The impact of medical errors on the practice of Brazilian physicians

Document Type: Original Article

Authors

University of Sao Paulo, Institute of Psychology, Brazil.

Abstract

Introduction: This article discusses how Brazilian physicians think about medical errors and the consequences on their professional careers. A retrospective study with a qualitative approach based on the professional experience of Brazilian physicians who work in a private hospital in Sao Paulo, Brazil.
Materials and methods: The participants were twenty Brazilian physicians, including ten without medical errors and ten with medical errors. In-depth interviews were conducted with the physicians, and content analysis was conducted based on the phenomenological method. 
Results: No significant difference between the two groups was found. Both groups indicated that there is no error-free practice and that educational and health institutions offer no specific training for what to do when an error occurs. Physicians believe that they should not let themselves be influenced by society’s judgment of a physician who commits an error or by the medical error concept. The Brazilian media and society tend to blame physicians for their errors. The availability of a service or an institution that supports physicians who have committed a medical error is important because these professionals do not feel supported when an error occurs and feel that they require mental health support to face the ethical and civil proceedings. Well-established doctor-patient relationships can promote the well-being of medical practitioners.
Conclusion: It is necessary to implement training and institutional practices that specify conduct conducive to improving Brazilian medical practice.

Keywords


1. Gomes JCM, Drumond JG, França GV. Erros médicos. Montes Claros: Unimontes; 2001. P. 27.
2. David G, Sureau C. De la sanction à la prévention del’erreur médicale. Paris: Lavoisier; 2006. P. 34-57.
3. Etchegaray JM, Ottosen MJ, Aigbe A, Sedlock E, Sage WM, Bell SK, et al. Patients as partners in learning from unexpected events. Health Serv Res. 2016;51:2600-14.
4. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington: National Academy Press; 2000. P. 13-49.
5. Department of Health. An organization with a memory: report of an expert group on learning from adverse events in the NHS. London: The Stationery Office; 2000.
6. Grange P, Papilon F. Erreurs médicales. Paris: Nil; 2008. P. 25-38.
7. Hiatt HO. Medical malpractice. Bull N Y Acad Med.1992; 68(2):254-64.
8. Weerakkody RA, Cheshire NJ, Riga C, Lear R, Hamady MS, Moorth K, et al. Surgical technology and operating-room safety failures: a systematic review of quantitative studies. BMJ Qual Saf. 2013;22(9):710-8.
9. Truog RD, Browning DM, Johnson JA, Gallagher TH.Talking with patients and families about medical error: a guide for education and practiceBaltimore: The Johns Hopkins University Press; 2011. P. 19-66.
10. Wu AW, McCay L, Levinson W, Iedema R, Wallace G, Boyle DJ, et al. Disclosing adverse events to patients: International norms and trends. J Patient Saf. 2017; 13(1):43-9.
11. Critelli DM. Analitica do sentido: uma aproximacao einterpretacao do real de orientacao fenomenologica. Sao Paulo: EDUC Brasiliense; 1996. P. 16-27.
12. Giorgi A, Sousa D. Metodo fenomenologico de investigacao em Psicologia. Lisboa: Fim Do Seculo; 2010. P. 10-77.
13. Giostri HT. Erro medico a luz da jurisprudencia comentada. Curitiba: Jurua; 2002. P. 8-91.
14. Resolucao CN. Federal council of medicine. Brasilia: Secao; 2009. P. 90.
15. Kfouri Neto M. Responsabilidade civil do medico.Sao Paulo: Editora Revista dos Tribunais; 2010. P.11-91.
16. Gomes AP, Rego S. Transformacao da educacao medica: e possivel formar um novo medico a partir de mudancas no metodo de ensino-aprendizagem? Rev Braz Educ Med. 2011; 35(4):557-66.
17. Mendonca VS, Gallagher TH, De Oliveira RA. The function of disclosing medical errors: new cultural challenges for physicians. HEC Forum. 2018; 30:1-9.
18. Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med. 2007; 356(26):2713-9.
19. Shapiro J, Galowitz P. Peer support for clinicians: a programmatic approach. Acad Med. 2016; 91(9):1200-4.
20. Lee BS, Gallagher TH. Saying I’m sorry: error disclosure for ophthalmologists. Am J Ophthalmol. 2014; 157(6):1108-10.