Extra brownie points and a shout-out go to Lisa Sanders, MD who shares her story of misdiagnosis of one of her patients in today’s New York Times.
Not that I’m pleased she made an error — not at all. Rather, her very public confession is an indication of her recognition that bringing errors out into the open will help other doctors learn from her mistakes, and will help patients choose the best doctors for them. [contrast this with my previous post about doctors from the Mayo Clinic who want to discuss errors among themselves, but want them to remain private.]
She tells the story of a patient of hers who was rushed to the emergency room with a heart rate and blood pressure that were so low that it was a miracle the man was alive. It turns out his problem was related to problems she had missed while managing a stroke he had suffered previously. She faults herself for missing something that should have been more obvious to her.
Why is this important? Why am I so impressed?
Problems not acknowledged cannot be fixed or changed. Those of us who observe the problems in medicine are so often frustrated by lack of acknowledgement. Whether it is fear of legal action, or an ego that won’t admit a mistake, or just the lack of an environment where admission of guilt is discouraged, it is rare that any health care provider will admit to making a mistake. (And please — you doctors who are willing — don’t write to me telling me I’m wrong. Your colleagues just don’t do it, no matter what you think.)
When mistakes are acknowledged, we know that’s the first step to making sure they won’t happen again. Further, others who respect the doctor who admits an error will also learn from that error. Multiply that admission, then, by the number of patients who will benefit long term, and you can see why it’s so important for healing. And, when errors become public, it later helps us patients choose the doctors who are best for us.
Even doctors benefit because confession is good for the soul.
Thanks, Dr. Sanders, for stepping up. Your patients are lucky to have you for their physician.
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If physicians could acknowledge their errors in a forum that would lead to analysis of why these errors occurred, patient safety could clearly be improved. But I think Dr. Sanders takes assigns too much of the blame on herself, and fails to consider the contributions of the increasingly limited amount of quality time a physician spends with patients during a visit, as well as, (in this case) the patient not confiding in her symptoms that likely would have led to an prostate exam.
However, the reason why Dr. Sanders newsworthy public admission of error is so rare is because most physicians are so constantly practicing with the concern they might be sued whenever a bad outcome occurs. This leads to defensive medicine, which leads to even a greater burden on patients.