MINNEAPOLIS, October 25, 2007 — An article in the Oct. 25 New England Journal of Medicine says that medical errors don't just affect the health of the patient -- they ruin a physician's relationship with they patient. And sometimes saying "I'm sorry" isn't enough.

Mistakes cause shame and fear in the physician responsible, which makes communication awkward, and sometimes impossible.

It can also lead to litigation.

But that's not always necessary, according to the authors of the article, Tom DelBanco, M.D., a professor of general medicine and primary care at Harvard Medical School and Sigall Bell, M.D., also of Harvard.

Often, doctors who frankly admit their mistake and tell patients how they will safeguard against future errors avoid litigation by doing so, Delbanco told a HealthDay reporter. Such doctors maintain strong, long-lasting bonds with the patient and the patient's family.

In the article, several patients interviewed said ther equivalent of: "We don't expect you to be perfect, everybody makes mistakes. We just want you to be honest when it happens. We can deal with that."

Some malpractice companies teach doctors to be honest and open, Delbanco told the reporter. There is evidence that it may prevent lawsuits.

Medical errors have received attention since the U.S. Institute of Medicine issued its 1999 report, To Err is Human. That report estimated that the deaths of more than 100,000 Americans each year are tied to some form of medical mistake.

Doctors who acknowledge that a mistake has happened, and outline steps to prevent such mistakes going forward, can ease distress for themselves and the patient.

But too often, physicians are uncertain of their communication skills and these frank and healing conversations don't happen.