Wherever humans are involved, mistakes are inevitable. For
many fields, this presents fairly minor problems and can be rectified without
physical harm. For the field of medicine, however, the stakes are high and even
the most routine surgeries can turn disastrous. For my final report, I explored
mistakes in the medical field, malpractice and otherwise.
Of course, all measures should be taken to ensure the safety
of every patient. All surgical instruments should be properly sterilized, all
patient samples should be labeled and handled with care, etc., but even the
most careful person makes mistakes. How do these mistakes, and how physicians
are held accountable, affect the doctor to patient relationship?
Physicians these days are heavily reluctant to directly
admit fault. Why is this the case; when a mistake is made (especially those
mistakes in high risk situations) an apology is standard fare, right?
Apparently not. According to a recent physician survey by Medscape, 81% of
physicians reported that they did not feel an apology would make a difference
in whether or not a malpractice suit would be brought against them. This is an
interesting observation, as it indicates many physicians don’t believe an
apology would make them any less likely to be sued. Why is this? In many states,
there are laws protecting physicians who express empathy and are apologetic,
but because of some conflicting wording, an apology CAN be used against them in
court and is a strong weapon for the prosecutor to wield. This fact sheds light
on why doctors are so reluctant to apologize. Instead they use vague,
impersonal language to alert the patient of the situation without implying
direct physician involvement. Instead of saying “I misplaced your biopsy
results, but we’re doing everything we can to locate it now”, they may alter the
speech to something resembling: “The results of your test are being located now
and will likely be located soon”. Language like this serves to diminish a
relationship between doctor and patient that can be so positive and productive.
This is not a case against accountability. Physicians should
absolutely be held to a high standard of care for their patients, because the
effects of malpractice can be devastating. Consider the case of Rhode Island
Hospital, which conducted 3 brain surgeries on the wrong side of the brain, all
in one year. In one of these instances, the doctor and nurse tried to explain
that they were not “trained how to do the pre-surgery checklist”. This is a
silly excuse, obviously shifting the blame to other personnel for their own
mistake. The second brain surgery was performed by an experienced surgeon (over
20 years), who interrupted the nurse performing the verbal checklist, saying it
was unnecessary because he obviously remembered which side of the brain
required surgery. He went on to operate on the wrong side of the brain. The
patient died a few weeks later. This surgeon’s arrogance cost a patient his
life. In the case of the third brain surgery, both the chief resident and nurse
confirmed which side of the brain needed treatment, yet still operated on the
wrong side. These were all examples of malpractice, and each patient paid
heavily for these mistakes.
These cases and many more prove the necessity for accountability.
However, I think it’s important to analyze the effects of this current system
on doctor-patient interactions. Personally, I think that the system works fine for
cut and dry cases, but as we will discuss during the presentation, not all
cases are so cut-and-dry.
Articles consulted:
For this next article, I will ask that you do not open it
before class. I want to maintain the element of surprise when we discuss these
cases of malpractice. Pretty please?
Quiz questions (to be answered during the presentation)
What risk does a physician face if he or she admits fault
after a procedure?
What percentage of doctors believe an apology won’t affect a
malpractice suit being filed against them according to a Medscape survey?
Instead of directly admitting fault, what might a physician
do to explain the situation instead of apologizing?
How many brain surgeries were performed on the wrong side of
the brain in one year at Rhode Island Hospital?
Instead of the pectoral enhancement surgery he expected,
what was the result of the surgery performed on Alexander Baez?
How did Carol Weihrer describe being conscious during the
surgery?
How much money were the parents of Bryan Mejia awarded as a decision
of the court?
Legally, as it was not deemed compensation, what was the
official reason the Meija family was given the money?
3. 81%
ReplyDeleteSo sad, and infuriating, that reasonable concerns for legal liability must shield docs from acknowledging their own and their patients' humanity with a simple expression of humility and contrition. The current "system" is fundamentally inhumane in this respect. Is it fixable?
ReplyDeleteI believe it is very fixable but people will always make it difficult because most see an apology as an indication of guilt. This is not always true as there are many cases where an apology is simply to offer sympathy to a difficult situation. When a family member dies, many offer an apology for your loss, yet it is not their fault that family member died. This is widely accepted as sympathetic yet when a doctor apologizes to a patient out of sympathy for rhe difficulties the patient is undergoing, it is always seen as an admission of guilt when it really is the doctor trying to treat the patient as they want to be treated: as a human, not a disease.
DeleteMalpractice is a serious concern for the modern world. While it can be an accident, the work of the people with evil intent can not be excused. Abuse of the elderly(http://www.nursinghomeabuseguide.org/shocking-elderly-patient-abuse-an-increasing-problem-at-us-nursing-homes/), pregnant women(https://www.upmc.com/patients-visitors/education/pregnancy/abuse-during-pregnancy), and the disabled(https://www.nbcsandiego.com/news/local/Nurse-Abuse-Autistic-Patient-Caregiver-Jamie-Oakley-San-Diego-204270061.html) are despicable.
ReplyDelete