Physician management of patients with adverse outcomes

The incidence of iatrogenic complications of medical or surgical care is increasing. Such adverse events may severely strain the patient/physician relationship. The nature of the underlying patient/physician relationship in terms of the style of interaction and the handling of uncertainty and decision making may influence the impact of adverse events on the relationship. Physicians may manage these situations poorly because of perceived threats to their self-image or sense of control, or because of fear of malpractice suits. Patients may consciously or subconsciously blame the physician, fall to express their concerns, or exaggerate their complaints. If possible, continuity of the patient/physician relationship should be maintained through full disclosure of all medical facts, frank and open communication, and a renewed commitment to the therapeutic relationship.