Physicians may also be naturally concerned about what a patient will do if you admit error. Will they stop seeing you? Will they sue you? “But the majority of the time, patients will understand, and you will be able to reach a consensus on how to make a resolution regarding the consequences,” Dr. Wax said.
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December 2015In fact, Jennifer Lavin, MD, assistant professor in the division of pediatric otolaryngology at the Ann and Robert H. Lurie Children’s Hospital and Northwestern University Feinberg School of Medicine in Chicago, reports that several studies have shown that disclosing adverse events to patients and families has not put physicians at increased risk of litigation. Currently, the nonprofit organizations Sorry Works and Medically Induced Trauma Support Services are working to disseminate this message to providers.
Onward and Upward
How can physicians move forward after making an error?
A recently published paper by Dr. Plews-Ogan and her colleagues, “Wisdom in Medicine: What Helps Physicians after a Medical Error?” offers ways physicians can move through the experience of making a harmful error (Acad Med. [Published online ahead of print September 4, 2015.])
One suggestion, in light of the fact that institutions are struggling to move from an entrenched system of shame and blame to a balanced system of personal and systems accountability, is to start a peer support program at your institution that puts each physician in touch with a trusted colleague who can help her through the process in a safe and healthy learning environment.
Dr. Plews-Ogan advises initiating a regular process of reviewing both adverse events and near misses. “That can accelerate learning and prevention strategies and at the same time create a more open environment for dealing with mistakes,” she said, adding that helping physicians cope positively after a medical error can create a more open and learning-focused environment, and can help doctors to be their best selves.
The bottom line, said Jo Shapiro, MD, chief of the division of otolaryngology and director of the Center for Professionalism and Peer Support at Brigham and Women’s Hospital in Boston, and a co-author of article, is that safe organizations have cultures where people are empowered and not afraid to raise concerns, admit mistakes, and ask questions. “While it’s easy to tell employees to do this, it’s another thing to develop and provide a culture where this is realistic for staff to do,” she said.
Under Dr. Shapiro’s leadership, her institution started the Center for Professionalism and Peer Support with the idea of supporting a culture of trust and respect throughout the hospital. As a graduate medical educator, she had been struck by some things that weren’t taught during medical training programs even though they significantly impacted patient care—such as how to deal with adverse events.