When A Physician Makes An Error

Emotional intelligence makes you better able to handle stress and more resilient. If there's anything a physician needs, it's that.

Doctors makes mistakes. They react emotionally when they do.

In what purports to be the first study on this, the Joint Commission Journal on Quality and Patient Safety (http://www.jcrinc.com) reported "The Emotional Impact of Medical Errors on Practicing Physicians in the United States and Canada" this month.

Of course the pressure in this life-and-death field is tremendous to never make an error. Medicine draws perfectionists and highly competent individuals who are hopefully well-trained, and if you are being cared for by a physician you would say -- I should hope so. I was married to a doctor and I know what they go through.

I can miss an appointment with a client. You can make a mistake and send the check to the wrong person. Nancy over there can cut someone's hair too short. Tom can mess up someone's bill. A cop can cuff the wrong guy and a college professor can teach the wrong theory. All these mistakes can be corrected. But for a doctor -- procedures, diagnostics, treatment -- make a mistake and someone dies. Actually it's usually called "an error."

The errors of omission are just as potentially fatal as the errors of commission. When I served on the board of an agency concerned with medical ethics, there was a case where a patient had been left in the basement of the hospital on the way for some test, and expired there.

Ultimate responsibility is understood in the field, but that doesn't make it any easier on the physician.

According to the study, 80% of physicians expressed a desire for help after making a mistake, but found there were many barriers.

"Counseling needs to be made available to patients and health care professionals so that everyone involved with errors receives the support they need," said the lead researcher.

Notable findings. After a mistake, physicians reported:

• increased anxiety about future errors (61 percent)
• loss of confidence (44 percent)
• sleeping difficulties (42 percent)
• reduced job satisfaction (42 percent)
• harm to their reputation (13 percent)

Only 18 percent of physicians surveyed had received education or training in disclosure of errors, and 86 percent expressed interest in such education or training.

While some physicians thought counseling after-the-fact would help, 35% did not think so. 25% were concerned about their malpractice insurance costs going up if they sought counseling, and also mentioned negative peer reactions, lack of time to seek services and other factors.

As reported in yahoo news, the study did not say whether any of the physicians had received, or would like to receive, emotional intelligence training. This is not counseling after the fact, it is preparation beforehand.

RESILIENCE

Making mistakes and recovering from them is about resilience, an emotional intelligence competency. It means being able to bounce back from adverse events, to recover and continue to move forward. As I say in my EQ and Resilience courses, the good news is you will get lots of practice. That is also the bad news. But you have to practice it right. In fact, why not be pro-active. Learn what others know.

Why not emotional intelligence training? I have coached physicians who were also burnt out from listening to other people's problems all day, trying to sort through the approximate language and high-level emotions, discern malingering, having to deny drugs, and having to deliver bad news.

Part of medicine is factual and a science. Part of medicine is emotional and an art and this has largely been ignored in medical training. The best physicians are those who know about both. There’s an important study that reported that when physicians make mistakes, it’s the ones who are perceived as arrogant who get sued.

Emotional intelligence is a pro-active way of dealing with stress. You know that stress is going to happen, and if you study resilience and emotional intelligence, you can prepare yourself. It's the emotionally intelligent thing to do, because bad things happen to good people, and good people also make mistakes.

When we took the turn toward positive psychology, scientists began to study what works instead of what doesn't (pathology). Much was learned about resilience by working backwards, by studying people who were resilient under the worst of circumstances, i.e., survivors. Some are so adept at this, there is even the term “post traumatic growth syndrome.” Instead of studying the people who didn’t, they studied the people who did, and were therefore able to break it down into learnable chunks. Most people call those chunks “the missing piece.”

One pioneer in the field is Martin Seligman who set out to study why some people were optimistic while others were pessimistic when life is the same mixed bag for all of us.

Whatever field you are in, and for life itself, why not learn what it is people do who are resilient, how they cope and bounce back, so if and when it strikes, you are more prepared? It’s the emotionally intelligent thing to do.