Growing up, my friends and I spent hours playing The Game of Life. Any good Life player knew that the key to winning came in the first 15 squares where careers were determined. Landing a profession in medicine guaranteed a big salary, a sedan full of pink and blue kid pegs, and lots of prestige in the end.
My, how times have changed.
An article this week in The New York Times calls the medical profession one of "The Falling-Down Professions" along with law. Quoting a 2006 poll by the American College of Physician Executives, the article says 60 percent of docs have considered leaving medicine because of low morale.
Apparently it's not enough just to help people anymore. The altruistic benefits are overshadowed by paperwork, Medicare cuts, time constraints, and criticism. Stories of medical errors and poor patient care dominate the media, and, if you admit you're in healthcare, cocktail party conversations become personal attacks on providers. Forget that most docs wouldn't want their children to follow in their career footsteps: Some want out today.
ACPE's poll isn't the first to remind us that doctors are human, too. A study published by The Joint Commission last August said that many physicians experience significant emotional distress and job-related stress following near misses and medical errors. Of the 3,100 physicians surveyed, 44 percent said they lost confidence in their professional capabilities after a medical error occurred, 42 percent reported having sleep problems, and the same percentage said they were less satisfied with their jobs after the incident.
My gut reaction to this study is of course doctors should feel regret for medical errors. Shouldn't they feel remorse for altering or ending another human's life? Won't a little humility make docs better caregivers and ensure that mistakes don't happen in the future? Yes, and yes. But, as leaders, you need to ensure that you turn that stress into something positive. Unhappy doctors just lead to decreased referrals, increased physician shortages, miserable nurses, and possibly even more medical errors.
Although there have been improvements in the process for tracking and reporting medical mistakes, most facilities have no way of helping caregivers, especially physicians, cope when a medical error does occur. Sorrel King, a patient advocate whose daughter Josie died from medical errors in 2001, recently told me about a pilot program at Johns Hopkins that's designed to do just that.
Several months after Josie died, one of her doctors contacted King and shared some of her "deepest, darkest secrets." The doctor told King that she wasn't sleeping or eating and was unable to move on from Josie's death. There were no professional resources to help her cope, and no process in place to ensure that she moved on from this error and became a better, stronger physician. Today, there is.
Hopkins' Care for the Caregiver program helps caregivers cope not just with harm, but with an array of job-related stressors and emotional upheavals using expressive writing and a trained psychologist. The program, currently being piloted, will eventually be a model for other hospitals.
We tend to think of physicians as superhuman--even cold--in their ability to shut off emotions, but they're not. Hospital leaders must ensure that families, processes, and the caregivers themselves (including physicians) receive the support that they need to move forward--while ensuring that errors aren't repeated.