Nowadays, the popular press focuses on medical errors from the perspective of the patient. Pick up any current patient-focused periodical and you’re apt to find a Doctor So-and-so did me wrong article. Many times the patient has a valid gripe.
In his recent TED talk Doctors make mistakes: Can we talk about that?, Canadian physician Brian Goldman offers a viewpoint from the opposite camp: How do clinicians react when confronted with the oft-times detrimental effects of errors in clinical judgement?
We know that Sir William Osler made at least one attempt to address this issue head on when he called his residents to the morgue to witness his error in diagnosis.
“Once in a ward class there was a big colored man whom he demonstrated as showing all the classical symptoms of croupous pneumonia. The man came to autopsy later. He had no pneumonia, but a chest full of fluid. Dr. Osler seemed delighted, sent especially for all those in his ward class, showed them what a mistake he had made, how it might have been avoided and how careful they should be not to repeat it. In 30 years of practice since then…I remember that case.”
Over the course of my career I’ve tried to get at such issues by writing about them. I recall one of my early pieces published in the premier issue of Dermanities, Abdominal Pain. Although revisiting it still leaves me feeling a bit queasy, it offers a lesson that I shall never forget. Or in Doctor Goldman’s words, “Yes, I remember…”
Facing our mistakes is one of the most effective tools that we clinicians have to improve our clinical diagnostic acumen. What a pity that more of us don’t take advantage of it.