Customer service vs. CMA (cover my ass) defensive medicine.

Aesthetic MD has commented that saying you're sorry to a patient prevents a large number of problems and can preempt the loss of a patient or possible litigation.

But the majority of doctors have a problem saying 'sorry'.

"Dr. Michael Migliori had the delicate task of telling the woman she needed a third operation. He began with two words that could make a defense attorney's head explode: I'm sorry.

"In this state," Migliori said in a recent interview, "that can be used essentially as an admission of guilt" if a patient files a malpractice suit...

...The surgeon said that he realizes an apology could come back to haunt him but that he considers saying "I'm sorry" essential to preserving the bond of trust between doctor and patient.

Otherwise, "patients think I'm hiding something, I must have done something wrong," he said.

Apology laws vary by state. In Arizona, Connecticut, Idaho, Maine and 11 other states, doctors can safely apologize to or commiserate with patients or their families about an undesirable or unexpected outcome, according to the AMA.

Personally, I think expressing concern and regret for unwanted outcomes is entirely appropriate.