Reforming Medical Culture Begins With The Elite

Dr. Ring Surgery.jpgWe’ve blogged a lot about how reforming the way that doctors and hospitals deal with medical errors requires a cultural transformation. Doctors need to stop regarding errors as signs of incompetence or intellectual weakness and need to adopt the ethos of engineering culture: mistakes are going to be made, so let’s be open and forthright about them and learn from them.
We’ve seen some movement in that direction, with medicine adopting some of the safety engineering principles of the aviation industry. But how does medicine get there? The answer is that it gets there when its elite, the profession’s best-credentialed and most respected members, own up to their mistakes and stop pretending that they’re a breed apart who don’t make mistakes.
Cultural change comes from doctors like Peter Pronovost, a MacArthur “genius grant” recipient and one of the leading clinical figures of his generation, frankly admitting that he made a grave medical error as a young physician (as previously blogged about here). This week we saw another crack in the wall as The New England Journal of Medicine published an article by Massachusetts General Hospital surgeon Peter Ring about an operation that he performed on the wrong hand of a patient in 2008.
As a Harvard-educated surgeon at Mass General Hospital (one of the world’s most renowned hospitals), Dr. Ring is, like Dr. Pronovost, a card-carrying member of the health care profession’s elite. Although Dr. Ring speculates that such a public airing of his mistake may harm his reputation among colleagues, it’s more likely to affect patient perception of him, as lay patients are generally much more ignorant of where their doctors stand in the professional hierarchy.
Dr. Ring deserves commendation for coming forward and helping to reverse the centuries-old tradition of doctors denying mistakes. When people at the pinnacle of their profession, like Dr. Pronovost and Dr. Ring admit that they too make mistakes, like us lesser mortals, it opens up space for those beneath them in the profession’s pecking order – young doctors, lesser-credentialed doctors – to admit their mistakes.
When we have a culture where doctors admit mistakes and make sure their colleagues learn from their errors, we’ll see a lot fewer “wrong site” surgeries and vastly improved patient safety.
You should read Dr. Ring’s account of the surgery here; it provides a nice illustration of how medical errors often have a multitude of causes and how responsibility is often spread throughout the operating room and even outside of it.

This blog is maintained by the Boston medical malpractice lawyers at The Law Office of Alan H. Crede, P.C.The blog neither contains nor offers legal advice.