Respect is a medicine

Aeon magazine has an excellent article on how social interactions among medical team members affect clinical outcomes, patient well-being and the number of medical errors that occur.

It’s probably worth saying that the vast majority of doctors and warm and respectful people but it remains one of the last professions where teaching though humiliation is given a place to survive.

The article in Aeon looks at research on teamwork, communication style and respect and finds out that this ‘treat ’em mean, keep ’em keen’ attitude actually leads to higher rates of medical errors.

…many in medicine actively protect the culture of disrespect because they hold a fundamentally flawed idea: that harshness creates competence. That fear is good for doctors-in-training and, by extension, good for patients. That public shaming holds us to higher standards. Efforts to change the current climate are shot down as medicine going ‘soft’. A medical school friend told me about a chief resident who publicly yelled at a new intern for suggesting a surgical problem could be treated with drugs. The resident then justified his tirade with: ‘Yeah, yeah, I know I was harsh. But she’s gotta learn.’

Arguments such as these run counter to all the data we have on patient outcomes. Brutality doesn’t make better doctors; it just makes crankier doctors. And shame doesn’t foster improvement; it fosters more mistakes and more near-misses. We know now that clinicians working in a culture of blame and punishment report their errors less often, pointing to fear of repercussion. Meanwhile, when blame is abolished, reporting of all types of errors increases.

This, incidentally, tends to impact on certain students and trainees more than others. I still meet medical students who want to train as psychiatrists but have to suffer being humiliated in front of their peers by senior doctors when the inevitable ‘what speciality are you interested in’ question comes up.

The Aeon article is a brilliant analysis of the dynamics and interactions in medical teams and why respectful communication and a supportive teaching style is actually better medicine in terms of medical outcomes.
 

Link to Aeon magazine on interactions in medicine.

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