An apology is more than the words, “I’m sorry,” especially to the person on the receiving end. According to Robert Taibbi, “Apologies are not about right and wrong, an argument about which reality is right, but instead about … taking responsibility for unintentionally (or yes, sometimes intentionally) hurting someone emotionally or physically.”1
If you invest time and effort in creating positive relationships between employers, employees, providers, and patients, apologizing, or taking responsibility, will not end with a negative outcome.
Diminishing value of apologies
Andrea Jucker noted the frequency of apologies has increased six times from 1810 to 2009. Unfortunately, she also noted that with increased frequency, “Taking on responsibility and explanation receded ... it is speculated that the force of apologies has decreased. What used to be sincere requests for exoneration has in many cases turned into token displays of regret.”2
Familiarity is breeding contempt. The hollow use of an apology has become so commonplace that the meaningfulness of a sincere apology can be overlooked. Here’s an example. A person who is chronically late apologizes with the promise to be better, then repeats the behavior. Their apology is hollow and meant nothing, and after the first few times, everyone knows it.
Decreased repercussions and increased reputation
Some would say an apology is a fast track to repercussions, however, the opposite may be true. After all, who would you be angrier with—the offender who diminishes your relationship as well as their part in the situation, or the offender who shows they care and acknowledges their mistakes?
I’d like to share two examples of conflict resolution: one where conflict is met with defensiveness, and another where an appropriate and meaningful apology is given to come to a positive resolution.
Conflict met with defensiveness
After a patient was handed off to me post-procedure (seating a crown), the patient told me he was off to rent a metal detector to help locate his crown. I was obviously confused, and it must have shown on my face. The patient explained that during the procedure to cement his crown, it fell to the back of his throat, and he instinctively swallowed. He maintained that the doctor dropped it down his throat and he had no choice but to swallow. The doctor argued that if the patient had not swallowed, he could have retrieved it.
Their unconventional solution was to rent a metal detector and wait for the patient’s next bowel movement. If the crown was not retrieved, the doctor insisted that the patient would pay the lab fee to have it remade. If the patient passed it, we would clean and cement it. After speaking with his spouse, the patient no longer agreed with the plan. When he called the office to tell us this, I told him I’d spoken with the doctor.
The new plan would not include a charge for remaking the crown, and I even gave him two movie tickets. The patient’s ire deflated, and he thanked me for my intervention. The most important distinction in this case is that the doctor did not value the patient and provider relationship the instant he started debating who was at fault. He recognized there was a problem, but he did not take ownership of the mistake and argued about who was harmed.
He ignored the possible repercussions to the patient, and only grudgingly made reparations. After the final crown was cemented and there were no further issues, the patient and his family left the practice. This seemingly small choice of placing fault on the patient rather than moving toward a mutually positive resolution led to the end of what could have been an exceptional relationship between patient and provider
Conflict met with resolution
Several years after this incident, I was working for a different dentist, and my room was adjacent to the doctor’s room. A patient and I had been joking throughout their appointment and unbeknownst to me, the doctor’s patient had been listening. Apparently, he laughed, and at just the wrong time. As he laughed, the doctor startled and, despite a rubber dam being in place, the patient swallowed the crown.
Both doctor and patient apologized. The doctor was concerned and wanted to have a scan done to verify which way the crown had gone. The doctor explained that it was possible the patient aspirated the crown instead of swallowing it. He then explained the repercussions of aspirating an object. Once the patient understood, he agreed to go to the hospital for a scan.
The doctor paid for the hospital visit, as well as for a new crown. Thankfully, the patient had not aspirated the crown and it passed naturally. In this case the doctor recognized a problem, took ownership, and acknowledged who was hurt by it. The doctor noted what the possible repercussions were, and made reparations by covering the hospital bill and the new crown. Ultimately, the patient and his family raved about our office—I was a fun hygienist, and the doctor was someone who did good work and could be trusted! These two scenarios were handled much differently, and had very different outcomes.
We’ve all had different experiences
I’ve worked in health care for more than 30 years, and I’ve seen countless people make mistakes, but I’ve witnessed only a small number of apologies. Why is this? Because taking responsibility and apologizing would make someone vulnerable to the “victim” and for reparation. The victim could sue them, or report them to the legislative body that’s over that person and/or position. Yes, we live in litigious times, and this has changed the patient/provider relationship, as well as the employee/employer relationship.
However, in my opinion, some of the best clinicians and business leaders today have found a way not to lose the personal relationships with the people they work with. It appears research supports my opinion. According to Sam Tonkin, “Researchers discovered that people experience less anger, contempt, and disgust when it’s their family or friends who have committed transgressions. This is because they believe them to be more moral and want to punish them less than strangers.”3
There will always be risks in providing care to the public. To mitigate these risks, clinicians should pursue continuing education, use the best techniques and materials possible, communicate thoroughly and clearly, behave ethically, and keep detailed records, as well as liability insurance.
Most importantly, however, is to create long-term, quality relationships. Friendly people can forgive a mistake, while strangers are not as likely to forgive.
Editor's note: This article appeared in the Aug/Sept 2024 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. Taibbi R. The art of the apology. November 11, 2018, Psychology Today. https://www.psychologytoday.com/us/blog/fixing-families/201811/the-art-the-apology
2. Jucker AH. Apologies in the history of English: evidence from the Corpus of Historical American English (COHA). Corpus Pragmatics. 2018;375–398. doi:/10.1007/s41701-018-0038-y
3. Tonkin S. Friends who behave badly are easier to forgive than strangers—but we still feel shame for their sins, study finds. Daily Mail. July 29, 2021. Accessed June 21, 2024. https://www.dailymail.co.uk/sciencetech/article-9839587/Friends-behave-badly-easier-forgive-strangers-study-finds.html
