No matter how skilled doctors are at providing treatment, mistakes happen. Misdiagnoses can lead to inadequate treatment or avoidable adverse reactions. Monitoring a patient’s progress incorrectly can weaken their prognosis. Surgeries can go wrong and create further health complications – some even fatal.
To protect patients and their families from these outcomes, it’s important for doctors to learn how to correctly monitor and prevent so-called medical malpractice. But in cases where mistakes occur unexpectedly, the least patients deserve is for doctors and healthcare institutions to respond in a professional manner. Practitioners should be able to communicate bad news as effectively as good news, but above all, they should be honest.
Otherwise, are patients of even the most reputable doctors really receiving a good standard of care? And why do doctors fail to handle breaking bad news?
Doctors Who Can’t Communicate: Merely Technicians, Expert Says
Transparency about problems that occur in hospitals and clinics is not easy to come by. Of course, these problems are compounded when they involve medical malpractice. As we’ve seen in recent studies, physicians struggle to have conversations with their patients about the aftermath of their errors.
This is particularly true, for example, when the situation involves patients whose “care” has made them terminally ill.
“Unfortunately, our system often treats patients who are dying [by] focusing on cure rather than care, and chasing fantasy even when cure is not an option,” said Jessica Nutik Zitter, MD, who practices palliative care at Highland Hospital in Oakland, California. In 1 case, Zitter consulted with a patient whose doctors didn’t even tell her or her husband that she was dying after a botched surgery.
Another serious example of miscommunication is failing to admit to a patient that they have been permanently impaired by a medical procedure. For example, conditions such as cerebral palsy commonly develop after injury before, during, or after birth. These preventable birth injuries can be caused by events such as prolonged labor, forced use of assisted delivery tools, and improper prenatal care – all to the fault of bad doctors. Often, however, doctors choose not to report these events to protect their reputation.
Even industry-leading, “A” team healthcare providers make mistakes such as this. But one could argue that, by covering these mistakes up, they are not fulfilling their duty as a “doctor” at all. Care, as a whole package, should include emotional as well as medical skill.
“Specialists with cutting-edge technical skills and the technology to support them are indeed a type of ‘A’ team,” Zitter noted. “But they often lack a different crucial skill, one I believe all doctors should hone: the ability to communicate bad news. Without that, they are an ‘A’ team of technicians, not physicians in the truest sense.”
The Solution: Doctors Need Better People Skills
Why, then, do doctors seem so afraid to approach diagnoses of death or disability? The problem, says Dr. Kate M. Lally, Chief of Palliative Care at Care New England Health System, is that some doctors don’t fully understand their role.
“I had an interaction recently with an oncologist about a patient,” Lally said. “We were a little at odds. She said, ‘Kate, we both went into medicine to save lives,’ which startled me. Most of us treat chronic conditions, but the ‘save lives’ thing isn’t the bulk of what we do in medicine.”
It’s this misconception that medicine is about saving lives that leaves no room for acknowledging undesirable outcomes. Denial towards a problem then clouds the doctor’s judgment on how best to proceed, which can have very serious consequences for birth injuries or life expectancy.
To avoid this, doctors need to be trained on how to deal with their mistakes effectively. In other words, they need to approach these difficult conversations by considering the patient’s point of view. Much less damage can be done by being honest than by saying nothing at all.
“We physicians must come out from behind our machines and high-tech treatments and do something that can be more difficult than replace a heart valve: talk with our patients and their family members about what is really going on,” Zitter continued. “We owe patients this essential information so they can understand the range of options and their limits. Each of us – physician, patient, and family member – must look carefully at our collective tendency to celebrate technology and to assume that more is always better.”
