Medical professionals like everybody else are prone to errors. These errors are pretty much an essential part of being human. No one is infallible and therefore to expect our clinicians to be free from mistakes is foolishness. In the case of medical professionals, however the consequences of a medical error can be horrendous. A small error can leave a patient in a wheel-chair for life or can lead to life threatening complications and even death. A recently published report by John Hopkins University School of Medicine estimated medical errors to be the third largest cause of death in the US accounting for a little over 250000 deaths in a year. In India, these numbers are difficult to estimate. Business Standard quoted a Harvard study in Oct 2018, estimating that a staggering 5 mn lives are lost to medical errors annually in India.
Medical negligence on the other hand implies that an adverse medical outcome occurred because a clinician or a care-giver failed to adhere to well-established standards of care. This happens because the care givers were too casual in their approach, did not take their onerous responsibilities seriously, failed to adhere to well established medical processes and procedures or were simply careless. Often, clinicians in busy hospitals are over-burdened, are constantly multi-tasking and perennially dealing with highly stressful situations. This leads to short-cuts, a deviation from the norms and established procedures causing a catastrophic outcome. Sometimes, medical negligence can be traced to over-confidence where a clinician has supreme belief in his own abilities and becomes a little cavalier in treating patients leading to a stupid unforgivable mistake.
As patients and consumers of healthcare services it is imperative for us to understand and recognize the difference between a genuine medical error and medical negligence. Patients often tend to blame doctors for an unexpected adverse outcome, not realizing that the practice of medicine is inherently fraught with risk and an adverse outcome is always in the realms of possibility. A doctor can only try and minimize this risk by his knowledge, skills and work-ethics, he cannot eliminate it or wish it away. Medical errors can also be significantly reduced by establishing a hospital-wide culture of patient safety. The use of cutting edge technology, which warns clinicians, nurses and care-givers whenever a deviation from an established process is detected, allows clinicians to review their decisions and stop just before an error was about to happen. Many private hospitals in India now use these smart systems to prevent medical errors thus improving their medical outcomes. (At Max Healthcare, we run a program called ”Chasing Zero”, which through multiple initiatives helps weed out clinical errors. While, this program is almost invisible to patients and consumers, it is one of the most important initiatives, running silently in the background ensuring greater patient safety and better outcomes.)
Medical Negligence, of course is completely unacceptable. That a clinician or a care-giver failed to adhere to a well-established standard of care is an egregious failure and must not be countermanded or swept under the carpet. Even a single case of medical negligence is a blot and the hospitals should not shy away from accepting the mistake and taking remedial action. Sadly, many don’t, fearing a media backlash and legal liabilities.
From a patient’s perspective, being a victim of either a medical error or medical negligence is terrible. Patient’s go to the hospitals in search of a cure and an enhanced quality of life. To emerge from a bout of hospitalization in a worse condition is a tragedy. It is hardly a consolation to know that the medical error was either ”unforeseen” or ”unavoidable” and a result of human fallibility. These patients have to learn to live in altered circumstances and daily face up to the new reality of their diminished lives.
It is thus imperative for hospitals to continue to invest in technologies, which help avoid medical errors. The hospital leadership teams should continuously work towards creating a culture which respects and honors professionals who are always vigilant, all the time looking over their shoulders and going out of their way to help ensure minimal medical errors. There can’t be anything more important in a hospital than patient safety.
If we have to err, let us always err on the side of caution.
The views expressed are personal