This is because . . .
- Doctors live in a false life of pseudo- perfectionism . “I can never err” attitude .
- Ego ! Their pride at stake !
- Accepting a mistake would affect their further client-age
- Feels humiliated among their colleagues and peers
- We are ready to accept our mistakes in public but the society is not yet ready to forgive us . So we hide !
Though all the above contributes for this behavior . It is the response 2 that plays havoc on patient care !
It is a well-known fact millions of medical mistakes happen every year across the globe .Most of them are committed by medical professionals and equal number of them result from untoward effects of drugs, complications of procedures and surgeries.
Apart from these , laboratory errors in reporting and interpreting diagnostic tests happen on hour to hour basis in any hospital . Many of them could have serious implication in patient outcome . Though doctors do periodic auditing the incidence continue to galore and there is very little data to suggest the overall incidence has reduced in any significant fashion .
In many sense doctors do share some similarities with drugs and devices . Like the ubiquitous drugs and devices , diagnostic tests, , doctors too cause side effects by their action or inaction . It is referred to as , undesired response, complications, error in judgement , negligence , ignorance etc ( Read a related article in my site)
Like the famous quote of ( Osler I think )
A drug which causes no side effect will not have the desired effect as well . . . a doctor who has not caused any injury to their patients can never be considered as an accomplished doctor !
Drugs like statin which is supposed to reduce cholesterol in blood misbehaves with liver and can even result in fatality .We accept it .The matter ends with a FDA box warning .
If a ventilator crashes due to a soft ware problem , we accept it . We can boldly admit medical errors if it is a fault of a drug or machine. But , errors by doctors are rarely pardoned ! So it is natural they are swept under the carpet.
When doctors do delicate cardiac surgeries , it takes only a fractional loss of concentration to cut the aorta and that could cause serious after effects .
These can be called as errors, mistakes or negligence in whichever way you like to call it. The problem is , these minor events (Which occur in thousands every day ) are not recorded, logged , or disseminated to our patients . Even medical law makers and judiciary is blinded to most of thing that happen inside the medical institutions.
So , the world will never know the reality .When we want transparency in all walks of life , we should at least fight for a minimum transparency from doctors.(Why cant they conduct the customary internal auditory meeting in the public domain !)
If only doctors admit their mistakes with courage medical profession will get more respect .Living behind veils never liberates . This traditional suppression of facts make the medical professionals high risk for guilt when truths unfolds .There is one Tamil proverb which says A half doctor is the one who has killed at-least 1000 patients . Still , a minuscule of doctors are ready to accept their mistakes .(Especially to their patients and their relatives , though they admit in private !)
- Implementing transparent medical care , right to information , informed consent etc all demand honesty. To be precise . . . extreme honesty ! Ego and honesty are rare companions .
- How many times we blame it on the disease and hide behind the technicalities for our mistakes and errors.
- Can any doctor accept an error that occurs during a surgery or a procedure that causes death and request a pardon from patient’s relatives . I suspect , if there is such a breed among doctors . . . I am sure he will be branded as a lunatic by their colleagues !
- Consequence of doctors not accepting errors !
- Errors in medical data base and literature.
- Imperfect science . Another important aspect of medical error is attributible to the vagaries of science itself. What looks as a perfect modality suddenly becomes , not only obsolete but also dangerous . If a surgeon does a gastro jejenostomy for acid peptic disease today , his license is at risk of being clipped , the same surgery was a privilege few decades ago. This aspect deserves special debate .