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What not to do after a medical mistake

Pamela Wible, MD
Physician
November 10, 2020
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If you are a doctor (or med student/health professional) and are human, you’ve probably made a medical mistake. You’ve probably not received emotional support for the mistake. Maybe you’ve never told anyone about a mistake that still haunts you today.

The truth is that almost all physicians have admitted to medical mistakes sometime in their careers. Depending on the patient outcome, many doctors carry the distress of medical errors for months, years, even a lifetime. Some may even develop PTSD.

If you’ve experienced anxiety, depression, guilt, loss of confidence or were haunted by intrusive thoughts in the aftermath of a medical error, you are normal. In fact, you’ve had second victim syndrome — a real condition that describes the psychological trauma a physician (or health professional) experiences as a result of an error.

I just got off the phone after speaking with a highly-skilled specialist suffering in isolation with grief, shame, and guilt after a recent medical mistake. During our hour-long conversation, she recalled another mistake from several years prior. I then shared de-identified case studies of other physicians I know (including my own) as examples of what not to do.

Top 3 ways NOT to respond to a medical error:

1. Do not die by suicide. I know of several physicians who have taken their own lives in the aftermath of making even a minor medical mistake. Do not kill yourself. Please. Call someone. Call me.

2. Do not respond with self-abuse. Do not take the patient’s chart home to punish yourself by obsessing on your mistake over and over again for years to remind yourself that you are not as smart as you think you are (like one doctor I know who did this). Do not allow a mistake to overshadow your years of excellent care.

3. Do not wait decades to share your trauma. One physician broke down in tears in front of me about a medical error she experienced 30 years ago. She then apologized for crying. Then she told me she had not been able to cry in 10 years!

After a decade helping doctors heal from suicidal thoughts, self-abuse, and isolation from recent and remote medical mistakes, I’ve discovered what actually works.

Top 5 ways to respond to a medical error:

1. Talk about your mistake. The most important thing you can do after a mistake is to talk to a trusted colleague (not a spouse, not even a nonphysician). If possible, choose someone within your specialty who understands innately your experience. Your conversation should be 100% confidential. You deserve psychological support. The sooner you talk, the better. Do not isolate. Please.

2. Forgive yourself. Avoid self-punishment by recognizing that you can not be a perfectionist in an imperfect world. You are human. You have often been subjected to hazardous working conditions, even human rights violations in medicine involving sleep deprivation and overwork. To understand the widespread risk of medical errors, please view the award-winning film, “Do No Harm: Exposing The Hippocratic Hoax,” that exposes how our working conditions lead to medical mistakes and doctor suicides.

3. Have faith. No matter what your spiritual or religious beliefs are, it is important to realize that there is a a force greater than us in this world. I personally love the quote, “Do your best and let God do the rest.” As long as you tried your best under the circumstances and were not malicious in your actions, please do not punish yourself.

4. Love your imperfections. Perfectionism is impossible to achieve. Be vulnerable and admit when you need help. You are human. Embrace your humanity. Have self-compassion and teach your colleagues to do the same.

5. Become an expert. Our most difficult cases teach us the most. Honor your patient by learning how to prevent future errors. Accept your error and grow professionally. Reframe your mistake as a positive teaching moment for your team and help other doctors prevent similar mistakes. Be a voice of inspiration and education for others.

You can not only survive a medical mistake; your mistake can make you a better doctor. Above all, please don’t give up on yourself or your career.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Human Rights Violations in Medicine: A-to-Z Action Guide, Physician Suicide Letters — Answered, and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.

Image credit: Shutterstock.com

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What not to do after a medical mistake
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