BCE 63 Failing Up after Medical Error

In anticipation of EM Cases Episode 103 Wellness Promotion and Burnout Prevention in Emergency Medicine with Sara Gray and Chris Trevelyan, in this Best Case Ever podcast, Dr. Gray tells us the story of her worst case ever and what she learned from it. About 50% of North American physicians involved in a serious medical error report increased anxiety for future errors, decreased confidence in their job, decreased job satisfaction, insomnia, PTSD, panic disorder – the list goes on. Dr. Gray shares how and why many of us react to medical error - the embarrassment, the shame, the guilt and sense of failure. She then explains the notion of acceptance that we all fail, that perfection is a myth, and how she learned that "failing up" after of the most difficult case of her career is the best choice after making a medical error... Podcast production, editing and sound design by Anton Helman, November 2017 We spend a lot of time and energy in EM talking about how to be a great clinician, discussing the latest evidence, great saves and the like. But we don’t talk about our failures, medical errors, disaster cases and screw-ups, which of course, if you’ve been practicing long enough, we’ve all had to deal with. When we make a medical error we have 3 choices 1. Live in perpetual doubt Blame yourself and practice defensive medicine - which really makes for an unsatisfying career. This is not a good choice for many reasons, one of which is that defensive medicine has been shown to not only increase costs and length of stay, but actually result in worse patient outcomes. Maybe you’ve seen this a colleague of yours. 2. Bury your head in the sand – blow it off, look the other way, shrug it off. This isn’t a great choice either because inevitably you end up becoming a hardened ruthless EM provider and end up not caring about what happens to your patients. Perhaps you’ve seen this in a colleague of yours as well. These first 2 choices (living in perpetual doubt and burying your head in the sand) are the “natural paths” that most docs take, probably because they don’t take much effort. But there’s a 3rd choice that does take a bit of effort but is almost certainly the best choice... 3. Failing up - learn from the fail Learning from your medical error takes effort, consideration and time – but it’s worth it. Learning from your mistake makes you even more accountable, compassionate and competent. “When we sweep our failures under the rug we miss an opportunity to heal from them, to learn from them, and to teach people about them more effectively….It’s important for people to feel that they are not alone.” - Sarah Gray After listening to this Best Case Ever learn more about preventing burnout and promoting wellness in emergency medicine in Episode 103