Must be 50 ways to say you're sorry

Paul Simon said there were 50 ways to leave your lover, and Grena Porto, RN, MS, ARM, CPHRM, says there are at least that many ways to say you're sorry ... without admitting responsibility.

Porto, a principal with QRS Healthcare Consulting in Hockessin, DE, and former president of the American Society for Healthcare Risk Management (ASHRM) in Chicago, rejects the idea that an apology naturally segues into an admission of guilt. It just has to be phrased correctly.

If you only say "I'm sorry" and leave it at that, then the patient is likely to ask, "Sorry for what?" And in the heat of the moment, a stressed and regretful physician might blurt out something like, "I'm sorry for nicking the artery and causing her to bleed out."

Above all else, don't use words like "my fault" or "my mistake" or "I made an error," she says. "Once you use a word like 'fault' in this scenario, you're behind the eight ball," Porto says. "You may regret that later."

In the immediate aftermath of a bad outcome, the right way to apologize is to say you're sorry for the situation and the effects on the patient, rather than stating as fact what caused that outcome, she says. A full statement of what happened and why might come later after a proper investigation.

These are some possible ways to apologize without admitting fault:

"I'm sorry this happened to you."

"I'm sorry for the suffering this caused you."

"I'm sorry this means you will have to undergo additional treatment."

"I'm sorry this didn't go as well as we hoped."

"I'm sorry this procedure was not a complete success."

"I'm sorry that you developed complications."

"I'm sorry that there was a bleeder during the surgery, and we did everything we could to repair it."