Mistakes In Medicine

In today’s blog I would like to share some thoughts and insights that could help you understand your doctor a little bit better. I truly believe that by understanding how we get trained and what we face that you will be able to understand that mistakes do happens in medicine, but when they do, that doesn’t mean that your doctor isn't well prepared.

There are few careers that require the amount of time in school and post-graduate training as medicine does. Depending on the specialty, there might be another 7 years of training after graduating from medical school. This lengthy academic commitment gives you an idea of the complexity of the human body. It takes a long time for us to settle down in our specialty.

The medical school curriculum starts with what is called basic sciences, which includes anatomy, physiology (function of the organs and systems), biochemistry, microbiology etc. These assignments are the foundation to the second part which is clinical sciences that include internal medicine, pediatrics, surgery and others. Then we graduate and continue with our post-graduate training.

Here in the post-graduate training, I am going to emphasize the word “training”. This process implies the intensive supervised exposure of the newly graduated doctors (residents) to patients and their clinical issues.  It is important during this training that the resident is exposed to a large volume of patients, variety of disease processes and good mentorship. By seeing patients with similar presentations, it becomes second nature to make a diagnosis and establish a treatment plan. Furthermore, this lengthy period allows the young doctor to see different variants or presentation of the same disease.

From my perspective, what makes medicine such a complex field is not only the thousands of diseases and variants in presentations, but also the similarity in signs and symptoms of certain illnesses. In other words, sometimes two clinical processes present very similar but their treatment is so very different. Believe me, sometimes it is nearly impossible to distinguish between them. This particular issue is notorious in what is called “acute abdomen," in simple terms a very painful belly. The problem with acute abdomen is that there are entities that produce severe abdominal pain but do not require surgery and vice versa; some diseases that require immediate surgery.  By now, I am sure that you have a friend or a relative in mind that had their abdomen opened and nothing was found wrong. 

The previous example constitutes one of the biggest challenges for the general surgeon because if they wait too long in a situation because he/she thinks it isn’t surgical, but in reality it is surgical, then we have a patient with a perforated organ and an infected abdomen. Now, you can understand why sometimes the surgeon errors on the side of opening and “taking a look."

My hope today is to giving you some insight about the particularities of the medical field and the decision processes in medicine. I hope that you can understand that indeed we (physicians) make mistakes because of the overwhelming variables we face, but a mistake is way different than negligence, which is defined as, “A failure to behave with the level of care that someone of ordinary prudence would have exercised under the same circumstances.”

There are certain traits you can expect from your doctor including compassion, transparency, being personable, that they take time and make every effort to explain to you the disease and treatment plan of that disease, diligence, and that they are well trained. But you can’t expect him/her to be perfect or not make mistakes.

There is only one perfect entity and that is God.