A few months ago, I wrote a blog related to cognitive dissonance and human nature. It was primarily focused on the reasons why the paleo diet is bad for you and why you won’t try it. Read more here.
At the conclusion of the blog I wrote, “We are all human; fallible yet capable of change.” This is important. Why? Because being human means, if not requires, that you make mistakes, even despite efforts to do your best.
I recently read an article in an Integrative Medicine journal written by an Emergency Physician. He cited an article published in the British Medical Journal.
This BMJ article ranked that allopathic/conventional medical care as the third leading cause of death in the United States.1 This is behind heart disease and cancer. Medical error is not an official cause of death since it isn’t reported on death certificates. Dr. Makary, author of this study, isn’t suggesting retribution to those errors, but rather offering a process to allow tracking and identification to reduce harm to patients.
I don’t bring this article to light in order for all to use as anti-MD rhetoric. Nor am I offering you any ammunition to avoid the hospital or medical care when it is necessary. I want to offer a few thoughts in support of the medical community, one of which I am married to and a part of.
1.The burden of responsibility on medical doctors is beyond what most can truly understand.
There are few professions whose line of work frequently deals with life and death (police officers, active service, and medical professionals). One of the reasons I chose NOT to go to medical school, besides feeling inadequate in intelligence, was I didn’t want to deal with life and death. I volunteered in a veterinary clinic in high school and held a cat while the doctor performed a procedure. The cat died in my arms. I was wrecked for days. As I read this article, I suddenly realized that I had attempted to avoid this particular problem by avoiding becoming a physician and going to physical therapy school instead. Then I became a parent and suddenly someone’s life was in my hands. My ability or lack of ability to care for them would determine their life or death and health. This is a burden that keeps me working hard to do my best. I have even written about my tips to successful parenting healthy kids because it includes making mistakes…apologize, learn, become…repeat. You can read more here….
2. It’s an uphill, if not impossible, battle to bring health into an artificial environment.
I have spent plenty of time inside the hospital both as a clinician, student and even as a patient. There is incredibly valuable equipment available in order to understand the medical problem as well as life saving medication. Yet, both have inherent risk associated with them. While resolving or discovering one problem, there is the likelihood to produce another (side-effects of pharmaceuticals are common as are adverse reactions to many procedures). Beyond these known risks, we have many environmental factors that are associated with poor health.
All of these issues are limiting healing but also affect the individual health of the providers that must work in these conditions at ALL hours of the night. It’s a LOSE-LOSE situation sometimes and at best a LOSE-WIN in the event the patient is saved, the physician is still working in an unhealthy environment.
3. Legal and financial disaster is a real threat should a medical doctor make a human error.
Even myself, a physical therapist, cannot fully grasp this threat. As a mother, I make human errors, E.V.E.R.Y D.A.Y. I can’t imagine how my life as a parent would be different if I would risk losing my children with every mistake I made. Blatant ignorance or intention of harm should be evaluated and treated appropriately, of course. Yet, what if you mixed two pharmaceuticals together inadvertently trying to save a person’s life only to have an adverse reaction occur? Resulting in the death of a patient, loss of your license, and jail time. I liken it to serving a child chicken that was undercooked and the child got sick and taken from their parents. We all know raw chicken isn’t good for you, but you missed checking the one chicken breast prior to serving it. Or a new parent so sleep deprived fell asleep with their infant and ended up suffocating their child. No new parent ever knew everything prior to bringing life into this world. You learned on the job and continue to learn E.V.E.R.Y S.I.N.G.L.E D.A.Y. The same is true for all healthcare professionals.
It’s true what Dr. Makary presents even if it isn’t entirely accurate. We all know that research too is fallible. We need to keep track of errors in an open format, not for retribution.
“A great nation is like a great man:
When he makes a mistake, he realizes it.
Having realized it, he admits it.
Having admitted it, he corrects it.
He considers those who point out his faults
As his most benevolent teachers.”
-Lao Tzu’s Tao Te Ching
Being human means that we are fallible yet capable of change. It is a waste to try to hide medical errors, not because we need to rid the healthcare system of all those who make a mistake, but because we need to learn from them. That is the biggest tragedy here. There is much to learn from each other from a global stage. Each physician can learn. Each patient can learn more about how to reduce their risk of illness by healthy lifestyles. Even maybe, require lifestyle changes before prescribing medications or invasive procedures in certain situations.
This study did not assess the actual number of lives saved. We cannot forget that. If we look at the whole picture, there are likely many millions saved from imminent death or disaster from misfortune or even chronic preventable diseases.
If we spend all of our time looking for someone to blame, we may lose the opportunity to learn and improve the situation. No person needs to lose a life or get sick to change, but sometimes it happens.
We can all work together to continue to be better by a willingness to learn from our past mistakes. Sharing our mistakes with others allows us to move forward without having to repeat the same thing.
“An ounce of prevention is worth a pound of cure.” – proverb
It’s much easier to stop something from happening in the first place than to repair the damage after it has happened. Like the best offense is a good defense. We have a personal responsibility today to care for our good health. There is too much data out there that supports this (including wheat, sugar, tobacco, sedantism). If you blatantly ignore this information, then the burden is on you, not the medical professional trying to keep you alive. You have already set him/her up for an impossible task. If you decide to ride the quad without a helmet then the burden is on you. If you followed governmental policies because of your job then any medical issues should be placed on the government, not the health care provider trying to fix the problem. If you are going to drink soda and alcohol every day, then the burden is on you, not the physician who tries to save your life from the liver disease you now have after years of abuse.
Our pediatrician has shared that he has only once in his career seen a family change their lifestyle to more healthy habits based on the information he shares with his patients. Even my husband, a surgeon, has been incorporating nutrition and lifestyle recommendations only to have people blatantly ignore it. Or to even put many of the recommendations into play, and still have significant pain and discomfort.
I agree, allopathic medicine can do better. BUT so can we personally and future patients do better. We can do better as parents too.
In the end, what I hope happens, is that we all WAKE UP!
Yes, WAKE UP.
You have a personal responsibility to eat well, move well and sleep well. As employers, we have a responsibility to allow that or provide the best opportunity to do that. As a physician, much like a parent, be that broken record every day. “Eating fruits, vegetables, whole protein, drinking water, exercise, and sleep 9-10 hrs is the best thing for your body.” Or “95210” as described here.
Repeat. Repeat. Repeat. And then repeat again.
Let’s open up the dialogue about mistakes without retribution, so we can learn and grow. Let’s celebrate the saves, not just the misses.
The burden of responsibility should fall on ALL of us, not just one single person or profession. It is much too easy to place blame than it is to solve problems.
Remove. Replace. Restore.
Remove blaming others, especially anti-MD rhetoric, for mistakes that have been made, since we are all fallible.
Replace with learning from not only your own mistakes, but the mistakes of others. Moving forward take personal responsibility for your health, so when you are dependent on someone else to save you, there is a better chance of survival with or without a mistake.
Restore humanity, health and maybe a sense of community.
Eat Well. Move Well. Sleep Well. Soar On.
1. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139.
Dr Carolyn Dolan DPT, Cert MDT, MSHN
Where physical therapy, nutrition and lifestyle meet, because how you live your life determines whether or not you soar. Inspiring action with information so you can reduce pain, optimize healing and improve function naturally during recovery from injury, surgery or painful condition. This is a website for the open-minded; obstinate need not apply.