The emotional impact of mistakes on family physicians.

OBJECTIVE

To explore the emotional impact of the most memorable mistake on family physicians, the support they needed and received, and their response to a hypothetical scenario in which a colleague's decision was associated with a fatal outcome.

SETTING AND PARTICIPANTS

Randomly selected members of a county chapter of a midwestern state academy of family physicians.

DESIGN

Qualitative cross-sectional survey using in-depth interviews subject to content analysis.

METHODS

I audiotaped interviews with each of the physicians in their offices. Two medical sociologists and I first independently, and then consensually, categorized the data based on the frequency with which a word or idea appeared in the text.

RESULTS

Thirty (75 %) of the 40 physicians originally contacted participated in the study. Twenty-three (77%) of the 30 physicians admitted to making a mistake. The physicians experienced emotional adversity. Of 27 physicians, 17 (63%) needed someone to talk to, 13 (48 %) needed to review their case management, 16 (59%) needed professional reaffirmation, and eight (30%) needed personal reassurance. Having someone to talk to was the support that 12 (44%) of the 27 physicians valued most. Eighteen (67%) of 27 received this support from someone other than their peers. Although all subjects recognized their colleague's pain and need for support in the hypothetical scenario, only nine (32%) of 28 physicians would have unconditionally offered support.

CONCLUSION

Making mistakes unfavorably affects family physicians and creates a strong need for support. Family physicians may benefit from sharing experiences that diminish perfectionism and recognize mistakes as a natural part of practicing medicine. Further research needs to address how physicians can be encouraged toward therapeutic self-disclosure and peer support.