Why do doctors fail?

Why do doctors fail?

Was listening to BBC Radio 4 as I started cooking dinner - and there was a trail for this year's Reith lectures. I only half-heard it, but it sounded very likely that it would be interesting to some people here.

Rather than my trying to summarise something that I didn't hear properly, about something that has not yet been broadcast, seems far better that I simply post a link to the appropriate page of the BBC web site.

Dr Atul Gawande: Why do doctors fail?

A collection of Reith lectures teasing out the big issues in medical ethics and futures.

bbc.co.uk/programmes/b04bsgqn

Perhaps, just maybe, if we understand doctors better, we might be able to help them to help us? Or at least see why they so often seem to fail in delivering what we think they should.

[Sorry - I have no idea what access those outside the UK might,or might not, have to these broadcasts or iPlayer/downloads.]

Rod

5 Replies

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  • Thanks Rod x

  • Rod, I've heard the trails too and am planning to listen. I usually enjoy the Reith Lectures.

  • Atul Gawande has a new book out. He was interviewed here about end of life care and competently delivered hospice care, how to make life better even if it's the end. Patients need to be listened to as to what they consider to be what they think makes their life worth living and when it's no longer worth living. His father, also a doctor, died of a brain tumour.

    I think a lot of doctors do not possess the tools to 'deal' effectively with patients who are under duress, whatever the case may be. They shut down when a patient is expressing personal distress. Given their professional responsibility, they need either to be screened for their capacity for empathy (not just high marks in school) or trained to at least be competent when faced with a patient who is overwhelmed by their health problems. Even if a doctor can't cure the patient, healing and helping has a big witch doctoring component. Just knowing that a doctor is listening and cares, even when that doctor can say, on the level with compassion, that they don't know and will do what they can, then that goes a long way to reassuring a patient that they are not in this alone.

    No one doctor knows everything all the time. We can't expect them to. But at the same time the doctor also needs to acknowledge this fact while at the same time doing whatever it takes to help find the problem and the solution.

    The word 'doctor' means 'teacher'. 'The word is originally an agentive noun of the Latin verb docēre [dɔˈkeːrɛ] 'to teach'.' These people are supposed to help their patients to learn and be part of the journey of healing. They need to recognize that in many circumstances, the patient is the expert of their own body. Listen. Listen. Listen. Dr. William Osler had it right (I paraphrase) 'the patient knows what's wrong, we just have to listen'.

  • I have just read your link and he does sound an excellent doctor in the USA. Even President Obama quoted some of Dr Gawande's quotes. This is from the first paragraph:

    "The first lecture, Why do Doctors Fail?, will explore the nature of imperfection in medicine. In particular, Gawande will examine how much of failure in medicine remains due to ignorance (lack of knowledge) and how much is due to ineptitude (failure to use existing knowledge) and what that means for where medical progress will come from in the future."

    He is actually giving (has given) 4 lectures and there is a further 3 links towards the bottom of the page about other aspects of Dr Gawande.

  • Rod, towards understanding what doctors deal with, this is a rather sobering article from Medscape about Physician suicide, a subject rarely talked about. PR

    medscape.com/viewarticle/83...

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