How do you handle fear of mistakes/malpractice?

[InATree]

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There is a part of me that really, really wants to be a doctor.

There is another part of me that is absolutely consumed with guilt if I hit a squirrel with a car, and realizes it would be a million times worse if I ever made a mistake that hurt a patient. And given that I'm human, I'm bound to make mistakes from time to time...

How do doctors live with knowing that their mistakes could (or worse, did!) cause harm/suffering to a patient?

 

[Hsandovaljr]

They buy malpractice insurance

 

[StoicJosher]

I am not going to be a doctor because I could potentially harm one (or more) person. Never mind the hundreds I could potentially help.

 

[Dr. Ducky]

To have the power to significantly help someone, there's going to be risk of harming as well. All you can do is your best, and remember that all doctors are human. Also, malpractice insurance doesn't hurt.....

 

[cincincyreds]

Thats is the wrong attitude. You have to believe you can do everything perfectly no matter how tired you are. You are expected to be perfect and that is it.

 

[pre med 2014]

go into a field like neurosurgery, neurosurgeons do not like to testify against each other making it more difficult to sue a neurosurgeon.

 

[Praefectus]

What a silly attitude. That'd be like saying you don't like going outside because there's a chance it'll hail.

 

[Law2Doc]

go into a field like neurosurgery, neurosurgeons do not like to testify against each other making it more difficult to sue a neurosurgeon.

That's actually not accurate. If you do a search in legal databases you will find plenty of neurosurgery cases, all with expert testimony. There are no medical fields where you can't find an expert if there was actual negligence.

 

[LizzyM]

Read: Healing the Wounds by David Hilfiker. Used copies are available for a couple dollars and you may find it through inter-library loan. I recall an exerpt of that book about dealing with a really horrific error made as a family practioner in rural Minnesota. We've used excerpts as required reading for med students about dealing with medical mistakes.

Another good one is Forgive and Remember by Charles Bosk. It is a sociological exposition of surgical training in an unnamed academic medical center and covers how different types of mistakes made by trainees (residents and fellows) are handled by the attending surgeons.

 

[duress]

What a silly attitude. That'd be like saying you don't like going outside because there's a chance it'll hail.

Except "hail" is a rather awful metaphor for the mistakes you'll inevitably make that kill patients and affect you afterwards, especially since your presence outside makes you responsible for the "hail."

It's a valid concern OP, some people can deal with that potentiality and the guilt thereafter more than others.

 

[45408]

If you do get sued, it's probably not for a time that you actually harmed a patient by missing something.


The bad news is that you're still going to feel awful if you harm a patient, but you probably won't get sued for it.

 

[Aerus]

Malpractice covers the fiscal matters. As for the sub conscience matter, just know you'll definitely help more people than you've harmed. Why deprive the rest of the world of what GOOD you can do because you're scared you might do something bad?

I might not be the best person to answer this, though. I plan on going into Primary Care (Family Practice), so I won't have to really worry about this on a daily basis, like surgeons do.

 

[LizzyM]

Malpractice covers the fiscal matters. As for the sub conscience matter, just know you'll definitely help more people than you've harmed. Why deprive the rest of the world of what GOOD you can do because you're scared you might do something bad?

I might not be the best person to answer this, though. I plan on going into Primary Care (Family Practice), so I won't have to really worry about this on a daily basis, like surgeons do.

Except for failures to diagnose cancer (not having it on your list of possible diagnoses and sending someone for diagnostic tests sooner rather than later) and failures to monitor medication side effects and drug-drug interactions that get people into trouble.

And depending on where you practice, you might do minor surgical and gynecologic procedures that can lead to trouble.

 

[pkwraith]

Better to hit the squirrel than swerve out of control, sideswipe the next car, total your car into a tree, kill the family in the car that you hit, and paralyze yourself.

That small amount of guilt you think is "consuming" is insignificant to real guilt in the hundreds of very real alternatives in which you wish that you had hit the squirrel instead.

Everything is all about perspective. Doctors live with their mistakes, because they know that worse can happen if they hadn't tried, that mistakes are inevitable, and to learn from it.

 

[tantacles]

Except for failures to diagnose cancer (not having it on your list of possible diagnoses and sending someone for diagnostic tests sooner rather than later) and failures to monitor medication side effects and drug-drug interactions that get people into trouble.

And depending on where you practice, you might do minor surgical and gynecologic procedures that can lead to trouble.

Yeah, I was about to say this as well. My PCP lost a malpractice suit for not referring a woman who had breast cancer.

 

[Praefectus]

Except "hail" is a rather awful metaphor for the mistakes you'll inevitably make that kill patients and affect you afterwards, especially since your presence outside makes you responsible for the "hail."

It's a valid concern OP, some people can deal with that potentiality and the guilt thereafter more than others.

The OP shouldn't be paralyzed from action just because he fears he'll kill a patient. That'll just make him a lousy doctor.

 

[Aerus]

Except for failures to diagnose cancer (not having it on your list of possible diagnoses and sending someone for diagnostic tests sooner rather than later) and failures to monitor medication side effects and drug-drug interactions that get people into trouble.

And depending on where you practice, you might do minor surgical and gynecologic procedures that can lead to trouble.

Yeah, I'll need to refer you back to the "ON A DAILY BASIS" part. I'm very well aware that no doctor is exempt from malpractice or surgeries.

 

[Bacchus]

Yeah, I'll need to refer you back to the "ON A DAILY BASIS" part. I'm very well aware that no doctor is exempt from malpractice or surgeries.

I'd have to agree with Lizzy. Every patient you see you'll be doing a basic review of symptoms and a lot of the questions screen for malignancy (not specifically, of course). My PCP does office procedures 2X a week, and if you don't think you're going to monitor side-effects day to day (not on the same patient, of course) you're mistaken.

Surgery, including OB, are high-risk because of the very nature of the practice, but you won't be exempt as a PCP and it's easy to make day to day mistakes.

 

[Law2Doc]

Better to hit the squirrel than swerve out of control, sideswipe the next car, total your car into a tree,...and paralyze yourself...

I had a neighbor to whom the above happened, except it was a rabbit. Nobody in our old neighborhood swerves for any nonhumans anymore. There aren't a lot of pets left on that block.

In medicine you do your best with the info you have available, which is often lacking. Sometimes you aren't right, sometimes more info presents itself later that would have swayed you differently. Sometimes patients simply present their findings uniquely and you miss the boat. but as long as the decisions you made seemed sound to you at the time and you had a rational basis for what you did, you don't second guess yourself, and continue driving on your merry way. No swerving for the rabbit.

 

[BA11]

1: I don't brake for squirrels.

2: Worrying about harming/mis-diagnosing a patient is about as productive as worrying about your parents dying. It's almost certainly going to happen and it's just a part of life (or in the case of medicine, the life you've chosen). It sucks when it happens, but you deal with it and move on. No need to spend the other 99% of your life constantly concerned about it.