"Medical Mistakes" Discussed by Caregivers At Mass General's Schwartz Center Rounds

MIAMISBURG, Ohio - "Medical Mistakes: A Workshop on Personal Perspectives"is the subject of an article published in The Schwartz Center Rounds of the recent issue of The Oncologist (Vol. 6, No. 1, 2001)-the bimonthly international peer-reviewed journal for physicians devoted to cancer patient care.

The Schwartz Center Rounds at Boston's Massachusetts General Hospital is a monthly multidisciplinary forum where healthcare professionals reflect on important psychosocial issues faced both by patients and their families as well as their physicians and nurses. Discussions are featured regularly in The Oncologist.

Dr. Richard T. Penson and colleagues at Mass General wrote the "Medical Mistakes"article in collaboration with Dr. Wendy Levinson of the University of Chicago.

The participants split into small groups and shared their experiences confronting medical mistakes. The most common errors included prescribing the incorrect drug or dosage, procedure-related problems, or diagnostic errors. Errors of omission were easier to gloss over than errors of commission involving patients' suffering or death and "although most felt the need for full disclosure,"wrote Dr. Penson et al., "there was less agreement about what constitutes a mistake and how the bad news should be broken to the patients or family."

It is estimated that 3 percent of hospitalizations result in significant medical errors and that two-thirds of these are preventable. The results of two separate studies suggest that between 44,000 and 98,000 Americans die each year from medical errors. "Despite an entrenched belief that doctors should be infallible, errors are inevitable,"said Dr. Penson et al.

Staff agreed that medical errors most often resulted in feelings of shame and guilt followed by vulnerability, fear of criticism, and anxiety about a "soiled"reputation. They discussed the punitive culture, guidelines for disclosure to patients and colleagues, and changes in medical practice-such as system management and improved communication-to prevent future mistakes. They concluded that sharing their experiences in "an open, confidential setting helps diffuse feelings of guilt and challenges the culture of shame and isolation that often surrounds medical errors."

It is hoped that the publication of The Schwartz Center Rounds will encourage a broader dialogue among health care givers for the betterment of patient care.

The Oncologist is a medical journal devoted to practitioners entrusted with cancer patient care. More than 21,000 physicians around the world read it. Its online edition (www.TheOncologist.com) is read by more than 50,000 each month.