When doctors learn how to perform a new procedure, they are likely to make mistakes before becoming proficient. Perhaps more than in any other profession, there are steep learning curves associated with what medical doctors do: starting a subclavian central line, removing an appendage, intubating, etc. How do doctors rationalize putting their patients at risk of harm while they're learning procedures?
One of my advisors brought the issue up in class in the spring. He's a pediatric critical care physician and unabashedly is one of the best central line starters in the Chicago area with nearly ten thousand procedures under his belt. It took a lot of mistakes for him to get to this point. As a patient, he asked the group, would you prefer an attending or a resident physician to perform procedures on you? The answer most gave was attending. Attendings are senior physicians who completed all aspects of training necessary for their practice; they're perceived to be the oldest and wisest of the bunch. Paradoxically, we prefer treatment by attendings, the doctors who have made the most mistakes in their careers.
By definition, the patient seeks treatment from a healthcare professional. When a patient walks into an office or clinic, there is an unspoken agreement that there will be some sort of invasive treatment done to improve his health. In most cases, the treatment is helpful but there is always a chance that it can cause more harm than good. When no harm is done, nobody thinks twice about the procedure. On the other hand, if a mistake is made then all hell breaks loose with accusations and patients seeking compensation. It's always about the money.
I rationalize this risk as the only way for me, an aspiring physician, to become competent at a procedure. For every one screwup I make in the youth of my career, I will perform a hundred flawless ones later. Being a medical student requires a certain amount of self-awareness, though, of knowing when to stop and ask for help from a more senior doctor. It's the price everyone pays for good medicine: doctors need training because they're not born with mad skillz.
One of my advisors brought the issue up in class in the spring. He's a pediatric critical care physician and unabashedly is one of the best central line starters in the Chicago area with nearly ten thousand procedures under his belt. It took a lot of mistakes for him to get to this point. As a patient, he asked the group, would you prefer an attending or a resident physician to perform procedures on you? The answer most gave was attending. Attendings are senior physicians who completed all aspects of training necessary for their practice; they're perceived to be the oldest and wisest of the bunch. Paradoxically, we prefer treatment by attendings, the doctors who have made the most mistakes in their careers.
By definition, the patient seeks treatment from a healthcare professional. When a patient walks into an office or clinic, there is an unspoken agreement that there will be some sort of invasive treatment done to improve his health. In most cases, the treatment is helpful but there is always a chance that it can cause more harm than good. When no harm is done, nobody thinks twice about the procedure. On the other hand, if a mistake is made then all hell breaks loose with accusations and patients seeking compensation. It's always about the money.
I rationalize this risk as the only way for me, an aspiring physician, to become competent at a procedure. For every one screwup I make in the youth of my career, I will perform a hundred flawless ones later. Being a medical student requires a certain amount of self-awareness, though, of knowing when to stop and ask for help from a more senior doctor. It's the price everyone pays for good medicine: doctors need training because they're not born with mad skillz.
No comments:
Post a Comment