A report from the AP last week, and reported by the Washington Post, Fox News and others, describes a survey of more than 3,000 doctors in both the US and Canada about their reactions to their own mistakes.
The survey was developed and issued by the Joint Commission (JCAHO), the body that accredits hospitals and other health care facilities. It asked doctors whether they had affected any near misses, minor medical errors, or serious medical errors which may have caused permanent or potentially life threatening harm.
92% admitted they had been involved in errors. And those involved also reported that after they made the errors, they felt increased anxiety about the potential for future mistakes, less confidence in their abilities, they reported sleep problems and a loss of job satisfaction.
Yes, doctors are human, too. No matter what kinds of egos some doctors may have, no matter that we put them on pedestals and expect them to be all-knowing, and regardless of their extensive educations — they are still human.
But the survey conclusions, and the news reports, fail to draw a few conclusions I think are important for sharp patients:
- I appreciate the fact that these doctors were so candid. Among the survey questions, the doctors were asked what kinds of help they were offered for dealing with their mistakes (counseling? further education?) and almost no help was offered. Hospitals, in particular, don’t want doctors to admit or discuss problems because they feel like they are open to lawsuits. I see both sides — but my sense tells me that helping these doctors deal with their mistakes in positive ways would perhaps prevent future problems.
- The number is huge — 92% !! We all make mistakes, granted, but our mistakes don’t usually cause harm to other lives. That’s 92 of every 100 doctors. We know that translates to almost 100,000 deaths per year, too. I don’t know how to do that math, but those numbers are huge.
- I can’t help but think some (not the majority, but some) of these doctors were affected less because they had caused harm to patients and more because they have huge egos. You’ll remember my blog post last week about the word “ego-dystonic” — a doctor who thinks he is omnipotent could be traumatized by making a mistake because he doesn’t think it’s possible for him to make. So their depression and sense of failure could be more self-indulgent than the reports or statistics might indicate. Further — there is a good chance that many of those egos didn’t report any errors; meaning, the other 8% who said they didn’t experience any errors are really just covering them up.
Medical mistakes are a lot like car accidents — everyone thinks they happen only to someone else. But when we learn to drive, we are taught to drive defensively. We are taught about how accidents happen, and we are taught the rules of the road.
No one teaches us defensive patienting. No one teaches us to watch out for the others on our patient road. No one teaches us how to read the signs or signal our intentions. We’re just expected to know these things.
So perhaps the biggest takeaway from this report is that we patients need to internalize is the sheer numbers of doctors who make mistakes. And we patients need to practice defensive treatment seeking.
Because at least 92% of our doctors are making errors and we are the ones paying the price.
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