Commonest error in medicine

Vic Nicholls nichollsvi2 at GMAIL.COM
Mon Dec 8 00:26:39 UTC 2014


Dr. Ruzicka, this sounds quite plausible.

The physician that I've had the biggest problem with in terms of missing 
things did not heed the warnings of previous medical history, my family 
(even to his face telling him things). He expected me to trust his 
judgement when he was the only one, well he and his medical buddies, who 
didn't trust me.

I find also that many physicians act as if they are experts in 
psychology and diagnosing mental issues. I can read the DSM-IV criteria 
and frankly I have no clue what these doctors were using diagnoses.

I find a good lack of questions and attempts at a relationship to verify 
it before pawning off someone on anxiety or depression meds.

I would certainly be happy to help in a study like this. I have an 
academic internist. She is very bright, willing to listen, looks at 
research, and can think logically. She is also willing to tell the truth 
on whether she thinks something is right or not. I value that respect 
very highly.

She is at EVMS.

Victoria

On 12/6/2014 11:06 PM, Amy Reinert wrote:
> 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 
> <mailto: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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