Careering Ahead

Learning from mistakes – a vital skill

“Those who cannot remember the past are condemned to repeat it.”

This quote from philosopher, George Santayana, is often applied to nation states but it’s equally relevant on a personal level, as I was reminded this week. A widely reported national study in Australia found that 3% of Australia’s medical workforce accounted for 49% of complaints and 1% accounted for a quarter of complaints.

Most significantly, the three-year study, which was published in BMJ Quality and Safety reported that the number of complaints that doctors experienced was a strong predictor of subsequent complaints. Thus doctors’ risks of further complaints increased sharply in the first 6 months following a complaint, and then declined steadily thereafter.

But those who caused greatest concern were the ‘frequent flyers’. Doctors who had been named in three complaints had a 38% chance of being subject to another complaint within a year; those named in a fifth complaint had a 59% chance of receiving another complaint within a year; and at 97% recurrence was virtually certain for doctors who had experienced 10 or more complaints.

Of course, the most important take-home message from the study was the need for hospitals and other organisations to identify and intervene to help high risk doctors and I hope the appraisal system will go some way to achieving this. But to me, it also begged the question, how much time do we invest in learning from our mistakes.

As doctors, we are expected to reflect on our mistakes and consider what we can do differently. However, that can be difficult when the experience is something we want to put behind us as quickly as possible, such as a complaint.

My advice to doctors in this situation is to try not to take it personally. If you are on the defensive, it will make it much harder to be objective about how your actions may have affected the patient. Accept that if a mistake has been made, the patient and their family have a moral right to ask questions and to be angry and you owe it to them to be open and honest. You also owe it to yourself: feeling aggrieved or prevaricating will make it harder to resolve the complaint; could get you into difficulties with your employer; and will make it much more difficult to take away anything useful from the experience.

It’s never comfortable to revisit our failures but it should be clear by now the most important reason for reflection and learning is that if you don’t take, you may well be condemning yourself to go through the whole thing again.

Healthcare Performance was established by two doctors with over 30 years’ experience of clinical governance and medico-legal work, and specialises in careers coaching, professional development and organisational trouble-shooting within the healthcare sector.

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