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: Malting 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.