Correspondence: Michael J. Howley Jr, Department of Marketing, Drexel University, 3141 Chestnut St, 503-J Matheson Hall, Philadelphia, PA 19104-2875, USA. E-mail: MikeHowley@drexel.edu

¹is an assistant professor at the LeBow College of Business, Drexel University. He has 20 years of clinical medical experience as a physician assistant, most recently in a multi-specialty surgical practice.

Received 22 August 2009; Revised 22 August 2009; Published online 18 September 2009.

Abstract

Apologizing after a health-care service failure is a surprisingly controversial issue that has received relatively little research attention. Health-care service providers are traditionally reluctant to apologize, worrying that an apology will be seen as an admission of guilt, which will decrease patient satisfaction and increase the risk of malpractice lawsuits. This apology aversion has led to a backlash, with some health-care advocacy groups even arguing that apologies should be mandated. This study explores the dynamics of apology in patients who experienced a service failure. As most health-care providers do not offer an apology in isolation, this study considers how coincident explanations and atonement change the effectiveness of apology. The results of this study generally support the use of apology, but its effectiveness depends on (i) the degree of patient dissatisfaction, (ii) the presence of explanations and atonement, and (iii) the relative balance of explanations and atonement. Explanations and atonement enhance the effectiveness of apologies in creating patient satisfaction, but the atonement should optimally be less than or equal to the intensity of explanations and apology. Overall, the results of this research suggest that apology is a complex and contextual social action and attempts to mandate apology are misguided.