To err is human, says the Institute of Medicine. But, as humans, we sometimes find it difficult to admit mistakes.
Explore this issue:December 2015
Nonetheless, it is important to be honest about errors for a number of reasons. “Admitting mistakes is the first and [an] essential step in learning from them,” said Margaret Plews-Ogan, MD, MS, Bernard B. and Anne L. Brodie Teaching Associate Professor of Medicine and director of the Center for Appreciative Practice at the University of Virginia in Charlottesville. “Talking about them openly expands that learning to your colleagues.”
James Stankiewicz, MD, professor in the department of otolaryngology head and neck surgery at Loyola University Stritch School of Medicine in Chicago, is well published on the topic of the importance of admitting errors. “If you can’t admit that there are problems with a technique, instrumentation, or packaging, you’re keeping important information from colleagues that might keep them out of trouble,” he said.
Along those lines, Dr. Plews-Ogan added that acknowledging our human fallibility also helps us to design systems that can protect us from our own, often predictable, imperfections. The bottom line, even though it may sound contradictory, is to view an error in a beneficial way. “Turn it into a positive,” Dr. Stankiewicz said.
Where We’ve Been
Not too long ago, the medical community was mostly closed mouth when something went wrong. “I don’t think people actively covered things up, but they were very loath to talk about them,” said Mark Wax, MD, professor of otolaryngology-head and neck surgery at Oregon Health and Science University School of Medicine in Portland. “Nowadays, it’s become more commonplace to have open discussions about errors. In our department, we discuss all errors and complications. If you admit a mistake and then try to rectify it, it is much better for patient care.”
Looking back, Dr. Plews-Ogan also recalls working in an environment where nobody talked about making mistakes. “We wrongly assumed that perfection was the norm,” she said. “But this is a dangerous and obviously flawed assumption. Instead, we can role model our own awareness of fallibility, be open about acknowledging our mistakes with patients, and be eager to discuss our mistakes with a keen desire to learn and create a safer system going forward.”
Dreading the Consequences
Despite the benefits of being honest about errors, many physicians have well-grounded fears about letting others know they failed. For one, they may fear how they will be perceived by others. “If you admit error to colleagues and partners, they may think less highly of you or be critical,” Dr. Wax said. “Even worse, there might be backlash at the department or hospital level, or referring physicians may stop sending you patients, and you won’t have a practice left.”