"I don't wish to be a doctor anymore. I used to do it to help relieve somebody else of their suffering. Now, all I do is to achieve some system's role or performance target, or fulfill some documentary requirement, or avoid some complaint, or guide the next generation in joining into this abyss. The suffering continues unabated. The sick and needy and injured keep coming. On my back, their care, and their satisfaction. On my back, the hospital - administration, ancillary, supporting services, and the others - insurers, payers, financiers, earn money. But on my back alone, I carry the burden when things go wrong"
Medical errors have received much attention. Doctors in administration and management have attempted to address it like doctors would - as a disease. Find out what happened, investigate to identify causes, and correct the problem with interventions. Like antibiotics for an infection. Initiate preventive measures to avoid the similar error happening again. Like vaccination.
But the problem is that the two main parts of the equation, doctor and patient, are human. And humans aren't exact like science. That inexactness of humans will result in inaccuracies with communication - listening, speaking, understanding, interpreting; variability of actions - due to awareness, urgency, concurrent situations, prevailing environment; and acceptance of outcomes. It is this inexactness that gives intuition, gestalt, clinical acumen; and it is this inexactness that contributes often to errors.
So medical errors will continue to be, as long as the parties involved continue to be human. System measures may place safeguards, usually to avoid simple mistakes; but often cannot address errors of interpretation. As medicine becomes ever more complex, and the body of knowledge expands to (almost) beyond capability, the number of errors are unlikely to be ever much less.
But when did we ever promise that Medicine was free of errors ? Some may argue that it was at the very beginning with Hippocrates' "first do no harm". Surely I cannot argue with Hippocrates, but it is hard to think of any medical therapy which doesn't at least carry the risk of some adverse effect. Hippocrates' had he lived today maybe have said "first try to do more good than harm" reflecting the risk-benefit analysis which we do all the time. But then again, Hippocrates had he lived today, would probably have quit Medicine altogether. Especially if he had known about lawyers.
You see medical errors are the lawyers windfall. Negligence, they claim in their letters of demand; Negligence they claim from their side of the aisle. The error was the worst they had seen, and had directly contributed to the injury, or death. The doctor did it. Inexcusable. Strike him off the register. Unforgiveable .... but some money will alleviate the suffering of the family; and 40% for the "suffering" of the lawyers.
It has gotten worse. In some countries, and some situations, medical errors have gone onto criminal proceedings. Crimes. Acts against the written law that may lead to jail. I cannot understand this. If I kill somebody, steal something, assault someone, cheat people, rape, maim, torture or even fake documents, I can understand jail-time because I did something. I committed a crime. BUT if I missed a diagnosis, when treating someone, I may end up in jail, professional career forever destroyed ? Is it a crime of commission, or of omission ? Are they the same ? Or is it, an eye for an eye type of justice ??
The crime of omission is a failure to act, often in medicine, a failure to recognize and therefore to act. This is considered in law, very different than crimes of commission, and therefore attracts different legal consequences. It give rise to liability only when the law imposes a duty to act. Yes, doctors often have that duty to act; but does the law impose a duty to be correct ? Furthermore, although the act of omission is considered actus reus ("the guilty act") criminal liability is considered only if proven in combination with mens rea ("the guilty mind"). So I really cannot understand criminal proceedings against doctors who are treating their patients. It is, to me, an eye-for-an-eye type of justice. Except that lawyers get paid for exacting the eye.
Most professional organizations say that such actions are necessary to protect the integrity of the profession and its standards. Judge yourself from the article in the 1st paragraph if you think this is still the case. I think by allowing this to happen, the medical fraternity is tearing at itself, a suicidal down-spiral to its ultimate doom. A future of doctors behaving as pseudo-lawyers, patients as potential adversaries, eyes all the time on the money earned versus the legal risk incurred.
The medical fraternity is already the only one that looks at itself with the most critical eye. Mortality Morbidity meetings, inquiries, clinical conferences, quality monitoring, sentinel events, compulsory reporting, audits etc etc. This doesn't happen to any other professions.
Imagine the gallery where a legal case in on-going involving medical negligence. Two spectators are there. One a doctor, the other a lawyer. The doctor is watching the doctors testimony and is thinking, that's wrong, i wouldn't have done this, or I may have done that in a similar situation. The lawyer is watching the defense lawyers tactics and line of questioning, and is thinking, that's not good, I wouldn't have used that tactic, he should have done this or that. And yet, only the doctor is on trial.