Disclosure of errors in optometric practice in Nigeria

Abstract

Background: Human beings are prone to making mistakes, whether in their personal or professional lives. Errors in health care are not uncommon. However, it is not certain if public and professional expectations of disclosure of these errors are met in everyday practice by practitioners.

Objective: The purpose of this study was to investigate patients’ and optometrists’ attitudes towards disclosure of errors in eye care.

Method: This was a qualitative study conducted in Benin City, Edo State, Nigeria, using focus group discussions (FGDs) and in-depth interviews (IDIs). The study population comprised 24 patients aged 18–42 years, with a mean age (±s.d.) of 38 ± 2.2 years, and 16 eye-care practitioners (ECPs), with a minimum of 5 years’ work experience. The optometrists were aged between 32 and 50 years with a mean age (±s.d.) of 42 ± 2.1 years. Three FGDs were conducted with the adult participants, while 16 IDIs were conducted with ECPs.

Results: All participants agreed that errors do occur in eye care. Poor communication between doctors and patients, patients lying to doctors and negligence on the doctor’s part were some of the reasons given for the occurrence of errors in optometric practice. Most of the practitioners (14) agreed that major errors should be disclosed when they occur. While many of the patients (20) would want detailed information about the error, a few (4) would prefer the doctor to rectify the error rather than explaining it to them. Practitioners reported fear of litigation as a factor that could discourage them from disclosing errors. Eighteen patients reported litigation as a last resort, in the event of an error. Both parties agreed that errors caused emotional distress to them and also added that additional charges incurred should be borne by whichever party was the cause of the error.

Conclusion: Errors are an unfortunate part of clinical practice. However, if patients were truthful and open in communication with their doctors and if doctors practiced within the ambit of ethical principles, the occurrence of serious errors should be few and far between.