Yesterday, I had the opportunity to hear a professor/practitioner of family medicine share how to address errors in the medical profession. Yes, the university hospital provides a unique environment for research, student-faculty-staff relationships, and connection with the world beyond the campus which it serves, but all members of the university community make mistakes (even sin). Gasp!
As you journey through Lent, join me in meditating upon living out the Greatest Commandment by taking some time to
- consider how loving your neighbor fits in relationship to being/following Jesus the Christ in one’s vocation/discipline.
- acknowledge, confess, and release when/where/how you have fallen short … Note: we are not perfect. We will err at times in our inter-personal interactions, spelling, presentations, research, articles, web posts/comments, patient care, advice, etc. But when we purposefully hide mistakes to our own benefit, point fingers at others to avoid the consequences, or turn frustration with our self into agitation with others, we encounter sin and the evil one coming forth to destroy all it can.
- seek reconciliation in broken relationships.
- be intentional about blessing those whom you’ve been called to serve through the resurrection power of Jesus the Christ.
Would enjoy reading some comments from those outside of the Medical profession as to how you might translate these thoughts from a Medical professor to your place in higher education (Note: the below section is just an excerpt from a larger presentation which included much more material). Also would you have any resources to recommend in addressing mistakes and/or offering apologies? From those within the Medical profession, any points to add?
When we are at risk of committing errors
- Tired: know your limits
- Under the influence (eg., alcohol, drugs, over the counter drugs)
- Competing demands
- Work stresses
- Family stresses (Note to those married: open communication between family members is very important)
- Practicing outside the usual scope of practice/expertise or attempting a procedure after it’s been awhile since one’s regular practice of it
Personal feelings associated with errors
- Guilt
- Shame
- Fear of loss of reputation
- Vulnerability
- Fear of criticism
These events can leave emotional scars. How to deal with a mistake
- Acknowledge a mistake has been made
- Find an open heart/mind to discuss the situation in confidence (e.g., mentor, attending physician, colleague, administrator, pastor, counselor)
Steps to address an error/mistake
- Acknowledge
- Explain
- Express Remorse
- Pray for patient and their family
- Ask Forgiveness
- Reparation
Minimizing our risks for errors
- Pray each day for wisdom, understanding, and caring as we serve our patients.
- Avoid situations that will degrade our performance
- Lack of sleep
- Alcohol, drugs, over the counter drugs
- Don’t work when impaired with illness
- Don’t be afraid to ask for help, assistance, advise
- The only dumb question is the one you didn’t ask.
- Be wary — we are human, and will err.
Resources for those in the Medical community:
- Apology in Medical Practice: An Emerging Clinical Skill, Aaron Lazare, JAMA, 9/20/2006, Vol. 296, No. 11, 1401. Note: Extract, i.e., first 150 words, available free at the above link.
- The Art of Apology: When and How to Seek Forgiveness, Family Practice Management, July/August 2007, 44-49. Note: Text available free at the above link.
- Medical Mistakes: A Workshop on Personal Perspectives, The Oncologist, Vol. 6, No. 1, 92-99, February 2001. Note: PDF available free at the above link.
Tom enjoys daily conversations regarding living out the Biblical Story with his wife Theresa and their four girls, around the block, at Elizabethtown Brethren in Christ Church (where he teaches adult electives and co-leads a small group), among healthcare professionals as the Northeast Regional Director for the Christian Medical & Dental Associations (CMDA), and in higher ed as a volunteer with the Emerging Scholars Network (ESN). For a number of years, the Christian Medical Society / CMDA at Penn State College of Medicine was the hub of his ministry with CMDA. Note: Tom served with InterVarsity Christian Fellowship / USA for 20+ years, including 6+ years as the Associate Director of ESN. He has written for the ESN blog from its launch in August 2008. He has studied Biology (B.S.), Higher Education (M.A.), Spiritual Direction (Certificate), Spiritual Formation (M.A.R.), Ministry to Emerging Generations (D.Min.). To God be the glory!
Thank you for this post. Academics could learn a lot from this… All too often I feel that pride prevents them from recognizing errors in judgement… When so much of their job is grading, evaluating, assessing, reviewing, revising…
I love the part about being intentional about those we (or they) are called to serve through the resurrection power of Christ. The professional training is good stuff – some is similar to the HALT acronym to be extra alert when one is Hungry Angry Lonely or Tired not to fall into temptation … but we can’t say enough for the believer to be relying on God’s wisdom and power, even as a doctor treating a patient. The patient is someone doctors are called to serve, and not to serve in human strength, but in resurrection power!
“As at many hospitals, we had dysfunctional teamwork because of an exceedingly hierarchal [sic] culture. When confrontations occurred, the problem was rarely framed in terms of what was best for the patient.” …
Q. IN YOUR BOOK, YOU MAINTAIN THAT HOSPITALS CAN REDUCE THEIR ERROR RATES BY EMPOWERING THEIR NURSES. WHY? “Because in every hospital in America, patients die because of hierarchy. The way doctors are trained, the experiential domain is seen as threatening and unimportant. Yet, a nurse or a family member may be with a patient for 12 hours in a day, while a doctor might only pop in for five minutes.” — Dr. Peter J. Pronovost in “A Conversation with Dr. Peter J. Pronovost: Doctor Leads Quest for Safer Ways to Care for Patients,” http://www.nytimes.com/2010/03/09/science/09conv.html (Claudia Dreifus NY Times, 3/8/2010)
Some challenging words from Dr. Peter J. Pronovost, medical director of the Quality and Safety Research Group, Johns Hopkins Hospital, Baltimore, MD. His passion for safety in patient care stems from personal experience and his comments relate not just to the health care profession, but also with regard to the educational culture in which health care professionals are trained. Again the university hospital is a unique setting, but none-the-less it is important for all members of higher education to ask the question “what is best for our neighbor” (i.e., loving our neighbor as yourself) under the larger call of “Loving God with all heart, soul, mind, and strength.”
I’m glad to see more open discussion about apologies when mistakes are made, in medicine and in life. It’s a very important step of healing for all involved. I’ve watched patients be tortured by the fact that no one will admit a mistake was made, while staff are told not to speak with them about it, and everyone is hurt. Good discussion.
Nancy, Thank-you for your encouragement. As I’ve shared in other places, I really appreciated your article “Malpractice—Neither Peaceful nor Practical” in the latest issue of SHALOM! (Winter 2010 VOL. 30, NO. 1, http://www.bic-church.org/connect/publications/Shalom/2010/winter2010.pdf). It’s great to have a quarterly denominational publication which seeks “to educate and stimulate Christ-like responses to the needs of society by providing biblical, theological, sociological, denominational and personal perspectives on a variety of contemporary issues.” Praying that many will find this a helpful resource both in and outside of the Brethren in Christ.