Errors in general practice: What should the doctor do next?

Abstract

All physicians, not merely those who are dysfunctional, make mistakes and commit errors. Patients suffer because of such faults, while the doctor is burdened by feelings of guilt and self‐reproach. The taboo regarding errors in medicine however impedes doctors from learning from their mistakes. Adequate management of these situations is of great importance. In order to minimise emotional damage to the patient and his relatives and to improve the quality of medical practice, acknowledgement of having made a mistake comes first: the general practitioner should be aware of personal defence mechanisms such as projection, denial or rationalisation. He should share his experience with some colleagues; in an atmosphere of trust the emotions of regret, shame and anger can be aired. Next a peer group should assist in analysing the incident step by step. This analysis will make it possible to learn from the error and perhaps to take measures to prevent recurrence. Thereafter management with respect to the patient or his relatives should be established with the help of the group. Important principles are: make an appointment without delay; take ample time and avoid disturbance; listen to the patient and respect his feelings, express regret with regard to the consequences for the patient; contact the patient again after an interval to check if new questions have arisen. This approach is helpful in restoring the patient–doctor relationship after a mistake has been made.