Physicians, by nature, are high achievers. We have been required to not just succeed but to excel in each step of our career trajectory in order to reach the pinnacle that is practicing medicine. The rigorous self-discipline that this achievement requires often leads to an intrinsic perfectionism. Because of this, when a medical error occurs the consequences can ripple far beyond the injured patient and impact the physician as well.
Having committed our lives to healing, knowing that an error we made has harmed our patient results in a significant emotional toll for most physicians; even an unexpected adverse outcome where no error has been committed can be devastating. There exist three separate but interconnected concerns in these situations:
- The worry for the patient’s eventual outcome;
- The personal guilt and feeling of failure associated with causing the event; and
- The anxiety of possible medicolegal consequences.
This constellation of emotions is often referred to as second victim phenomenon and can have lasting impacts on the clinician and their practice. Following an error, physicians may have impaired confidence in their clinical acumen which could result in subsequent over-treatment or over-testing for future patients. Avoidance of similar patients or situations is also common and impacts access in an already strained healthcare system. At times, the lingering emotional toll can be so severe that a physician may choose to leave the practice of medicine altogether.
Traditionally, the culture of our profession treated mistakes as personal failings; any physician who erred was guilty of neglect at best and ineptitude at worst. Research indicates that one of the primary feelings experienced by physicians following an error is shame, likely fueled by this culture of personal perfectionism. Strides have been made in the past few decades to focus not on blaming those caring for the patient, but instead to look at ways the healthcare system may have failed.
When looking at the entire cascade of events, or lack of events, that led to the harm of a patient, factors beyond a physician’s control can be identified and corrected. Such implementation of systems-based approaches to analyzing medical errors not only shift away from the blame game but provide concrete ways to prevent similar errors from harming patients in the future. Taking part in this process can provide a physician with reassurance that the lessons of their mistake will reach beyond their own practice patterns and result in improved care for their community.
Physicians who are hurting after a medical error need not suffer in silence. Peer support can be vital in these situations; talking to someone who understands the complexities of modern medical practice can provide perspective and encourage healthy coping mechanisms. Many models of peer support networks have been reported in the literature and have been implemented at various levels. For example, the LifeBridge program in Nebraska provides peer-to-peer coaching for any physician experiencing stress, such as that which occurs after a medical error. The program is confidential, free, and protected from disclosure. Similarly, the National Physician Support Line (1-888-409-0141) is staffed by psychiatrists who volunteer their time to provide confidential, anonymous support to physicians across the country.
Beyond peer resources, physicians experiencing considerable strife following a medical error should not hesitate to seek mental health services. Working with a psychologist or licensed therapist can help process the event, recognize and cope with the associated grief, and lessen the impact of the error on your life outside of medicine. Focusing on caring for yourself as you would encourage a patient to do can also provide some healing. Exercising regularly, eating healthy meals, and taking time to rest are essential for your long-term well-being. Some physicians also find that keeping a journal can help them deal with the day-to-day stresses of practicing medicine.
Physicians care for thousands of patients throughout their career and expecting each encounter to be perfect is a set-up for failure. Preemptively recognizing our own fallibility can help lessen the self-criticism following an error. As a profession, we must continue to shift our response to mistakes toward compassion, support, and learning. By recognizing the impact of errors on second victims, we can lessen their future effects on our first priority: our patients.
The information provided herein does not, and is not intended to constitute legal, medical, or other professional advice; instead, this information is for general informational purposes only. The specifics of each state’s laws and the specifics of each circumstance may impact its accuracy and applicability, therefore, the information should not be relied upon for medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation.
Article originally published in Copic’s Copiscope 4Q25 newsletter.
