Patient Safety and Quality

Physicians say counseling and education would be useful in reducing their stress after medical errors occur

Although the patient safety movement contends that errors are caused by system rather than individual failures, most doctors involved in medical mishaps still suffer silently, a new study finds. A survey of 3,171 physicians in the United States and Canada found that doctors lost confidence (44 percent), sleep (42 percent), and job satisfaction (42 percent), and feared their reputations would be harmed (13 percent) after medical errors were reported.

The more serious the error and the greater the odds of a malpractice suit, the more serious the physician's anxiety was. Most of the physicians (90 percent) said their hospital or health care organization did not offer them support after an error, and 82 percent said they would welcome counseling to cope with their mistakes.

Barriers to counseling included missing time from work and uncertainty about the confidentiality of the sessions. Amy D. Waterman, Ph.D., of the Washington University School of Medicine, and colleagues suggest hospitals broaden the services they offer to physicians to include after-hours counseling. They should also ensure doctors know that the content of counseling sessions generally cannot be used in malpractice suits.

Almost 90 percent of the physicians surveyed said that within the past 12 months, they had told a patient a serious mistake had occurred. Yet only 18 percent of the doctors received formal education on breaking the news. The study team recommends that patient safety specialists and risk managers assist physicians in handling these discussions, because physicians were four times more likely to experience distress when a mistake disclosure to a patient did not go well.

This study was funded in part by the Agency for Healthcare Research and Quality (HS11890 and HS14020).

See "The emotional impact of medical errors on practicing physicians in the United States and Canada," by Dr. Waterman, Jane Garbutt, M.B., Ch.B., Erik Hazel, Ph.D., and others in the August 2007 Joint Commission Journal on Quality and Patient Safety 33(8) pp. 467-476.

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