Failure is a state when the desirable or intended objective is not met. When anybody discusses failure it is usually with the intention of avoiding it. In life, failures are bound to occur but what differs is the response.
Medical practice is no different. Success in treatment is usually reported, but failures should not be ignored.
Everybody learns from failures. The challenges and thrill of the medical profession has attracted many. Since the profession deals with life and death, assessment of failures differ from many other professions. In 1947, the life expectancy in India was around 32 years, which has increased to more than 70 years presently.
Improvement in medical treatment over time is one of the main reasons for this success.
Failure in medical practice is a challenge and not always easy to deal with. As assumed by many, doctors are not responsible in all cases. The causes may be:
- Human factor (medical professionals)
- Infrastructural deficiencies
- Patient (severity of disease)
- Incorrect interpretation of a complex medical problem
Communication
In medical practice proper communication is important as it can avoid failure. Although there is no formal training on communication in the undergraduate medical courses, it is an essential requirement throughout a physician’s practice.
The usual requirements of a patient’s relatives are:
- Availability of the doctor as required
- Proper information regarding the patient
- All-time contactability
- Quality treatment at the lowest cost.
Non-contactability of a physician when the patient is in a desperate crisis is a problem. It is, however, not feasible for any physician to be contactable all the time. Visiting the nearest hospital Emergency may be useful. However, a common complaint is that the hospital Emergency does not have specialists , especially during odd hours.
During consultation, the patient is also expected to give correct information. Many suppress history of smoking or chewing tobacco for fear of insurance denial.
For any physician it is better to be contactable for a couple of hours every day at a fixed time for better communication. Proper information should be provided both by the patient and physician as it can prevent medical failure.
Social media
Successful medical treatment, especially operations, are widely reported in various social media, but failures are seldom highlighted. It is true that no physician can be successful in all cases.
Various studies indicate that self-reporting of failures is most important but that does not happen. Thus, success is well documented but failures are difficult to trace. Alleged medical failures get noticed only if there is a complaint.
Interpretation of medical failures by the patient and the physician can differ. Similar medical failures in Bengal and outside the state are interpreted differently on many occasions.
Corporate hospitals use social media for branding and marketing. The various claims made are not always substantiated. Common people tend to get confused with multiple medical advertisements. The use of social media for personal gain ignoring failures is unfortunate.
Training
Though qualifications are important, proper training of physicians and surgeons are absolutely essential. This can drastically reduce the incidence of failure.
When faced with failure or any complication, it is best to discuss with seniors and review literature.
Preparation is the key to success. Confidence is important but there is no harm in taking help wherever necessary.
Professional brilliance and good attitude shape a quality surgeon. Though failures may occur, learning from such events is necessary. A capable surgeon should be able to focus on the job and overcome problems.
There was a time when training outside India was considered ideal. Presently training and qualifications in the country are adequate and preferred by various hospitals. Medical training is a continuous process which can reduce failure significantly.
Students preparing for undergraduate and postgraduate courses should not fear failure, but they should always try to succeed. Failure can always be overcome.
Teamwork
A significant change that has occurred during the past few years is teamwork. A number of surgeons or physicians have joined together to provide service.
Some patients do not prefer to be examined by different doctors on separate days. However, there are some advantages compared to the standalone doctors of the past. These include
- The responsibility is divided.
- The chances of medical failure is reduced.
- Contactability is increased.
- There is an option of taking second opinion within the team.
The concept of full-time doctors in every corporate hospital has also brought about a change. Since the availability of such doctors in the hospital is full-time, contactability has increased and communication is better.
This can reduce the chances of medical failure.
Today, the patient has many choices among institutions, individual doctors and various teams. They need to make the correct choice.
Defensive practice
There has been a significant change in attitude among the common people towards physicians. Negative outcomes are not accepted even if correctly treated.
The fear of failure or complaints have pushed some physicians to defensive medical practice. The concept of good faith or trust cease to exist today.
Medical failure cannot be managed by blaming each other. Risks need to be taken if the situation demands without fear of failure.
Gautam Mukhopadhyay is a surgical oncologist trained at the Tata Memorial Hospital, Mumbai. At present, he is associated with RN Tagore International Institute of Cardiac Sciences and Narayana Health Cancer Hospital
