Posts Tagged ‘medical errors’

Doctors would simply hate  this book   because  it tries to  expose them !

I would n’t agree with  the tone and conclusion of  this book . But one should soul search  , why such books are written  in the first place ?

The medical professionals  definitely  need to ponder over this  issue .

I stumbled upon this book  in Amazon book store



How  frequently doctors make blunders  ?   What  is your take ?

Would you like to vote in this poll  ?

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                                                                                 Image courtesey : Jupeter Images

This  is because  . . .

  1. Doctors live in a  false life of pseudo- perfectionism . “I can never err”  attitude .
  2. Ego !  Their  pride at stake !
  3. Accepting a mistake would affect their further client-age
  4. Feels humiliated  among their colleagues and peers
  5. 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 !)

Final message

  • 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 !

Coming soon

  • 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 .

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Doctors are obsessed  with science .  Science is man-made , often , the quality of which is far from perfect (Apart from scientific inaccuracies , personal and commercial conflicts creep in )  .Hence  ,  patients   may not get  the true benefits of genuine science  today . This has a huge moral and economic implications .

The entire life time savings  of  our population , is threatened to be consumed by the vagaries of modern medicine. A recent WHO  report  reveals  , the  major cause for  poverty  is attributable to  the frivolous and  greedy   modern health care delivery system. Many times,  bulk of the nation’s wealth is  being  spent on  prolonging the final   few  months  of     lives(Often unproductive ! )  of their fellow citizens.

The irony is ,  many of these expenditures have questionable benefits.

  • A simple car is prone for fewer errors but it still serves it’s purpose .A hybrid car which switches between hydrogen, petrol and electricity  is obviously vested with numerous unexpected issues.
  • An ordinary  cell phone is easy to operate,  while an Andorid 2.2 phone  is loaded with great  applications  ,  but the  original purpose of a phone  ,  namely communicating with others is often   compromised.
  • Modern medicine  is a monster machine  with  thousands of  visible and invisible switches . The funny thing is most of us do not even know jobs assigned to these switches .Worst of  all , these controls  can self ignite  or put off  on its own . One can imagine . . .  the potential errors  from this monster controlled by a  minuscule master of medicine .

Does your patient aware of all those uncertainties ! Why is it so difficult for us to communicate  the above facts to our patients ? Mankind can benefit ,    if we put across the  following  doctrine to our public domain.

A medical  non  intervention can be as safe  as  an  intervention ,  but one has to accept the occasional complications  arising out of a  non intervention . In this context  it should be  realised  ,  we never hesitate to  accept the   consequence of  a  modern  intervention.

Why and how our  mind is readily accepting even deaths  during an  inappropriate procedure , while we struggle to accept  even a temporary set back  for not doing a needy intervention.

What is the solution ? We need to uncomplicate  medicine . . . simplify them .When doctors intervene with common sense as a weapon  to tackle the  scientific excesses patient is bound to  benefit.

Don’t ask don’t tell  dogma   should be replaced by ‘”Tell  without asking” .Be transparent about the limitation  of science.

Documenting and adhering to protocols is satisfying for upholders of science , but one should realize being unscientific also   can help our patients many times.

When your hospital protocol says check for hypoxia in every patient  with dyspnea ,  mind you it may land your patient to a totally   unwarranted  ventilator assistance for a very transient hypoxia reported your fellow over phone.

Here is an article that reveals ,   how a  few oral words of   advice could help  both financially and academically in critical care.



Final message

William Osler said   ” Lesser is better” in medical  communication  . It may not apply today.

Did Osler  was  referring to  falsehoods in medicine ? , Then ,  probably he  is 100 %  is right . . . for the current times !

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One of the important principles of medicine  is  “Diagnosis should  always precede treatment”

This quote , though appear reasonable , can not be practiced always especially in emergencies,  where we  have to first stabilise the patient   without a  prior diagnosis  .(Like administering IV fluids in hypotension , acetaminophen for fever , etc)

Modern medicine  considers treating a patient without a diagnosis as unscientific.

But,  it is a well recognised fact ,  millions  of decision in everyday medical practice is not based on scientific diagnosis  but on clinical acumen and empirical therapy . There are many  instances  wherein , we are never near the  diagnosis  even after exhaustive investigations. 


                       Ironically , in this era of evidence based medicine , when  we are  unable to  conclude ,  we are forced  to do the most  funniest  thing , namely converting patient’s symptom itself as disease entity and  be happy  in labelling them. Like , Motion sickness ,  poly-arthritis, , chronic fatigue syndrome, adult respiratory distress syndrome ,  pre mature ejaculation, fever of unknown origin  , attention deficit disorder , etc (The list is endless . . .)

               This happens because physicians always feel guilty if they are unable to label a patient with a disease entity.

Is the guilt  justified ?  Not necessarily so !  Symptomatic treatment without  diagnosis  is the most dominant theme even today (Fever, pain etc ).So don’t feel unduly negative* when one is not able to fit a patent’s  symptom into a disease entity  but ensure  he  gets relief from his symptom.

 *Except of course , one has to rule out a serious disorder.

 Comments welcome

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