“No man is an island, Entire of itself, Every man is a piece of the continent, A part of the main.” This is an excerpt from a poem by John Donne. Though he was not describing the medical community in his poem, doctors would do well to take his words to heart. A recent report in The New England Journal of Medicine, suggests that many doctors see medical mistakes made by their peers yet stay silent and do not tell the patient or the at-fault doctor of the mistake.
The reasoning behind these decisions not to speak up is not clear but the outcome is. The Journal of Patient Safety estimates between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death. Doctors have an ethical duty to disclose their own errors to patients. But many times the doctor may not realize he has made a mistake during surgery. Such as during many laparoscopic and da Vinci robot surgeries.
The point of contention seems to be what physicians should do when they discover someone else’s mistake. It hardly seems like a question to me. But in a recent survey of doctors more than half said that, in the prior year, they identified at least one error by a colleague. Some reasons doctors may stay quiet is that doctors depend on each other for business. So a physician who does the right thing and speaks up may lose referrals. Or maybe they aren’t sure exactly what happened to the patient and don’t want to take the time to try and unravel it. Ultimately doctors also may be wary of becoming entangled in a medical malpractice case, or of causing a colleague to face legal consequences.
The NEJM report stresses that patients come first and recommends that doctors should explore, not ignore, a colleague’s error. But as the report clearly shows the patient’s well-being is often ignored which is why many times medical malpractice lawyers end up being the advocate for the patient.