Disclosing errors and adverse events in the intensive care unit.

Objective: To review the issue of disclosing errors in care and adverse events that have caused harm to patients in critical care.

Design: Review the scope of the problem, the definitions of errors and adverse events, and the benefits and problems of disclosing errors and adverse events and provide an approach by which to have these difficult discussions.

Setting: Medical center.

Discussing health care costs with patients: an opportunity for empathic communication.

Escalating health care costs are affecting patients across the country. As employers and insurance companies face higher expenses, they may move to a cost-sharing strategy, which potentially increases financial burdens on patients. In this situation, physicians may find themselves serving as both medical and financial advisors for their patients.

Talking about the unthinkable: perinatal/neonatal communication issues and procedures.

Clinician-parent conversations in perinatology and neonatology are demanding. They take place over a period of time and ask much of the clinician. Many parents insist that they want thorough explanations so they can understand the medical information and its impact on them.