“It’s a funny thing about life, once you begin to take note of the things you are grateful for, you begin to lose sight of the things that you lack.” – Germany Kent
We love our Morbidity and Mortality rounds in medicine.
This is a chance to look over some medical mistakes and take some time to analyze them. We debate, criticize, and some of us like to imagine that we’d never make such errors.
We focus our attention here, on things that went wrong. Hoping that we’ll learn something that will keep them from happening again.
But why are we always paying attention to the negative outcomes?
One perspective is that it’s a function of how our minds work. Our minds are interesting machines. We know that we are much more primed to avoid bad outcomes, than to seek out favourable ones.
As well, we have a negativity bias, meaning that negative events and outcomes have a much greater effect on us than positive ones.
In short, we’re engineered to focus on negativity.
Another perspective is that it’s a part of our culture. In many ways, our medical culture is one of negativity. Doctors tend to be Type A, perfectionistic, hard striving people, always looking to be better and often trying to one-up each other.
We argue frequently. And like to judge each other.
And face it, we sometimes love it when our colleagues make mistakes.
But the truth is, we all make mistakes at times. In the ER, where I work, we are constantly making difficult decisions with a great degree of uncertainly. It’s impossible to be right all of the time. Sometimes, well thought out decisions don’t work out.
So by reviewing an error, there’s a relief in knowing that your peers are just as fallible as you are. That you’re not alone.
Finally, it might also serve to actually make us feel a little better about our own practice.
It’s in our nature to compare ourselves to our peers. We all like to think that we’re doing a good job, and I surmise that we think that we’re doing a little bit better than our colleagues. When mistakes happen, it just adds to that belief a bit more. Messed up as that may be.
The downsides
To be clear, I’m not here to say that we shouldn’t pay attention to our mistakes. When a medical mistake happens, it’s certainly a great opportunity for us all to learn. We want to know what went wrong, and what we can to do prevent something bad from happening again.
But there is a downside to all of this focus on error. We have a burnout problem in medicine and with all the difficulties in our jobs, it can often be hard to remember the things that went well.
We go home and perseverate on the mistakes, difficulties, and stresses we’ve had. Our expectations are so ridiculously high that we gloss over all the things we actually did well.
Isn’t it time that we also start celebrating the successes in medicine?
So many times, things go right and patients get better.
Someone comes into our ER with vague symptoms, or a lot of pain, and through your own intuition and training, you decide to do the right investigations. Perhaps you’re able to make a diagnosis and treatment plan right on the spot. And then that patient heals, and gets better. Goes on to live for a long time.
Congrats. You’ve just made an incredible impact on another human being’s life.
And that should be celebrated too. What we do on a daily basis is truly an incredible thing.
Don’t forget the successes.
I think we as doctors ignore these kinds of positive outcomes because we expect that this is the way things are supposed to go. In our twisted, perfect, ideal, we are always supposed to make the right diagnoses and things are supposed to improve.
But anyone with any actual medical experience knows that this truly isn’t the case. Things are messy. Mistakes are made. And sometimes people don’t get better, even when everything goes right.
Positivity Rounds
So I am advocating for you and your group to throw in some positivity rounds now and again. Forget the mistakes for a week. Discuss a few cases where things went right and you had successful outcomes.
If you’re able, bring in patients to talk about their experiences and the impact that was had on their lives.
Imagine how nice it would feel to revel in our successes for a change. There’s a lot of them, and it’s important to look once in a while.
We do amazing work. But it’s important to remind ourselves of that…. often.
