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| Version 1 | Version 2 |
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| To err is human - but not if you're a doctor | To err is human - but not if you're a doctor |
| (about 7 hours later) | |
| VIEWPOINT Dr George Fernie Medical and Dental Defence Union of Scotland | VIEWPOINT Dr George Fernie Medical and Dental Defence Union of Scotland |
| Doctors character Melody Bell had to act quickly to rectify an error | Doctors character Melody Bell had to act quickly to rectify an error |
| We've all made mistakes in our work. But if you're a doctor, the consequences can be deadly. | We've all made mistakes in our work. But if you're a doctor, the consequences can be deadly. |
| In this week's health opinion column Scrubbing Up, medical law expert Dr George Fernie looks at what can go wrong - for a GP's patient or under the knife - and urges sympathy for the beleaguered health professional. | In this week's health opinion column Scrubbing Up, medical law expert Dr George Fernie looks at what can go wrong - for a GP's patient or under the knife - and urges sympathy for the beleaguered health professional. |
| A recent episode of the BBC daytime drama series Doctors - set in a GP group practice - featured a doctor who failed to spot the tell-tale symptoms of angina in a patient. | A recent episode of the BBC daytime drama series Doctors - set in a GP group practice - featured a doctor who failed to spot the tell-tale symptoms of angina in a patient. |
| Luckily, her professional instincts rang alarm bells and she got to him shortly after he suffered a heart attack, saving his life. | Luckily, her professional instincts rang alarm bells and she got to him shortly after he suffered a heart attack, saving his life. |
| Doctors suffer, too Read your comments | Doctors suffer, too Read your comments |
| How realistic is that scenario? | How realistic is that scenario? |
| Doctors are undoubtedly human like the rest of us. It's just that clinical mistakes can have dire consequences. | Doctors are undoubtedly human like the rest of us. It's just that clinical mistakes can have dire consequences. |
| Mention Dr Melody Bell's failure to spot a condition to any doctor and you'll hear them muttering "there but for the grace of God, go I...". | Mention Dr Melody Bell's failure to spot a condition to any doctor and you'll hear them muttering "there but for the grace of God, go I...". |
| NHS figures suggest that 850,000 patients suffer what experts call "adverse events" every year: clinical negligence, missed diagnoses, medical mistakes and more. | NHS figures suggest that 850,000 patients suffer what experts call "adverse events" every year: clinical negligence, missed diagnoses, medical mistakes and more. |
| The toll in terms of human grief and misery is incalculable. The cost to the NHS - in effect, a cost to us - is around £6bn. But doctors suffer too. | The toll in terms of human grief and misery is incalculable. The cost to the NHS - in effect, a cost to us - is around £6bn. But doctors suffer too. |
| As Sir Liam Donaldson noted in a recent Scrubbing Up, victims of medical mistakes want an apology and an assurance that the mishap won't recur. | As Sir Liam Donaldson noted in a recent Scrubbing Up, victims of medical mistakes want an apology and an assurance that the mishap won't recur. |
| Yet the current blame culture in healthcare risks crushing individual medics for one regretful error. | Yet the current blame culture in healthcare risks crushing individual medics for one regretful error. |
| Failure a 'team effort' | Failure a 'team effort' |
| Take the case of Dr A, a surgeon who mistakenly removed a functioning kidney. At a hearing of the doctors' regulator, the General Medical Council, he admitted his fault. | Take the case of Dr A, a surgeon who mistakenly removed a functioning kidney. At a hearing of the doctors' regulator, the General Medical Council, he admitted his fault. |
| The GMC panel hearing his case accepted that shortcomings by his hospital had contributed to the mistake. | The GMC panel hearing his case accepted that shortcomings by his hospital had contributed to the mistake. |
| It acknowledged that support from the hospital was poor. | It acknowledged that support from the hospital was poor. |
| It observed that doctors, nurses and managers all communicated badly, leaving our medic - and through him, the patient - vulnerable. | It observed that doctors, nurses and managers all communicated badly, leaving our medic - and through him, the patient - vulnerable. |
| Failure was "a team effort". | Failure was "a team effort". |
| They don't set out to slip up | They don't set out to slip up |
| But it was the surgeon who took the rap. | But it was the surgeon who took the rap. |
| He was found to have seriously failed in his clinical responsibilities and suspended for a year. | He was found to have seriously failed in his clinical responsibilities and suspended for a year. |
| Consider also the experience of Dr B, a young GP who was called to the home of a 15-year-old girl complaining of a severe headache, fever and pains in her legs. | Consider also the experience of Dr B, a young GP who was called to the home of a 15-year-old girl complaining of a severe headache, fever and pains in her legs. |
| The GP examined the girl for any rash or bruising, the tell-tale signs of meningococcal septicaemia - a bacterial infection of the blood, commonly known as blood poisoning and didn't see any. | The GP examined the girl for any rash or bruising, the tell-tale signs of meningococcal septicaemia - a bacterial infection of the blood, commonly known as blood poisoning and didn't see any. |
| He did the right thing in examining her, but crucially made no medical note of it. | He did the right thing in examining her, but crucially made no medical note of it. |
| 'Not reckless' | 'Not reckless' |
| Medical tragedies are awful disasters for patients and those near to them. This is what makes the practice of medicine unique. Patients rightly trust doctors. | Medical tragedies are awful disasters for patients and those near to them. This is what makes the practice of medicine unique. Patients rightly trust doctors. |
| The point is, doctors tend not to be reckless. They don't set out to slip up. | The point is, doctors tend not to be reckless. They don't set out to slip up. |
| Yet the consequences for a doctor who blunders may be dire, particularly if a patient dies. | Yet the consequences for a doctor who blunders may be dire, particularly if a patient dies. |
| Being called to give evidence at an inquest is the least of it. They may be suspended from duty, face an NHS enquiry or disciplinary proceedings, and be dismissed. | Being called to give evidence at an inquest is the least of it. They may be suspended from duty, face an NHS enquiry or disciplinary proceedings, and be dismissed. |
| They may be suspended in advance of a GMC hearing, and then "erased" following it - that is, stripped of their licence to practise. The career that they loved is at an end. | They may be suspended in advance of a GMC hearing, and then "erased" following it - that is, stripped of their licence to practise. The career that they loved is at an end. |
| They can face a police investigation and criminal charges, and a civil trial for negligence. Public vilification is bad enough. Guilt and self doubt are arguably worse. | They can face a police investigation and criminal charges, and a civil trial for negligence. Public vilification is bad enough. Guilt and self doubt are arguably worse. |
| You might think that one or two of these consequences might follow a professional mistake. But at the MDDUS we have heard of many cases where all have followed. | You might think that one or two of these consequences might follow a professional mistake. But at the MDDUS we have heard of many cases where all have followed. |
| Yes, doctors have to account for themselves when things go wrong. But perhaps a blame culture is not the best way to encourage them to "fess up" to such mistakes. | Yes, doctors have to account for themselves when things go wrong. But perhaps a blame culture is not the best way to encourage them to "fess up" to such mistakes. |
| And mistakes are so easily made. Just ask Dr Melody Bell. | And mistakes are so easily made. Just ask Dr Melody Bell. |