Every physician fears making a medical mistake, yet errors are inevitable, and being responsible for one is often psychologically devastating.
“For every medical error there are two people injured, the patient and the physician,” says Anthony Ottaviani, DO, who has given presentations on preventing medical errors at medical society meetings and to his residents.
Adverse incidents weigh heavily on physicians, who may subsequently suffer from depression and burnout because they internalize responsibility for the error.
“For some people it’s just a career-ending event, not because the state took their medial license, but they just can’t come back and deal with the possibility of it happening again,” says Brad Chappell, DO, who has written about medical errors.
The DO spoke with Drs. Ottaviani and Chappell and consulted medical journals to put together five steps physicians can take to move forward after a medical error. Be sure to check your hospital or institution’s protocol before taking action.
Lean on your peers
Build a strong support network within your medical community in advance, so you’re not dealing with the emotional distress of a medical error on your own.
Find someone who is a good listener, understands the severity of the issue and is able to provide perspective. Someone with a clinical background will better understand the shame, guilt, fear and other emotions of the circumstance, but talking with a friend or relative is also an option.
“These are normal emotions, and it’s not a shameful thing to talk to someone about it,” says Dr. Chappell, emergency department medical director at Harbor UCLA Medical Center. “Often times, you’re not the only person that this has happened to.”
Talking about a medical error with a peer, with consideration of confidentiality and legal ramifications, also has other benefits, notes Dr. Ottaviani, director of the pulmonary critical care fellowship at Largo Medical Center.
“Reviewing an adverse incident in the proper setting can help identify the cause and help prevent a recurrence,” he says.
Talk to your patient
When a medical error happens, letting the patient know objectively what went wrong and the proper recourse is the best course of action, Dr. Ottaviani says.
“Honesty remains the best policy in medicine,” he notes.
For example, if the team putting in an IV accidentally poked a hole in a lung, explain why it’s necessary to now put in a chest tube. From there, the patient might have questions and ask if it was a known complication or if it happened because a medical student performed the procedure without adequate supervision.
When talking with patients about a medical error, Dr. Chappell suggests sharing that the medical team will take it to their quality improvement committee and see what they can do to prevent it from happening again.
Apologizing to the patient after an incident has the potential to decrease the risk of a medical malpractice lawsuit, according to an Orthopedics and Related Research article. Fear of potential litigation is often why physicians don’t apologize after a medical error, but the link between litigation and apology is weak.
See the opportunity for growth
After an error, many physicians desired to become an expert in the processes and procedures related to the mistake. Developing expertise is a way for physicians to move forward and heal, according to Academic Medicine.
Improve patient safety by analyzing the mistake
Blaming an individual for an error doesn’t help anyone get to the bottom of how the mistake happened or prevent similar errors.
“The purpose for identifying medical errors is to prevent them, not shame people,” Dr. Ottaviani says.
Most medical mistakes go unreported. In order to develop safer health care, it’s necessary to analyze errors and understand what went wrong.
Fostering a workplace atmosphere where medical errors are openly discussed will help everyone on the care team learn from mistakes.
Empower your team
No one practicing medicine is infallible. It can be dangerous to get into the mindset that attending or senior physicians don’t make mistakes.
“You’re not the only person who’s made mistakes nor will you be the last, but it’s also important to not brush them off as a non-event,” Dr. Chappell says.
Maybe you witnessed accidental contamination of the sterile field. Speaking up about it helps create an open environment where these concerns are supported.
“Empower every individual to stand up and voice a concern when something is amiss,” Dr. Chappell says. “This can happen to any one of us, so let’s all learn as a group how to prevent mistakes.”
Most medical errors don’t happen because of a single mishap, it’s usually a cascade of events.
“Mistakes happen,” Dr. Chappell says. “Let’s see what contributed to the problem and take an objective step to look at what we can do differently next time.”