MDNews - Greater Boston

+++++++++++++++++++++++++++++++ + +++ +PHYSICIAN LIFE BALANCE U +++ +++++++++++++++++++++++++++++++ Navigating the Medical Error Muddle By Thomas Crocker DEALING WITH THE CONSEQUENCES OF A MEDICAL ERROR — A VIRTUAL CERTAINTY FOR MANY PHYSICIANS DURING THEIR CAREERS — CAN TAKE A SIGNIFICANT TOLL ON CLINICIANS' HEALTH AND ABILITY TO PRACTICE MEDICINE. THE BEST WAY TO HANDLE SUCH MISTAKES? TAKE OWNERSHIP OF THEM. IN The New England Journal of Medicine published some eye-opening statistics from research funded by the RAND Institute for Civil Justice and the National Institute on Aging: Ninetynine percent of surgeons in many specialties — including cardiothoracic surgery, general surgery, neurosurgery and orthopedic surgery — will face a malpractice claim by age 65. The research also found that more than 75 percent of family practice physicians and pediatricians must navigate the claims process by the same age. "[T]he literature doesn't support the concept that one can go his or her entire career without significant error," says Alan Lembitz, MD, MMM, a board-certified family practice physician in Denver, Colo., and Chief Medical Officer at COPIC, a medical liability insurer based in Denver and Lincoln, Neb. "It is important to realize, however, that errors do not indicate character flaws; physicians don't intend them to happen. So many errors are multifactorial — system-based or human factors-based. Bearing those points in mind, the next realization is much easier: It is always better to be transparent with patients early and often. Disclosure is a process, not an event." Fostering a culture of safety in which physicians and medical staff recognize the inevitability of medical errors and are comfortable reporting close calls is critical, Dr. Lembitz contends. 14 2011, | Greater Boston MD NEWS I MDNEWS.COM "If individuals feel free to report near misses, everyone can learn from them, and the practice might very well avoid significant error in the future," he says. Health Hazards Beyond their potential to damage physicians' reputations and finances, medical errors and their fallout can have well-documented effects on physicians' health, contributing to anxiety, stress, poor sleep, changes in mood and behavior, and depression. The strain of handling malpractice claims can harm physicians' personal relationships; it can even cause them to question their professional competence and desire to continue practicing medicine. "Medical errors often aren't personal, but physicians take them personally," Dr. Lembitz says. "When errors occur, report them early, seek assistance quickly — many institutions are developing 'care for care provider programs' to support physicians facing these situations — and ensure your own feelings and emotions don't overwhelm you to the point that you're unable to care for your patients. The bottom line: Healthcare leaders must develop and institutionalize support for injured families following medical errors, but they must also do the same for physicians and other care providers so they don't experience adverse emotional, financial and physical outcomes following what are all too often common medical errors." I

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