What happens when you make a medical mistake? This guide is about what to do next, how to prevent further errors, and how to heal.
Dr. Colin West tells us, “You can’t go through training without making an error unless you are not taking care of patients. And if you are really invested in the care of patients, there’s a personal cost when things don’t go well.”
When there's a medical mistake or oversight of some kind, you’ll likely experience immense guilt, inadequacy, anguish, and shame. You may fear for your reputation, job, license, or future. Many doctors also then have excessive caution when treating other patients. They are at increased risk for drug and alcohol use disorders, depression, and even suicide.
Some doctors choose to leave the profession altogether after a medical mistake.
It's not a pretty picture, right?
Many factors contribute to medical error, including having an excessive and demanding workload, lots of interruptions and distractions, inadequate clinical support, burnout, depression, and sleep deprivation. On average, doctors working 30 hours straight make about 36% more medical errors than those working less than 16 hours. Our brains and bodies don’t work well without sleep, and we are more likely to make errors in coordination and decision-making.
So why don’t we talk more about medical mistakes? I think it’s the shame. When something we’re ashamed of happens, we want to move past it as quickly as possible. But sometimes, that means we don’t heal.
Shame dissipates when we share in safe spaces with people we trust, and the support we receive from others often predicts our healing.
If and when a medical mistake happens, then what?
Here’s a four-step approach (from the medical literature) that can help:
1. First, take responsibility for what happened.
2. Allow for feelings of remorse, shame, even anguish. Know that these are normal.
3. Act sincerely to make amends and repair damage. If in training, disclosure to the supervising attending should happen first, then to the patient in the right setting and timing (along with a sincere apology). Assess if there is a way to repair damage, and if so, take those steps. Consider reviewing the incident with a trusted colleague or team to identify contributing factors and develop strategies for preventing it from happening again.
4. Release negative emotions to allow for healing. This is not forgetting but stopping self-punishment, embracing self-compassion, and finding a way forward. This may take years.
Things that can help in this process include journaling, therapy, and support from colleagues.
When possible, support your friends and peers facing a medical error by being a listening ear and willing to share your own stories. Normalize these conversations to help release shame.
We should also strive to reduce the risk factors that contribute to burnout. This means, at the national and institutional level, prioritizing reasonable workloads, adequate support, and sufficient rest for all clinicians, including those in training and practice.
Seek and secure mental health support proactively BEFORE emergency strikes. Like having a structure and habit in place to protect your physical health, do the same for your mental health. Don’t wait to find a therapist. Do it now.
Here are some resources that can help:
• Physician Support Line (free & confidential): 1 (888) 409-0141
• Mental health services at your institution—confidential & free
• Heretomorrow.org: No-wait, no-cost mental health support for those with suicidal ideation
• Suicide Hotline: 988
• Psychologytoday.com: Free website to identify local & telehealth therapists
When a medical mistake happens, expect a rollercoaster of negative emotions. Shame. Anguish. Fear. Know that it will take time to heal. And know that you aren’t the only person facing this.
Comments