Commonest error in medicine

Amy Reinert amy.reinert at GMAIL.COM
Sun Dec 7 04:06:30 UTC 2014


The recent research in "empathy failure" on the part of physicians is a
good place to start if searching the literature for data that supports a
need for a more humanistic approach to healthcare. It has only been in the
last 3-4 years that this topic has received any attention at all, but it is
picking up steam.

For those looking to do something about the problem, a good place to start
might be to encourage some cross pollination between humanistic psychology
and medicine. Carl Roger's seminal work On Becoming a Person lays out the
case for the necessity of mutual trust and respect in the clinical
relationship. I firmly believe that Rogers' principles are as applicable to
physicians as they are to psychologists. Unfortunately, in my
observation, a great many MD's don't learn enough about psychology
(humanistic in particular) to really know what they are dismissing before
they refuse to entertain certain concepts within the physician-patient
relationship. Too many think it is about "sensitivity training," which
really is not the case. Unless something has been published very recently,
as far as I know, there are no studies yet that demonstrate whether or not
a more humanistic approach would be helpful in reducing errors. Perhaps
this group could work with a medical school to do a long-term study on the
effects of humanistic training on diagnostic accuracy.

Amy Ruzicka, Ph.D.

On Saturday, December 6, 2014, Robert Bell <
0000000296e45ec4-dmarc-request at list.improvediagnosis.org> wrote:

> Good points Vic.
>
> First, do we have good information that most errors come the way you
> suggest?
>
> If they do, do we need a code of practice interaction with patients,
> different but similar to what is being worked out with the police and
> public to de-escalate situations? Sounds like something the Speciality
> Societies could work on as with each branch of medicine the interactions
> would be different. But there could be a general code of patient contact
> put out by say the AMA to start the ball rolling if your thesis is correct.
>
> Is there any information in hospital Root Cause Analyses to suggest hat
> you are correct?
>
> If there was information, then getting it published would be a way to get
> things started.
>
> However, you bring to the front that generally we have no good data on
> anything related to errors. Also, the police do not have good nationwide
> data on how many unarmed people they kill each year.
>
> There is a great reluctance to make this information available on the
> part of the hospitals, physicians, and police because of litigation
> possibility.
>
> Then the question becomes do we first change the litigation laws.
>
> It is so complex - hard to know where to start.
>
> Rob Bell
>
>   ------------------------------
>  *From:* Vic Nicholls <nichollsvi2 at gmail.com
> <javascript:_e(%7B%7D,'cvml','nichollsvi2 at gmail.com');>>
> *To:* Robert Bell <rmsbell200 at YAHOO.COM
> <javascript:_e(%7B%7D,'cvml','rmsbell200 at YAHOO.COM');>>
> *Sent:* Saturday, December 6, 2014 3:01 PM
> *Subject:* Re: [IMPROVEDX] Commonest error in medicine
>
> The most common errors in medicine are not listening to the patient and
> respecting that the patient might be telling you the truth, inability to
> believe a HCP can be wrong and to consider alternate diagnoses. Giving
> mental diagnoses because HCP's don't want to be bothered to do legwork.
>
> Last but most important is being human. I can think of a number of people
> harmed who would expect something other than bullying, gaslighting,
> stalking, gang stalking, risk managers/lawyers, and trying to use the cops
> to silence people. Not everyone is a lawsuit. Some people just want better
> & more compassionate care.
>
> I would add that being your own worst enemy ranks up there guys. If you
> can't consider the patient, consider why you got into medicine in the first
> place. When a doc says they see 60-70% talking about money, we're going to
> respond like that.
>
> Victoria
>
>
>
>
> On 12/6/2014 11:21 AM, Robert Bell wrote:
>
> Dear all,
>
> I had the idea that instead of talking and sharing thoughts on a list server that some of the good will, and the time of the contributors could be used to actually DO something useful. Be it a resolution sent to the organizers of the list on a particular issue, or the basis for an article/publication. This, and perhaps a little naively, considering that the most successful technology companies operate on the basis of creativity and inclusiveness being intertwined. And this list had an amazing cross section of talent and diversity. Somehow I had the idea that we could miraculously DO something to help with the apperent lack of progress in the last 15 years since the IOM report on Errors.
>
> But I think the hurdles of confidentiality, available tIme of contributors, differing society aims, competing projects, differing individual aims, patent considerations, litigation issues, and institute affiliations, etc., etc, are likely to make this all too great of an uphill battle.
>
> Thank you for all being so gracious, to at least try to move the idea forward.
>
> Robert Bell, M.D.
>
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