When a Physician Makes an Error

Emotional intelligence makes you better able to handle stress and more resilient. IF there's anything a physician needs, it's that.

Doctors makes mistakes. They react emotionally when they do.

In what purports to be the first study on this, the Joint Commission Journal on Quality and Patient Safety reported "The Emotional Impact of Medical Errors on Practicing Physicians in the United States and Canada" this month. (See article here: Study Indicates Physicians Experience Stress Following Medical Errors on Yahoo! News )

Of course the pressure in this life-and-death field is tremendous to NEVER make an error. It draws perfectionists and highly competent individuals, and if you are being cared for by a physician you would say -- I should hope so. I was married to a doctor and I know what they go through.

I can miss an appointment with a client. You can make a mistake and send the check to the wrong person. Nancy over there can cut some one's hair too short. Tom can mess up someone's bill. A cop can cuff the wrong person and a college professor can cite the wrong date or theory. All these mistakes can be corrected. But for a doctor -- procedures, diagnostics, treatment -- make a mistake and someone dies. Actually it's usually called "an error."

The errors of omission are just as potentially fatal as the errors of commission. When I worked with a group concerned with medical ethics, there was a case where a patient had been "left in the basement of the hospital" on the way for some test, and expired there.

That sort of responsiblity is understood in the field, but that doesn't make it any easier.

According to the study, 80% of physicians expressed a desire for help after such an incident, but found there were many barriers.

"Counseling needs to be made available to patients and health care professionals so that everyone involved with errors receives the support they need," said Waterman, who led the study.

Notable findings. After a mistake, physicians reported:

• increased anxiety about future errors (61 percent),
  
• loss of confidence (44 percent),


• sleeping difficulties (42 percent),


• reduced job satisfaction (42 percent),


• harm to their reputation (13 percent) following errors

Only 18 percent of physicians surveyed had received education or training in disclosure of errors, and 86 percent expressed interest in such education or training.

While some physicians thought counseling after-the-fact would help, 35% did not think so. 25% were concerned about their malpractice insurance costs going up if they sought counseling, negative peer reactions, lack of time to seek services.

RESILIENCE

Making mistakes and recovering from them is about resilience, an emotional intelligence competency. It means being able to bounce back from adverse events, to recover and continue to move forward. As I say in my EQ and Resilience courses, the good news is you will get lots of practice. That is also the bad news.

Why not emotional intelligence training? I have coached physicians who were also burnt out from listening to other people's problems all day, trying to sort through the approximate language and high-level emotions, having to deny drugs, and having to tell someone a bad diagnosis.

Part of medicine is factual and a science. Part of medicine is emotional and an art and this has largely been ignored in medical training.

Emotional intelligence is a pro-active way of dealing with stress. You know that stress is going to happen, and if you study resilience and emotional intelligence, you can prepare yourself. It's the emotionally intelligent thing to do, because bad things happen to good people, and good people also make mistakes.