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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Wednesday, October 24, 2007

Patients and doctors struggle separately with medical errors, Journal authors say

Doctors aren’t the only ones who can become paralyzed by guilt, fear and isolation after medical errors occur.

Patients and families also struggle with these emotions, Dr. Tom Delbanco and Dr. Sigall K. Bell discovered when they made a documentary about the impact of medical errors. They write about the parallel experiences in tomorrow’s New England Journal of Medicine.

“I had no idea, frankly, and I’ve been a primary care provider for 36 years,” Delbanco said in an interview. He and Bell are both from Harvard Medical School and Beth Israel Deaconess Medical Center. “It had never entered my mind that family members could feel the same kind of guilt that we as doctors feel. It had never entered my mind they would say, ‘If only I’d been more assertive with the doctor before this happened’ or ‘If only I’d listened to my instincts.’ ”

Another surprise, Delbanco said, was how reluctant people are to speak up, afraid that they will get worse care, particularly if they are from disadvantaged immigrant groups.

Doctors don’t talk for three different reasons, he said.

“We tend to run away from people we hurt rather than get close to them, we just plain don’t know what to say, and we’ve been told by lawyers to keep our mouths shut and that someone will take care of this,” he said. “We drift away rather than reach out to the people who need us.”

Building bridges to injured patients would be a first step, after the taboo of mentioning mistakes is dispelled, the authors write. They also suggest teaching healthcare providers about preventing errors and how to respond when they do happen. Their 2006 documentary has been shown to third-year medical students at Harvard.

"Everyone involved needs an organized structure that restores communication and supports emotional needs," they write. "The yield from working in partnership could be enormous, both improving people's experience with medical errors and preventing harm from occurring in the future."

Posted by Elizabeth Cooney at 05:16 PM
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