Fatal Medical Errors – The Taboo

Medical Errors – Leading Cause of Death in the USA

Medical Errors are a lot more common than you think, however they don’t just affect one side, the providers feel just as much if not more for the mistakes that occurred.

It’s not uncommon, medical errors are a leading cause of death in the USA — and unfortunately these medical errors are only one cause to physician burnout, mental stress, mental problems, and everything that starts with “mental”. However, it’s one of the most difficult subjects to discuss and write about because it’s considered “taboo” by many. How can people who are meant to cure others, meant to understand others, and meant to care for others possess mental problems and issues?

In her collection of letters, Dr. Pamela Wible, discusses Physician Suicide. A taboo topic where more than 1 million people a year lose their physicians to suicide. Burnout, stress, burnout, stress. It’s a perpetuating cycle in an society that continues to ask for more without understanding the realistic limits. The prestige of the medical profession has fallen, and anyone that goes into the field because of the “prestige” is in for a difficult career. Sure, there still is prestige and respect in the field, but compared to 100-200 years ago? It’s only a fraction of what it was. Back then, it was an unconditional trust and faith, no matter the outcome. Now, in a society pervaded by unrealistic medical procedures and outcomes from television and media along with the bureaucratic obstacles, medicine is seen as a profession where people want 4 things.

Smarts, Respect, Money, and Women

It’s unfortunate, but burnout and stress are very common, the workload has increased, the time per patient has decreased, and the outcomes are expected to rise. But research has shown that it isn’t the amount of money spent in healthcare, but it is how it is used. It’s not the form of government and the infrastructure supporting the healthcare system, it’s how the money is distributed and how it is emphasized in certain aspects. Despite the US’ outrageous healthcare expenditures, it still ranks as one of the worst developed countries in terms of health care quality indicators. Now back to the original topic, and more of a zoom-in into one of the causes that has increased the healthcare system’s rise in medical costs. Medical errors.

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Medical errors kill more people each year than plane crashes, terrorist attacks, and drug overdoses combined. However the exact numbers and representation is often times difficult to consider because how do you boil it all down to a medical error as opposed to medical negligence? Or even complications of a symptom and disease that might have gone unnoticed but still treated for?

And there’s collateral damage that often goes unnoticed: Every day, our healers quietly live with those they have wounded or even killed. Their ghosts creep into exam rooms, their cries haunt dreams, and seeing new patients can reopen old wounds.

Aside from the “victims”, the providers usually follow up quickly as the “second victims” of the mistake. The providers face similar anguish, turmoil, and emotional trauma in the wake of a serious medical error. A large percentage has experienced depression, lack of empathy, or worst case, the fear of caring and practicing medicine for another fear of making a similar mistake. It’s unfortunate because these mistakes and these feelings are often bottled up: depression, pain, stress, anxiety are all viewed as weaknesses and vulnerabilities, as instability in practicing medicine.

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Medical Errors

 

I know, what right do I have to talk about this? What source? What do I know huh? I’m just an ignorant little college kid writing about things I don’t have experience in, or writing about things I simply don’t understand. And yes, that’s true and this was a very difficult to decision for me to write about… but like these providers that don’t have an outlet, it’s my way of writing about something that genuinely concerns me and piques my interest. I have a physician relative, and although he doesn’t talk about the deaths and unfortunate events that he comes across, whenever he comes home, there is simply a shroud of heavy air around him. He eats silently and then goes into his den to work the night away or just sits and watches TV. It’s not too different from his normal daily routine, but there are distinct differences and I have learned to keep quiet and let him process it. I wish he would talk about it and seek comfort, but this is the best way for him to do it after so many years of experiencing it.

I would hate for this family member to feel isolated and alone, without anyone to contact or even to see comfort in. I know for many, people will write it off as weakness, instability, and insignificant compared to the patients and families, but the struggle is different. “What if I had done this differently?” or “Why didn’t I do this earlier?” or “How do I speak to the family?”. Mistakes and pain are pushed away as these clinicians continue to see patients and perform procedures. They have to move on and regain their confidence, or others could suffer. In many of Atul Gawande’s books, he always talks about the hardships that physicians face: depression and burnout from medical errors, stress, and a multitude of other factors, but as a result, he also stresses the necessity to support providers in cases like this as well as to provide resources for providers to seek help and consolation. Many hospitals, dozens even now nationwide, have begun to setup hotlines for discussion. To set up a safe space, isolation from a judgmental medical environment or even to speak openly. For my relative, I am grateful that he has faith, religion, and close friends to talk with, even if it isn’t to his own family, I appreciate the fact that he still has a support infrastructure around him.

In a study conducted by Albert Wu in the late 1980’s (I know it’s old, but the point is still valid) that after medical errors, it wasn’t if people learned or not from their mistake but the emphasis on how little people knew what to do afterwards. There was and is no course in medical school that teaches and works with the aspiring physicians to think about a patient’s life and death and its after effects. In the study, of the physicians that responded, those that had caused a death had become more secretive although they have paid more attention to details.

  1. Errors are common Source1 14.7% of medical residents admitted to making an error in the past 3 months. And that half of all clinicians are involved in a “serious adverse event” each year.
  2. Many health care providers experience significant emotional and physical stress, anxiety, and difficulties. Source2 says that 81% of the surveyed providers experience some degree of emotional distress.
  3. Providers believe it is an isolated environment. An isolated incident. An isolated occurrence. Many don’t realize or think their co-workers have experienced similar distress. It amplifies the isolation and many feel that those have experienced it, simply moved on just fine.

“Around me, it didn’t seem like people were experiencing what I was experiencing,” Moulton says. “I wondered whether I was unusual or whether this was a common phenomenon.”

It’s a shame but also blessing that I am reading and learning about this now. I’ve learned that many suffer alone and think that their co-workers are just fine. That these devastated providers feel that they are the only ones reacting emotionally to the errors.

Medical Errors

In some places, there have been hotlines set up to ensure providers feel comfortable about speaking  regarding their problems. However, there are some hospitals that have pushed back, arguing that doctors committing harm shouldn’t get these resources and that their pain and suffering is payment for their wrongdoing. Provider grief is now a highly spoken topic in patient safety committees in hospitals and medical healthcare groups. Policies and changes have been enacted for error prevention and to improve best practices for patient safety. But nothing really have been pushed for provider grief counseling. The primary reason is fear of losing their jobs, punitive retaliation from the hospital, or increasing costs in medical liability. It’s unfortunate that only dozens of the 4,000 hospitals have done something like this. The resources to build a hotline is not difficult per say, and the truth is, all that is needed is a place where providers are not just allowed but encouraged to discuss their mistakes. Doing so is a huge leap for a system that routinely demands secrecy. It’s not that providers facing physical and emotional injury that will drive this, but the possible consequences in care towards someone else. 

 

Article by Sir. Lappleton III

I'm a happy-go-lucky college student that started a blog as a way to not only document my education and my experiences, but also to share it with whoever stumbles upon my site! Hopefully I can keep you guys entertained as well as learn about a few things from IT as well as from my time and experiences as I plunge deeper and deeper into healthcare! A couple of my areas of focus is data management, system security (cyber security), as well as information technology policy.