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Friday, December 4, 2015

The Stress Of Making Mistakes

Doctors are human. 
It's a simple but profound statement that I think many clients may forget.  Sure, they know that we're human beings, but I don't know that everyone goes to the full extent of that particular concept.
It means that we make mistakes.
Sorry to break it to you, but no doctor (human or animal) is perfect and always does things exactly right.  We aren't any more imperfect than any other person, and we are prone to the same oversights and failings as anyone else.  I can promise you that there isn't a person alive that hasn't made a bad decision or a mistake in their job.  And if a doctor tells you that they've never made a mistake I will call them a liar to their face.
The difference with mistakes made by a doctor is that they can directly impact health and life. 
We know that and it weighs heavily on us.  It's a different kind of situation than getting pizza topings wrong, scratching a car's paint during an oil change or even getting a hotel room booked for the wrong dates.  Our choices are often literally a matter of life and death.  We try everything we can to always make the right diagnosis, chose the right medications, perform the surgery correctly, and order things properly.  We are fully aware of the potential consequences of our mistakes and how important our decision-making skills are.  The majority of us veterinarians are in this profession knowing full well that we're never going to be rich and are unlikely to make six-figure salaries like most of our human counterparts.  We do it because our hearts call us to it.  And most of us care deeply about our clients and patients.  We actually take it very personally when we somehow mess up and fret about it constantly, mentally beating ourselves up.
Yes, I've made many mistakes in the past.  And yes, I've made some recently, which is why I'm writing about it today.  Perhpas this is kind of a catharsis.
Some of those mistakes don't involve patients or aren't even really "mistakes".  For example, recently I had a surgery that didn't do well post-operatively after taking a tumor off the foot.  The tissues didn't heal well and there were some big complications.  I did the surgery to the best of my ability and have done tumor removals like this in the past, so I know that I'm a competent surgeon.  But I still second-guess myself and what could have been done differently.  I've been worrying over that case for weeks, even though there wasn't anything else that could have been done differently.  In the case of non-patient related issues, I make the schedules for the vets in my hospital and a couple of sister hospitals in our practice and accidentally over-scheduled one of the doctors.  I also didn't appropriately schedule one location for Christmas eve, and had to fix both of those very quickly.
There is no way that we can do our job perfectly every time.  Hopefully we succeed more than we fail, otherwise we need to revisit our career choice.  But it is inevitable that we will screw up, get a dosage wrong, make the wrong diagnosis, or otherwise slip up where we really shouldn't have.  We then have to do everything we can to make it better and fix the problem that we ourselves created.
Any caring doctor will worry about these mistakes and berate themselves for making them.  Believe me, I've been losing sleep over some of my bone-headed recent mistakes and worry how those things will impact my clients, patiemts, staff, and colleagues.  Yet how can we not sometimes mess up?  It's a real dilemma and is one that significantly contributes to burn-out and mental health issues in this profession.  We are expected to be perfect by most clients, and even expect it of ourselves.  Then when the inevitable mistake happens the clients get mad (sometimes justifiably so) and we struggle with anxiety and depression because we see what we could have done better or should have done differently.  We are presented with impossible circumstances where we are never supposed to err or fail, and yet inevitably will do so because of our humanity.

Please understand that I'm not saying that just because mistakes will happen we should always excuse them.  Some mistakes are small and have little impact.  Others are life-changing and could be considered malpractice.  These latter cases really do need to be taken seriously.  Heck,  all mistakes need to be taken seriously!  But we need to show compassion, forgiveness, and understanding when something goes wrong, especially to ourselves.  And clients need to understand our imperfection and give us the opportunity to fix it.  There is a big difference between an accidental oversight and willful negligence.

Be kind to your vet.  You often don't know the burdens he/she is carrying and how much they worry about what they do.