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How Ego and Fear Negatively Impact Patient Safety

In every profession, there is a hierarchy and certain unwritten rules of conduct and which are widely practiced and followed. In many cases, the more education, skills and experience necessary; the more likely those in positions of power are to abuse their power. When it comes to the health care industry, such abuses of power and inflated egos can come at a cost to patients’ safety.

The results of a study titled, “Residents’ reluctance to challenge negative hierarchy in the operating room,” were recently published and help shed light on the role that pecking order may play in contributing to surgical and anesthesia errors. For the study, 49 Canadian medical residents took part in a simulated experiment during which they were asked to participate in administering a blood transfusion to a patient whose known religious beliefs forbid such medical intervention.

When study participants were asked to help administer the medical procedure which was against the patient’s express wishes, none of them protested or questioned the anesthesiologist’s actions. When asked to provide more details about their failure to speak up, participants described being trained in an environment in which fear of humiliation and retaliation reign.

Some of the participating medical residents even detailed specific real-life incidences in which a patient suffered harm because they failed to intervene or speak up. One described the process of residency and learning to be a doctor as being one in which “shock and trauma,” dominate and where residents are constantly trying to “keep their heads ‘below the parapet’.”

The results of this study are troubling. This is especially true for the millions of patients who trust surgeons and anesthesiologists with their health and lives. There are often several factors that contribute to a surgical error or anesthesiology mistake. In cases where poor or lack of communication are to blame, legal action may be appropriate.

Source: National Post, “Medical residents yield to doctors’ orders even when they’€™re wrong€” and patients suffer, study suggests,” Tom Blackwell, March 29, 2015

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