Thursday, March 27, 2014

Why doctors are reluctant to acknowledge errors



When doctors make a mistake , they find it very hard to acknowledge the error. There are many reasons for this.

Doctors do their best to not to make mistakes , and therefore , just like all of us , when we do make a mistake , the first response is to always try to justify or explain it away by blaming someone else . Common justifications are – It wasn't my fault that a mistake was made – it was made by my nurse or my assistant ! We all need to live with our self-esteems intact , and doctors have egos which need protection, which is why it's hard for them to acknowledge that they are human and can err.

Doctors think of themselves as being in a helping profession and want their patients to get better. When they realize ( often to their horror) that they have committed a mistake which has ended up harming their patient, it becomes hard for them to live with this bitter truth. In order to prevent cognitive dissonance , it’s perfectly natural for them to refuse to accept the truth – and even hide the fact from themselves.

Doctors will often try to cover up errors because they are scared that if they acknowledge that they have goofed, their colleagues will think poorly of them – and their juniors and staff members will no longer respect them.  They are also understandably worried that that if their patients find out that an error was made, they will want to punish them , by taking legal action against them in a court of law .

Also, doctors have been brainwashed by their professional liability insurance companies , hospital management professionals,  risk management companies and lawyers to never confess to having made an error. They are told to clam up and shut up, rather than say sorry or apologise to the patient. This is because lawyers are worried that if doctors are truthful and acknowledge that they have made a mistake, this will be used against them in a court .

Doctors are also scared that  if they tell the patient they made a mistake , the patient will no longer trust them , and this will damage the doctor-patient relationship . This is why the reflex action for most doctors is to cover up mistakes, much like a child does, rather than face up to them , like a mature adult should.

The first response is often one of denial - to hide the mistake , not just from the patient or from the rest of the medical team , but even from themselves . It is hard for all of us to acknowledge the fact that we have made an error - not just for doctors!

All doctors will agree that mistakes are made commonly in medical practice – but all of them will also claim in  the same breath that they have not made any.  This is why you start to wonder – who makes all these mistakes ?

Doctors need to learn to be honest and open - not just with patients , but with themselves also , so that even if a mistake occurs , they can do something constructive about it . Not only will this minimize the harm caused by the error, they can also take action to prevent this mistake from happening again . This is extremely important , not just for the patient and the healthcare system in general , but for the doctor. himself . Trying to cover up mistakes ends up in creating a major burden of guilt and shame , which can get progressively worse as time goes by .

Doctors need to remember that patients can be quite forgiving , and many will accept the fact that honest errors were made . They can forgive their doctor for these – but they will never forgive a doctor for trying to cover these up by lying to them.

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