It could have been a big deal, but it wasn’t. Our appointment to discuss our options for diagnosing and treating a potential malignancy had been scheduled with the wrong interventional radiologist.

We had each taken time off from work, picked up copies of records and scans from two offices and the hospital, driven an hour to get there, and then were told by the receptionist that we were there on the wrong day and that she would call us later to reschedule the appointment. By the time we got home, we were both very upset. There was a message on our machine asking that we call the radiology office as soon as possible. Wondering what else could go wrong, we called and were put through to the office manager. “I’m terribly sorry for what happened today. It was our fault, not yours, and I’m meeting with the scheduling staff tomorrow to make sure we fix our system so this doesn’t happen again. I can’t undo the lost time and extra effort, but I spoke to Dr. Betkin about it and he told me to figure out a way to work your appointment in at your earliest convenience and he’ll adjust his schedule. Is there a day that works best for you?” We suggested a time and she said “OK, I’ll make sure that works. And again, I’m terribly sorry for the stress and inconvenience our screw-up caused.” Our anger was totally gone, and we felt comfortable and cared for.

It got me thinking about apologies. In general, there seem to be seven necessary components for the ideal apology:

  • Rapid. It should occur as soon as is possible after the offense or problem is discovered. The longer the gap, the less sincere it feels and less impact it has.
  • Remorse. It should always begin (and probably end) with an unqualified expression of remorse. Simpler is better. “I’m terribly sorry.”  “I apologize.” Body language, tone of voice, eye contact (if in person) and other meta-cues are important. No apology works if delivered with a shrug or smirk.
  • Recognition. It should specify concretely and succinctly what the apology is about. “I’m sorry I didn’t follow through after our discussion.” This is the only way the recipient can judge your understanding of what happened.
  • Responsibility. It should clearly convey ownership of the error and the outcome. “It was my fault.” “Our office missed the boat.” There can be no wiggling here. “I’m sorry about the error. My assistant screwed up.” That just doesn’t work. Even worse: “I’m sorry the book arrived damaged. We do our best, but these things happen.” (“These things happen.” is what the recipient can say when accepting the apology.)
  • Repercussions. When appropriate and possible, there should be over recognition of the impact of the error. “The delay must have caused quite a problem for you.” “I feel terrible that our error ruined your evening.”
  • Restitution. An apology without any offer of restitution can seem empty, and it is almost always possible to offer something without claiming it will make things right. “I can’t do anything about the pictures that were lost, but I’d be happy to have you come in for a free session to take some more.”  One way to offer restitution is by committing to action to prevent a recurrence. “We’re sitting down as a staff next week to review this and work on strategies to prevent it from happening in the future.”
  • Repetition. And repetition (sic). The apology should be bookended, closed with a repeat or rephrase of the opening apology. “Again, I’m really sorry. This should simply not have happened.”

What’s notably absent?

  • Any hint that others (especially the injured party) shares the blame. (”I’m sorry you weren’t seen in a timely manner. Your insurance card was out of date.”)
  • Any deflection. (“I’m sorry you were upset by what happened.”)
  • Any minimizing. (“This never happens.” “Mistakes like this are fortunately very rare.” “At least no serious harm was done.”)
  • Proxies. (If I screw up, I should apologize and not delegate it to someone else.)
  • Multi-tasking. (“Now that we’ve covered that, I’d like to offer you the opportunity to...”)

It’s never easy or fun to apologize. It means acknowledging making an error that caused harm. But a good apology, one that is sincere and direct, is the necessary first step to rebuilding trust and maintaining a healthy partnership.


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