THE LAST WORD
Five Ways to Respond to a Medical Mistake
You can make things right if you don’t give in to shame, defensiveness and fear.
Fam Pract Manag. 2009 Mar-Apr;16(2):40.
“To err is human,” so the adage goes, but when physicians err, they can be treated very inhumanly by others and by themselves. The emotional impact of a medical error, even when there is no litigation, can be severe, resembling what we witness in patients with post-traumatic stress disorder. Physicians can become emotionally labile, obsess constantly, have difficulty sleeping, lose self-confidence, consider quitting medical practice and experience profound agony. So what helps when you have made a serious medical mistake?
1. Acknowledge your mistake to the patient or family. This is what patients want, and it has the likelihood of decreasing the risk of litigation.1 Beyond this, acknowledgement does something for the physician. Confession, which has been practiced throughout history as part of many religions, is a vital component of learning from our mistakes and beginning the process of healing. The opposite approach, denying or defending our mistakes and our feelings, is destructive not only for the patient but also for ourselves.
2. Discuss the situation with a trusted colleague. Having a “conspiracy of silence” about the mistake out of embarrassment or shame stifles the healing process, whereas talking to a trusted colleague can bring release and perspective. Most physicians can understand because they too have walked this painful mile of medical life. They can listen and give assurance that you are competent and will get back on track.
3. Seek professional advice. If there is litigation or expected litigation, make no assumptions and speak carefully with your attorney. Some physicians do not know the legal system well and assume, often to their detriment, that they can maneuver in this arena based on their intelligence and medical knowledge. Others are overly anxious about anything legal and assume the worst. Knowledge and instruction early on can minimize uncertainty and help you take a reasonable approach.
4. Review your successes and accomplishments in medicine. Recall the significant interventions you have made for patients. Remember the patients who care deeply for you and respect you greatly. The good you have done can be erased in your mind when you commit a mistake. Challenge the thoughts that shame you and combat them with the good you have done and the successes you have had. A single mistake does not negate all the good treatment you have given.
5. Don’t forget basic self-care. Exercise to decrease the agitation and stress. Eat well. Be careful with the use of alcohol. Do healthy things that distract you from what has happened. Allow yourself time each day to think about the incident and address why it happened, but set a boundary or it will invade your life. Find a support group or spiritual home where you know you are accepted. These self-care activities are your lifeline to getting back to normal.
1. Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA. 2003;289:1001–1007.
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