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Doctors make mistakes

But talking openly about mistakes still seems to be shrouded by fears of being judged by colleagues and the sense of being a failure as a doctor. At least so says Brian Goldman, an ER doctor at Mount Sinai Hospital in Toronto. He sought to throw open the doors to what he sees as a taboo subject in a TED talk, by exploring the culture around making mistakes and whether it can change.  

Where does this culture come from?

Goldman says that it starts with sending doctors out into the world with ‘the admonition to be perfect – never ever, ever, make a mistake, but you worry about the details of how that’s going to happen’.  

We asked Lucy-Anne Webb, a medical student at the University of East Anglia, if she could identify with Brian Goldman’s account. ‘His description of arming yourself with knowledge in an attempt to immunise yourself from making mistakes is something I know I do.  

The unwillingness of medics (students and doctors alike) to discuss mistakes or misunderstandings with colleagues for fear of being judged and the highly self-critical nature with which we conduct ourselves is prevalent and apparent in the medical community.’  

Separating the good shame from the bad shame

Making mistakes in this culture can hugely damage doctors’ confidence. But Goldman argues that you have to differentiate between good shame in which you acknowledge that what you did was bad, and the unhealthy shame which leaves you feeling that you were bad.  

‘The former allows you to acknowledge, learn and move on,’ says Lucy-Anne, ‘whereas the latter provokes sensations of isolation and inadequacy.  

Recognising these different types of shame would be helpful to all doctors, juniors in particular – we all make mistakes, and (hopefully) we all regret them, but there is a way to do that with a positive outcome.’  

Making mistakes is part of learning

So can the culture change to allow doctors and students to talk openly about their mistakes?  

‘Occasionally consultants do disclose to us mistakes they have made, how they made them and what the outcome was,’ says Lucy-Anne. ‘When an experience like that is shared with you as student, I believe it demands more respect.  

‘A consultant who can compromise their infallible status in order to benefit your learning is not only a superb teacher, but a great doctor.’  

Do you think doctors can and should talk about their mistakes?

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