Dr. Brotman believes in leading by example. “What you want is an open-door policy where faculty members can say, ‘Something bad happened, I need to get it off my chest, and I need to do it now,’” he says.
The group leader also needs to know what happened in case there’s a need for damage control beyond the hospitalist group. The leader should ultimately be the one who confers forgiveness.
“If somebody feels they are keeping a secret, it’s going to make matters worse,” Dr. Brotman says.
Research confirms the needs for “confession, restitution, and absolution,” and hospitalists need their competence validated.6
Even though I [have been] honest and said, ‘I don’t think I would have made that decision,’ I also have said, ‘I know that in terms of your thought process, you were acting in the best interest of the patient … and you’re one of the most compassionate physicians I know,” Dr. Brotman says.
As leaders gather information on an adverse event, they may also be in a better position to advocate for the hospitalist in subsequent conversations. In so doing, they can save that individual further embarrassment and humiliation.
“I hope that I’m able to process what I was experiencing in a way that doesn’t paralyze me,” Dr. Feldman says. “But I hope it informs me to the gravity of the situation.” TH
Andrea Sattinger is a medical writer based in North Carolina.
References
- West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071-1078.
- Goldberg RM, Kuhn G, Andrew LB, et al. Coping with medical mistakes and errors in judgment. Ann Emerg Med. 2002;39(3):287-292.
- Wu AW. Handling hospital errors: is disclosure the best defense? Ann Intern Med. 1999;131(12):970-972.
- Wu AW. Medical error: the second victim. BMJ. 2000;320(7237):726-727.
- Wu AW, Folkman S, McPhee SJ, Lo B. Do house officers learn from their mistakes? JAMA. 1991;265(16):2089-2094.
- Wears RL, Wu AW. Dealing with failure: the aftermath of errors and adverse events. Ann Emerg Med. 2002;39(3):344-346.