In healthcare, “sorry” may not be enough
When it comes to medical mistakes, apologies matter. But are they always what patients need most?
New AUT research examined this question through five studies involving more than 1200 participants. Conducted in Taiwan, the research asked participants to complete a questionnaire based on real-life medical incidents, including a vaccine administration error and a wrong-site surgical procedure. Rather than assuming apology is the best acknowledgement, we examined how different initial responses from healthcare providers shape patients’ emotional reactions and their willingness to trust again.
On one hand, especially when medical mishaps are serious, an apology effectively signals responsibility and remorse. Failing to apologise can intensify anger towards or deepen mistrust of the clinicians and/or the system in which they work.
If not an apology, then what?
Another option is to express gratitude — for example, thanking patients for their patience, cooperation, or understanding while the issue is addressed. At first glance, this may seem counterintuitive. Why thank someone when a mistake has been made?
We found that the effectiveness of apology and gratitude is not uniform. Their impact depends on the nature of the error — how severe the mistake is, whether it is an isolated incident, and where or with whom the responsibility lies.
Why context matters
Medical errors vary dramatically in severity. A wrong-site surgery carries a very different emotional weight from a minor procedural mistake. Patients’ expectations shift accordingly.
When harm is severe, explicit acknowledgment of responsibility becomes especially important. In lower-severity situations, relational reassurance may carry more weight than repeated expressions of regret.
This suggests that communication after a medical error cannot rely on a single scripted formula. What works in one context may not work in another.
Why this matters in New Zealand
Although our data were collected in Taiwan, the underlying issue is not confined to one health system. New Zealand places strong emphasis on transparency and apology following adverse events. Maintaining public trust is central to the legitimacy of publicly funded healthcare.
The question, then, is not whether apology is important — it clearly is. Rather, it is whether apology alone is always sufficient.
For clinicians and health organisations in New Zealand, this raises practical considerations. Communication training often promotes clear acknowledgment and expressions of regret. Our findings suggest that flexibility may also be valuable. In some circumstances, pairing responsibility with recognition of the patient’s cooperation or understanding may better support emotional repair.
Read the article: Restoring trust: gratitude vs. apology in healthcare service recovery