Thursday, March 27, 2014


The Physician linked to a fantastic TEDxToronto talk about medical errors and how we treat them.  In it a doctor discusses some of the many errors he made during his career including one that killed someone.  He goes on to urge us to change medical culture to avoid the assumption of perfection and make it possible for doctors to teach each other when mistakes occur and not simply bury them.

I think it was funny that in the beginning of the video he talked about batting averages and how a 400 batting average was truly amazing.  Then he asked the audience if they would be okay with a cardiac surgeon who only batted 400.  I suspect the great majority of people recoiled in horror at the thought of going under the knife with a surgeon who failed 60% of the time but I saw it entirely differently.  If my chance of living without surgery is less than 40% and other surgeons are less than 40% then I sure do volunteer to get operated on by someone batting 400.  It all depends on the other numbers.

Generally I suspect I have a much higher tolerance for failure than society does.  Medicine is not alone in creating all kinds of terrible outcomes out of a desperate desire to avoid any appearance of disaster as this happens in schools and businesses and everywhere else.  To avoid letting any child down in school we refuse to push children to do well.  In order to make sure that nobody ever gets hurt we make the schoolyard a wasteland and prevent children from learning how to deal with being hurt and avoid it in future.  There is no end of waste all in the name of preventing some unlikely outcome and the rallying cry is always the same "Safety first!"

Safety is great and all but the important thing is generating the best possible outcomes overall.  Refusing to let children go out and play to keep them safe is a great way to make them fearful, unhealthy, and lacking in useful life skills.  Making it culturally and legally difficult for physicians to share stories of failure in a desperate bid to convince everyone that the medical establishment is flawless leads to mistakes being repeated.  Even the War On Drugs is based on a similar idea - the sentiment that if we can somehow prevent even one person from becoming an addict it is worth jailing a thousand regular people for no good reason.

The world isn't perfectly safe.  Bad things happen.  The best thing we can do is look at the numbers, figure out if we can stop those bad things effectively, and then take the appropriate action.  Sometimes, in a world with limited time and resources, that action is nothing at all.

1 comment:

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    The Physician ...