[How to continue after an error in family practice?]

Abstract

Not just malfunctioning doctors make mistakes and errors, all doctors do. Patients suffer through errors, while the doctor is burdened by feelings of guilt and self-reproach. Furthermore the taboo on errors in medicine impedes doctors from learning from mistakes. Adequate management of these situations is of great importance. In order to minimise emotional damage to the patient and his relatives and to improve the quality of medical practice, acknowledgement of having made a mistake comes first; the general practitioner should be aware of personal defence mechanisms such as projection, denial or rationalisation. He should share his experience with some colleagues; in an atmosphere of trust the emotions of regret, shame and anger can be aired. Next the peer group assists in analysing the incident step by step. This analysis makes it possible to learn from the error and perhaps to take measures to prevent recurrence. Thereafter management with respect to the patient or his relatives should be established with aid of the group. Guidelines are: make an appointment with the patient without delay; take ample time and avoid disturbance; listen to the patient and respect his feelings; express regret with regard to the consequences for the patient; contact the patient again after an interval to check if new questions have arisen. This approach is helpful in restoring the patient-doctor relation after a mistake.