This is from the newspaper’s Patient and Doctor column by Pauline W. Chen, M.D., a transplant surgeon.

She is skilled at taking patients where, otherwise, they never could go into the world of medicine.

A medical educator quoted below, Colin P. West, M.D., at the Mayo Clinic, concluded:

“In 21st century medicine, there’s no reason for a patient to accept suboptimal care,” Dr. West said. “At the same time, patients need to balance their expectations against the reality of the physician experience. And the medical establishment needs to do a better job of helping patients understand what physician lives are really like.” (Emphasis added)

This column makes an important point patients seldom hear about, if ever.

Your doctor is human, too, and humans can make honest mistakes.

If you and your doctor work in a real partnership—-and that is what you need to get optimal care—-then each of you has to respect the other’s risks for honest errors.

Of course, doctors who think they can do no wrong do harm.

Doctors who are too hard on themselves, oddly enough, can do harm, too.

Throughout my career, my best doctor friends seem to remember every case in which they thought they could have, or should have, been able to get a better result. They have all been mature, balanced, skilled physicians—- still carrying a list in their heads about each one patient who got less than they believed possible.

That is a high price to pay for any human being, regardless of training, license or professional responsibility.

Patients who are wise will remember it is not as easy being the one in the white cost as it may seem. This is especially true in rural areas, where a specialist may be the only one in that specialty practicing—-they are lonely without any peers.

No one here is making a case for doctor pity. Instead, the issue is this: How can doctors respond to error as they should, preventing that one in the future, when possible, and continuing to improve their skills?

The New York Times

By Pauline W. Chen, M.D.

…” I called Dr. Colin P. West recently, a practicing general internist and the associate director of the internal medicine residency training program at the Mayo Clinic in Rochester, Minn. About three years ago, Dr. West and his colleagues published an article in The Journal of the American Medical Association on the effect of errors on physicians-in-training and on the outcomes of their future patients. The researchers found that self-perceived errors not only increased the risk of burnout and depression but also adversely affected subsequent patient care. Over time, young doctors who believed they had made errors in the past felt less and less empathy toward their patients, which then led to an even greater risk of subsequent errors.

“What we are learning is that there’s clearly a cost for doctors and patients,” Dr. West said. “There’s probably a certain amount of stress that’s constructive, but when you deal with it for too long and take it too far, that’s when work suffers.”

“While doctors should strive for as few errors as possible, “you can’t go through training without making an error unless you are not taking care of patients,” Dr. West said. “And if you are really invested in the care of patients, there’s a personal cost when things don’t go well.”

“That cost can extend to patients. Doctors who are depressed are as much as two times more likely to make subsequent errors than doctors who are not. “From the point of view of the patient,” Dr. West observed, “it’s important whether the doctor treating you is experiencing symptoms of depression or burnout.”

Source: New York Times, July 9, 2009, Doctor and Patient Column