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Male Surgeons Report Highest Rate Of Mistakes In Patient Care

Male surgeons report the highest rate of mistakes in patient care, reveals a study of doctors' attitudes to "adverse events" in the journal Quality and Safety in Health Care.

But the study also shows how difficult doctors find it to criticise the ethics and professional conduct of their colleagues, to their own and their colleagues' detriment.

The findings are based on a survey carried out by the Research Institute of the Norwegian Medical Association, to which over 90% of practising doctors in Norway belong.

Just over 1600 doctors were surveyed on various political and social aspects of medical practice. They were specifically asked if they had ever made any mistakes while caring for a patient and how difficult they found it to mete out criticism to colleagues.

In all, 1318 responses were received from doctors in general medicine, primary care, laboratory medicine, internal medicine, surgery, psychiatry, public health, and occupational medicine.

Around seven out of 10 of the respondents said that a patient had never come to serious harm under their care. But 354 (27%) answered "a few times, and 14 (1%) answered "several times."

Male surgeons were significantly more likely to make mistakes than other doctors, although the authors point out that it may be easier to measure errors in surgery. And doctors don't always recognise "adverse events," so the figures in other disciplines may actually be higher, they say.

A proportion of respondents had sought professional help after making a serious mistake or found that the incident had made it harder to work as a doctor. And almost one in five said that it had had a negative impact on their private life.

One in four doctors admitting to serious mistakes said that they had not been supported by their colleagues afterwards.

Around half the doctors found it difficult to criticise a colleague's performance. But those who felt more comfortable doing so also tended to feel more supported by colleagues when they made a serious mistake themselves.

The authors conclude: "Discussion among colleagues after a serious event has taken place is vital to understanding what went wrong and is thus an important factor in quality improvement. We have to change the culture of medicine so early discussion is seen as the right and responsible thing to do."

Source: BMJ Specialty Journals. February 2005

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