Doctors face emotion, error and ‘state of panic’

By Robert Leitner

Dr. Danielle Ofri, author of What Doctors Feel, speaks in the Cavalla Room on April 5 about the doctor-patient connection.
Dr. Danielle Ofri, author of What Doctors Feel, speaks in the Cavalla Room on April 5 about the doctor-patient connection.

Doctors face the possibility of being overwhelmed with emotions and often struggle with how to deal with them appropriately, according to a physician and writer who spoke in the Cavalla Room on April 5.

Danielle Ofri, M.D., Ph.D., the author of What Doctors Feel, explained that nobody likes to be afraid, especially doctors, because it makes them feel like they are not in control. Often doctors deal with the emotion by pretending it doesn’t exist.

“Owning up to fear is very hard for doctors because we are expected to be right all the time,” she said. “Owning up to it and asking for help, those are things we do not do well.”

As a medical student, Ofri was overwhelmed by fear and wanted to find a way to eliminate this emotion. However, her thoughts on fear have since changed.

“I think if we eradicate our fears completely, we would become those sorts of cocky cowboy doctors,” she said. “We also can’t live in a state of panic all the time. When fear takes over, I have to remember that’s the time to turn and ask for help, rather than put patients at risk because a mistake might be made.”

After the speech, Dr. Bryan Spiegelberg, associate professor of chemistry and biochemistry, elaborated on this idea.

“I’m sure that the first time a medical student or new doctor performs a potentially dangerous procedure, he or she experiences perhaps a significant amount of trepidation,” he said.  “But I’m also sure that training and experience keep all but the newest students from feeling true ‘fear.’ I think that fear would be a significant negative factor in the quality of care.”

Ofri went on to maintain that any death because of a medical error is unacceptable. Two types of biases impact doctors and account for many of the medical errors made today, she said.

“Doctors who are experiencing negative emotions tend to be less flexible in their thinking, and are prone to anchoring bias – when the patient comes in with one diagnosis and doctors ‘anchor’ to that diagnosis. Thereafter, every other piece of data that may contradict the original diagnosis you discard.

“Doctors who experience positive emotions like joy and happiness are more flexible in their thinking, but they can make medical errors using attribution bias. Attribution bias is attributing the disease to who the patient is rather than the actual pathology.”

Doctors have conferences to discuss specific medical errors in order to minimize the chances of these mistakes happening again. According to Ofri, these conferences are usually unproductive and end up shaming doctors.

“It’s a great idea in theory to go over what went wrong, and what errors were made,” she said. “Often these conferences are about who can we blame and who can we put up on the stand.”

Dr. Nancy Wiencek, an assistant professor of communication who coordinated the event, embraced looking at medical errors but also thought it should be done in a supportive manner.

“Yes, mistakes happen,” said Wiencek. “But there are always lessons to be learned from mistakes. To be able to deal with it and turn it into a learning experience, where you don’t feel as if you will just be punished, that’s a positive thing.”

Many in the audience attended because they’re interested in the new health communication minor.

The university is also developing programs in allied health studies, healthcare management, health sciences and healthcare policy.

Ofri made the point that in order for doctors to be able to discuss errors productively, it’s important to understand guilt and shame. Guilt prods people to make amends, and shame is about people’s failure. Once doctors come to terms with their shame, it is easier for them to discuss their mistakes, according to Ofri.

“Research shows that patients would much rather be told about the error, even the near misses,” said Ofri. “In fact, they’re less likely to drop their doctor if you tell them about the error.”

Senior communication major Jared Strand supported Ofri’s idea about doctors’ honesty with medical errors.

“Ofri made a very valid point,” Strand said. “If a doctor is honest to their patients about medical errors, it would build trust between patients. I feel like if a doctor told me bad news or that there was almost an error, I would appreciate their honesty.”

When asked about what inspires her to keep going in a job with all these emotions and dealing with constant sickness, Ofri described the opportunity she has to be a part of the lives of others.

“I feel like I have an incredible privilege to be in on people’s lives and hear about their pains and passions,” she said. “That is beautiful even when it’s painful. Even when I’m helping patients face their death, there is something so beautiful about being in on a vulnerable moment and trying to make it better.”

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