feel most people understand that key words can reduce anxiety, improve compliance with the treatment plan, and offer many positive benefits.

As for the person who inspired this blog post, let’s hope he did not understand the why of saying “I’m sorry” and of using a script. If he said these things out of his own discomfort, let’s hope that once training is provided, he will come to understand the why of de-escalating the situation. Patients, families, physicians, and employees have enough stress in their roles without letting situations that can be calmed down get heated up.

And if after learning the benefits of saying “I’m sorry” and putting powerful key words into practice, the person still can’t get it, he just may not be right for healthcare.


Quint Studer

Quint Studer, CEO

Studer Group




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