Admitting someone was harmed from a medical mistake can be particularly daunting to healthcare professionals, often to the point where many care providers put off reporting errors entirely, which creates more barriers to rectifying them, three authors argue in a Scientific American op-ed.
Ingrid Melvaer Paulin, senior behavioral researcher at Durham, N.C.-based Duke University; Clare Marash, writer, producer and project manager for the Medical Professionalism Project; and Rebecca Ortega, director of strategic development for the Center for Interventional Cardiovascular Research and Clinical Trials at New York City-based Icahn School of Medicine, explore how failing to discuss medical errors harms everyone involved in the care process.
Here are five insights from the op-ed.
1. The authors cited Medscape's 2016 Ethics Report, which revealed 7 percent of physicians believe it is acceptable to hide clinical errors that may harm patients, and an additional 14 percent believe it depends on the situation. "When no one talks about making mistakes, it can seem like you're the only one struggling," the authors wrote. "And more importantly, when we aren't talking about our mistakes, we aren't fixing them."
2. The authors also explored reasons physicians may conceal their own mistakes or a colleague's mistakes, including fear of retaliation, losing the respect of peers or superiors, or not having enough time to complete necessary paperwork. "But the problem isn't bad people in healthcare; it's that good people are working in a system where they're not feeling safe to report errors," the authors wrote. "And when there's lack of trust in a system, problems escalate."
3. To address this issue, the authors suggest applying insights from behavioral science to healthcare systems as a way to help curb medical mistakes, boost trust between medical professionals and their institutions, and foster a culture in which physicians feel comfortable disclosing their mistakes.
4. The authors noted several ways to raise trust between physicians and healthcare institutions, such as having regular conversations about medical professionalism, increasing accountability by monitoring and evaluating care providers' behavior, and ensuring that making the right decision and reporting an error does not mean taking the full blame for what happened.
5. "Reporting a mistake should be the start of a conversation where both the physician and the institution review what they could have done better," the authors wrote. "In cases where there's public scrutiny, the institution often gains more trust if they avoid throwing physicians under the bus and take some of the responsibility themselves."