Doctors Make Mistakes: A Commentary On Medical Errors

Background: “When Doctor Make Mistakes” is the essay from Gawande’s book Complications. It is mainly about the mistakes that doctor make.

Atul Gawande in his article “When the Doctor Makes Mistakes” exposes the mystery, uncertainty and fallibility of medicine in true stories that involve real patients. In a society where attorneys protect hospitals and physicians from zealous trials from clients following medical errors, doctors make mistakes is a testimony that Gawande a representative of other doctors speak openly about failures within the medical fields. In this article, Gawande exposes those errors with an intention of showing the entire society and specifically those within the medicine field that when errors are hidden, learning is squelched and those within the system are provided with an opportunity to continue committing the same errors. What you find when you critically analyse Gawande, “When Doctors Make Mistakes essay is how messy and uncertain medicine turns out to be. Throughout the entire article you experience the havoc within the medicine field as the inexperienced doctor misapplies a central line in a patient.

Healthcare workers are not the only ones fearful of exposing medical errors. The medical institutes themselves operate behind a wall of silence. The IOM first recommended a national medical error reporting system in 1999 and despite attempts by then President Clinton, the American Medical Association and the American Hospital Association successfully lobbied against it (Dyess, 2009). As of 2009, only 20 states have a mandatory medical error reporting system and only a fraction of estimated

Blendon, R. DesRoches, C. Brodie, M., Benson, J. Rosen, A., & Schneider, A. (2002). Views of practicing physicians and the public on medical errors. New England Journal of Medicine. 347, 1933-1940.

In this essay “When Doctors Make Mistakes” Atul Gawande (1999) talks about the day when he made a mistake as a doctor. He writes everything that he did step by step to show what he did wrong. He talks about how tried to open her airway and couldn’t so he had attending come help him. He also talks about the patient barely surviving and how the attending had to tell the family that the patient was alive but in a critical condition. He then goes on and talks about other mistakes physicians have made but admits that “all doctors make terrible mistakes” (p.385).

Medical errors in the United States has been an intense topic of interest for politicians, researchers, and the general public alike for a number of years now. Concern about medical errors grew in the US following the release of “To ERR is Human: Building a safer Health System” report issued by the Institute of Medicine (IOM). This apprehension most noticeably started during the Clinton administration; IOM released their groundbreaking report in 1999 during the Clinton administration. Results shed light on the reality of diagnostic errors and raised awareness to the public. The alarm created by IOM catapulted the matter to President Bill Clinton. According to Janet Brooks (2009) (a Canadian journalist who has completed

Disclosing medical errors is considered necessary by patients and practitioners. They are advised to disclose in the form of an apology when necessary and appropriate. When a medical error causes damage to the patient, it seen as not acceptable because a patient goes for treatment in order to get better not to get worse therefore it calls for the situation to be addressed. When a medical error is not disclosed, the fellow peers who have witnessed the error must decide whether they should remain silent and keep the error to themselves or reveal the error to the higher up, although it would be in good faith to report the medical error to a higher up, unless it has caused harm or long-term damage to the patient. (Youngson. p. 69) There are many hospitals that the practitioners keep the errors made to themselves and do not disclose the medical errors to the families of patients or the patients themselves. Medical errors become a topic of conversation if the family of a patient or the patient themselves become aware about the error. Medical errors are something that should be disclosed in a good faith manner

In the United States, state laws dictate the abilities and skills medical professional would need to perform in a medical professional’s scope of practice and sets the legal boundaries in which they can work within. Due to an increasing influx of patient care that is needed due to the Affordable Care Act, the scope of practice boundaries are being crossed, which in turn has turned many legislative heads but not in a positive light. Since the issues in medical errors are being brought to the fore front it has become controversial and now legislature is asking the states to look into restructuring the scope of practices in all areas the medical industry. Without restructuring patient care will continue to be poor or inadequate and litigation will continue to rise due to poor patient care, incorrect testing, ineffective specimen collection, missed diagnosis, and poor supervision and communication. Death related cases due to medical errors are the 5th largest in the United States which makes it the 5th leading cause of death in the United States. Many medical errors are actually billed and paid for by insurance companies and the physician receives payment for the errors. The United States spends billions on litigation per year and therefore restructuring the medical industry could save the United States millions of dollars per year and make for a safer over all environment for everyone.

In the article “Why the American Medical Establishment Cannot Reduce Medical Errors” by Philips Levitt, the main points are the “incompetent” physician are the reasons behind hundreds of thousands of deaths in America and what the hospital can do to prevent the deaths. After I read the article, I was surprised that “…a small number of doctors—about two percent—are responsible for half the cases in which a patient is seriously and unnecessarily harmed in the process of being treated” (Levitt) because I was shocked that about two percent of doctors are liable for half of the case of the harm or deaths of the patient and this is the reason why it cost the people so much for health care. For example, “…$300 billion a year are spent on the waste

The article written by Jerome Groopman, discusses the different mental processes and representations used by doctors when diagnosing patients. Groopman describes three cases where a doctor misdiagnosed a patient by overlooking an important aspect of the patient’s condition. In the case of Dr. Pat Croskerry, originally an experimental psychologist and later a medical doctor, believes that in medical training there should be more focus on the “cognitive dimension” of being a physician. Meaning the decision-making process to which doctors interpret symptoms and test results should be a priority in medical schools in addition to the science and application of medicine. This way to avoid misdiagnosis and then save more lives. In each case, the

In nutshell, unrecording of medical errors leads to various problems not only for the patient and family but also for the organization. Because revealing of errors helps the higher authority to eliminate errors in future and improve patient safety within the organization. At the end, there should be a good policies and guidelines for the health personnel that is important to maximize reporting of errors and near-misses and ensure quality of care (Institute for Healthcare Improvement,

By ensuring patients are fully informed about procedures with risks and benefits, the consequences of minor errors are drastically reduced. Though Baylis (1997) admits that many professionals believe that disclosure of errors leads to loss of confidence in the physician or even medicine in general, this is usually false. According to Matlow, et al. (2006), “the preference for full disclosure is almost universal.” This thought goes hand-in-hand with informed consent. Patients wish to be autonomous, especially regarding their health, and to withhold information diminishes their autonomy and trust in the physician. In addition, to assuage professional opinions, Popp (2003) found that admission of error typically reduced the financial liability of a hospital drastically compared to when no disclosure was present. This honesty also leads to a discussion of causes for the error rather and potential improvements to avoid the same outcome for future cases. Morbidity and Mortality (M&M) conferences at hospitals seek to do the same thing and simultaneously educate many in the field to reduce stigma of equating error with personal flaws (Matlow, et al.,

A practice commonly used in the medical field, “benevolent deception” is the act of physicians suppressing information about diagnoses in hopes of not causing patients emotional turmoil (Skloot 63). Benevolent deception is a contentious subject because when used, the bioethical principles of respect for autonomy and beneficence can conflict with each other. Respect for autonomy is when physicians acknowledge their patients’ abilities to make voluntary decisions on their own regarding their health care (McCormick 4). Meanwhile, beneficence is the duty of doctors to be of a benefit to patients, while also taking measures to prevent and remove harm from them (McCormick 5). When giving patients diagnoses, physicians need to follow these

Physicians have a unique set of moral obligations. The general public sees physicians as experts in their fields. They have gone to school for many years to gain knowledge that the average person does not have. Therefore, the average person naturally has a respect for physicians. Physicians have moral obligations to patients. Patients assume physicians keep current with the latest in the medical field. They are morally obligated to do their best for their patients, be an advocate for their patients and freely share the knowledge that they have. They should order the correct tests, make the correct diagnosis and create the best individualized treatment plan for their patients. They

Baillie, Garrett and Garrett believe that "the suspicion of a few tends to blacken the many." Eventually, patients may keep away from the health care system, due to the lack of trust in the profession (pp. 128-129).