Friday, August 23, 2019

The Infallibility of Doctors' “Mindset”

The ongoing saga of Mount Carmel Health System in my home state of Ohio should be a wakeup call for all Medical Organizations. Specifically, that Doctors are fallible.

But to the root of the problem, how did this happen. It happened because Medical Organizations are created by Doctors who have a "negativity bias."

How does the negativity bias affect patient care? Catherine Hambley, PhD discusses this in an article, “What you can do about the negativity bias in Medicine.

The negativity bias is alive and well in medicine. It starts in medical school where students are frequently exposed to teaching methods that create feelings of shame, ineptitude and incompetency. Early on in their careers, physicians learn both the importance of preventing and avoiding errors as well as the need for perfection.”

This trait is then carried over into their working lives and into the Medical Practices and Organizations in which they create and work. Staff is expected to maintain this super human level of perfection, which causes tremendous stress and burn out. As Dr. Hambley states:

“…we know that mistakes are inevitable. We also know that if we talk about them, we are more likely to prevent their recurrence. The problem is that healthcare workers often avoid acknowledging that an error has occurred. This is typically due to a culture where mistakes are accompanied by some form of punishment, and people often feel humiliated and blamed. Hospital settings can also perpetuate a culture where the negativity bias is enhanced with physician peer review committees and incident reporting systems.”

I have seen this negativity time and again in the Medical Profession. Staff are intimidated not to complain about the “Bad Doctor” because they have seen their peers who do complain punished. In job interviews I am always asked about dealing with the “Bad Doctor”. I always know when that question is coming because the interviewer becomes quiet, usually sighs or breaths in audibly, and then tentatively begins the question. The question is asked because there is a “Bad Doctor” in the organization that has been ignored, supported, and accommodated when in reality he/she should have been acknowledged, discouraged, and censored.

What happens instead is that good, ethical employees become jaundiced to management, which effects their job performance and ultimately leads to less than adequate care. The case of Mount Carmel is the extreme, but it will happen again as long as the Infallibility Mindset is a part of Medical Management.

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