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- เผยแพร่เมื่อ 4 ต.ค. 2024
- www.ted.com Every doctor makes mistakes. But, says physician Brian Goldman, medicine's culture of denial (and shame) keeps doctors from ever talking about those mistakes, or using them to learn and improve. Telling stories from his own long practice, he calls on doctors to start talking about being wrong.
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My parents are both doctors. I've grown up seeing how heavy this lays on them. If my father loses a patient he's out of it for days. When I used to live at home I'd find my mom sitting at the kitchen table researching at 3am because she worried about a patient so much. My grandfather who used to be a doctor as well is now demented, and sometimes starts crying out of nowhere for the guilt of not having been able to restore a child's eyesight more than 40 years ago. I know my mom still has nightmares about the first loss of a patient.
There are crap doctors, of course there are, but it's an incredibly hard job to do as well. I know for sure I wouldn't be able to handle it, ever.
My doctors do not care about my 10.6mmol TC, because they expect me tp change the diet rather than care to draw advanced blood lipids. I live in Sweden, where doctors are lazy bastards and private hospitals do not have advanced NMR lipid tests or CAC tests.
Crap doctors make other doctors look terrible. Unfortunately there are bad doctors every where and many time you don't know which one. That ruins your health.
Thank you for sharing this. I am perhaps like your mother too having nightmares and cant sleep if I worry too much about my patients. But over time I learn to manage my stress and anxiety. If not I will go crazy or end up with heart attact or depression. Later I learn to do HEALING work besides practicing fully as an eye doctor.
I don't think the problem lays with the difficult serious cases. It is the people that come in with a relatively simple obvious problem that evolves in to a much more serious one because the doctors don't take it serious and don't listen to the patient good enough. I have developed a serious anxiety problem after figuring out how bad of a job some doctors, hospitals and specially dispatchers do. I simply don't dare to do my job anymore. I have seen guys with arms ripped off half way and the dispatcher telling them to take a taxi to the hospital since their injury was not serious enough for an ambulance. I go through life assuming there are no hospitals or doctors. Imagine that. Imagine going to a high risk job knowing that when you get injured there is most likely no one to help you. Would you manage? And I have had therapy for it but we can not unlearn what we have learned can we. I can not unsee the guy sitting there for hours with his arm dangling besides him and he fainting off all the time because the pain is just to much. Waiting for a taxi that might not even come since there is a big concert in town just ending so all the taxis are there and have plenty of people to transport that won't ruin their clean taxi with blood.
I am an ER physician and I do remember... Dr Goldman, thank you so much for being honest and real. We all do mistakes but we live with it alone, with no support and no help. This is so much weight on our shoulders. You made me feel better and give me strenght to do my job with even more humanism and love. People need me to treat them, even if I am not perfect. But I DO CARE. Your message is important and worth teaching.
Not every idiot, i think you thing otherwise of him. :)
One of the best Talks I have ever seen. You can feel his heart telling us he regrets all the mistakes he ever made. He deserves respect for beeing so brave. I almost cried at the end when he sad, I Do Remember.
What made the difference for me, was my surgeon, who made a near fatal error during surgery, which she missed, apologized to me. She was thoughtful, caring, explained her mistake and how it happened, and that it became a teaching moment for all the surgeons in the practice. I appreciated her honesty that when I was having a major medical crisis, I called her even though it wasn’t her area of expertise, and she sorted out my medical records, got me to the correct physicians and surgeons. Then without me knowing, I was in the operating room talking with my new surgeon and she said they had a surprise for me, my first surgeon was there, she made sure to be there for me. She put her hands around my face as I drifted into sleep and said she’d always take care of me. Mistakes happen, it’s how you treat the person or their family after the mistake.
"Let's talk about our medical mistakes and learn together."-- what a wonderful message to all the human doctors and the public.
Being a med student myself, this is what terrifies me. Failing a test in medschool, only affects my grades, but I know later if I do make it and graduate, my mistakes and failures could cost a person's life. Even worse, a person who trusted me with his/her life. It terrifies me every night.
It makes me wanna quit med. But this message is absolutely right, if only the medical community would be more accepting and adaptive to honest mistakes, so many others would learn from it, it would be advantageous to everyone especially the patients. We are human, we all know for a fact that we are not perfect, mistakes are inevitable.
I'm sitting here bawling my eyes out after making my first ever mistake with potential consequences on others at my first ever job after graduating. I've never felt such a sense of shame and anger towards myself and even though i know my colleagues might have put a patch on it, and i know I'm knew and I'm still learning.....it feels soul crushing. I'm lucky enough to work with understanding and patient people, but goddamnit. Thank for saying all this.
How are you now
I first watched this video back in my second or third year of medical school. I remember feeling strongly about it at the time and recommended it to friends, those in healthcare and those not; it's just a generally good message to share about the unmentioned side of healthcare. I come back to this video now and then.
Here I am now in my 5th year as a doctor and my 2nd in emergency medicine and my feelings about this talk make far more sense to me now having experienced them first hand. In healthcare you're surrounded by the strive and ideal for perfection - of course we all want the very best for our patients and it's why we dedicate our lives to the profession. But mistakes happen, we are all imperfect humans; and those mistakes have varying consequences. How a healthcare professional and their colleagues respond to these mistakes is also equally varying.
I distinctly recall my first "doozy" of a prescribing error resulting in a patient going to the high dependency unit. I remember getting a very sarcastic evening handover about her that "someone thought it was a good idea to prescribe x and y" and I clearly remember thinking to myself "wow, what clown would do that?". It wasn't until the next day on ward rounds that I recognised my handwriting and signature on the prescription, and my mistake became apparent and I (a large man in his late 20s) cried openly in front of my colleagues. I later came clean to the patient and her family, and apologised to her and them. They could not have been more supportive, and I'm forever grateful to them for that act of kindness. The patient improved and ended up getting discharged, healthy, a couple of days later. Sadly, the support I received from my colleagues and supervisors at the time was mainly joking and dismissive.
There's been a couple more (I'm glad to say different) mistakes sense. There's probably countless more mistakes that I'm not aware of. I'm working my hardest to be the best doctor that I can and I'm sorry for the mistakes I have made and will make. I'm extremely grateful that I'm now surrounded by colleagues who recognise and acknowledge their own and each other's mistakes, and support others through that process. We are humans and we make mistakes. Sometimes people come to harm because of those mistakes. Recognising, learning from, and creating a system with checks in place to minimise those mistakes is all we can do to prevent them in future. The first step is acknowledging them.
We need more healthcare professionals like Dr Goldman. Thanks Brian.
Doctors have to do their best and yes thet will make mistakes because life and death is in gods hands. Docs don’t need to take that guilt on themselves as long as they are trying their best and working together for second opinions and also giving each patient enough time and attention.
Thank you Dr. Goldman. My son is an IM resident in Vancouver and my daughter an ER trauma nurse. both have watched your video and it has helped them tremendously. Thank you for sharing your heart.
This is called courage..
This man is one of the bravest people in the world. I would be honored to have such a caring and wise person as my doctor.
That takes guts, I'm very proud of you Dr! Unfortunately this takes place in all aspects of life not only in medicine (which I am as well engaged in) and it is extremely difficult to deal with.
♡ I am only a human being and I make mistakes and I'm sorry for that.. and I'll end with these three words " I DO REMEMBER" 👍
My family Dr. of 23 years used to say any Dr. that thinks they know you better than you know youself is not a good Dr., and if a Dr. listens to you, you will tell them what is wrong with you. As well he said he's just a prescription pad. What i remember best is no matter how simple the diagnosis was he always excused himself to refer back to his medical books, (pre computers) ha did this with every patiant. So trust youself, you have the answers in you above and beyond any Dr.! Thank you Dr. Rossalini !
It blows my mind to read some of these comments. Do people seriously think MD's are perfect and will never make a mistake? Seriously? I love this Doc and this is the second time in my life that I have ever heard a medical professional publicly admit to making a mistake. And to that I say BRAVO. I'd want him to be my Doc - not some liar who pretends to be perfect.
doctor do make mistakes. If those mistakes causes a patient to be injured then the doctor should be liable to damages. To lose a life due to negligance has consequences.
@@1mandrywallarmytv144 not all mistakes are due to. Negligence.
If can't tell you how much I feel you. I'm an emergency physician in India and sometime the days and the work seem so overwhelming I feel like I'm gonna crack. I mean the whole sleep deprivation and the emotional roller coaster that one has to go through. Everyday after my shift I pray I didn't make a mistake. It's a gnawing unnerving feeling. Over the days I've found myself becoming more rude and irritable. Around patients as well as family. Hope this passes over....
Vyas Vishwanathan I can relate to this so much.
I feel like I can breathe a sigh of relief.you've freed me from the Shame iv been carrying this past week.I made mistake.I'm human .I'm sorry.and iv learned from it.wow.thank you
Beautifully honest! We sometimes forget doctors are human. I hope this talk helps more physicians open up.
Superb. I am a hospitalist in the US and have come back to this video a number of times over the years. I have also referred it to colleagues. Thank you Dr. Goldman for your transparency and candidness. We all, on the front lines of medicine, deal with mistakes. And we must continue to find ways to minimize their frequency. Thank you for your passion on this issue.
I really needed this message. (who's cutting onions in here?) his message about shame and coming to terms with our mistakes goes so much further than medicine. in all our personal lives we all fuck up big time from time to time, because of our shortcomings in character. being able to be honest with eachother about it is such a gift.
Those last 3 words really did it for me. The value of mistakes has been underestimated...
I come back to this talk every year or so and it's impact is still amazing.
Human beings are story tellers. We tell stories to help each other to prepare for possible future scenarios. To discourage this is the biggest mistake of all. I am completely with Brian on this. Great talk!
I love this idea - that we tell stories to help each other. It is very true. Hearing Dr. Goldman's talk has helped me.
I am a patient healing and facing another potential surgery for a mistake claimed by a doctor. He is human and so am I. I don't want retribution. I want a grateful lesson learned, whatever it may be, learned from his end or mine. And I want to heal and to take care of my Loved ones. I don't want a scared surgeon becoming a dangerous one. I want a scared surgeon to become a wiser, better, and grateful one. Thank you Dr. Goldman.
Upon closer observation, I can thankfully say that it was not the surgeon, but the lack of hospital instruction for family and self aware care. I have since sent that information to my surgeon with suggestions and optimal outcome before the start of his work week. Again Thank you Doctor Goldman. Doctor and patient, we learn together, this is the optimal outcome.
One of the best TED talks I've ever seen. I'm a fourth year medical student and every now and then a courageous physician like Brian Goldman tells us the most terrible mistakes he/she made so she won't repeat them. It really does make a difference.
The one thing I hope all medical personnel remember is that you too are human, mistakes happen. We forget things. It's okay. How it effects you is so valid. How you feel is valid. Your story us valid. If you speak about it, others can learn with you. From you. Mad respect and appreciation to you all, it's not an easy job.
This is one of the most powerful TedTalks I've seen. If only more physicians were like Dr. Goldman.
I think you missed the point. With you judging many wont be.
With my mothers health issues, we have been bouncing around from doctor to doctor and i have experienced mistakes. Watching this convinces me that medical error is based on the pressure of the doctor to know everything and to NOT make mistakes. So, instead of looking at a case and communicating with the family doctor and neurologist every doctor is self contained within a bubble. The lack of communication within doctors themselves and the shame attached to not knowing is the key to everything.
They should start every M&M conference with this video
I think that's something that we all need to keep in mind. Doctors are people just like us. In which means that they make mistakes, just like us. Doctors are human, not robots. And I think that is a huge issue in healthcare. Brian mentioned malpractice. If we didn't let people sue for stupid things, doctors wouldn't have to pay so much in malpractice insurance. And if that's the case, we could probably lower the cost of health care. I commend him for being able to speak up about the things he is not proud of in order to help others out there. Being a doctor is a tough job. The human body is so complex that I can understand why misdiagnosis can occur. But should doctors really be shamed for being human. I think Brian is doing a great job by breaking down those barriers and opening up communication pathways for other clinicians. I think if more doctors talked about their mistakes, there would be less mistakes because everyone could learn from each other. On top of that, I think doctors do make mistakes because so much is asked of them. Like I stated above, the human body is so complex. When a doctor only has a limited amount of time with a patient how are they really getting to know what that patient needs and what is really wrong with them. I think our current health care system does not help this situation. Doctors need to have the time to understand issues of patients because their 10 minutes is up and it is time to move onto the next one.
Really important point. One doctor giving diagnoses and prognoses is prone to significant error, especially if there is a culture of isolation when it comes to admitting faults. The amount the medical systems of the world have to benefit from a network of doctors openly expressing their concerns or insecurities would be astronomical.
Re: "...If we didn't let people sue for stupid things..." Give an example of what you consider a "stupid" malpractice claim.
Also, we also have a mechanism for judges to throw out frivolous lawsuits. What more do you see as needed?
I actually think that the impetus for most malpractice lawsuits is to get the money to pay for lifelong care for disability. If we had an adequate public health care system-- like medicare for all-- people wouldn't feel compelled to come up with a contrived way to sue somebody with deep pockets when a life-changing accident or illness occurs.
I agree with most of what you say, though. I also think we ought to stop pretending that sleep deprivation is a good way to train doctors. It seems as much professional hazing as anything else. "I suffered through it, so all the doctors who come after me should do so as well!"
I have to admit, as someone whose lifelong dream has been to become a physician, his stories made my stomach turn inside out. Very very very powerful talk.
I love how lighthearted this video begins that kind of eases you into the idea. As a medical student, this is something that is constantly in the back of my mind. When I do poorly on an exam, I worry how that knowledge I didn’t remember could impact my future patients. I worry about my abilities to recognize the life threatening things that need to be recognized or patients will die. Even this feeling of shame that Dr. Goldman talks about is alive and well long before finishing medical school. The pressure to do well and succeed and check off every little thing to make yourself the most appealing applicant for residency carries immense pressure. When we don’t feel like we have lived up to these expectations myself, and many of my fellow medical students, feel weak and unworthy. The toxic culture of medicine begins so early on in our careers and is so engrained in our brains. This video is 9 years old and this culture of shame is still so present. I feel like my fellow students and I are much more open in discussing our shortcomings and struggles, but I will admit, we all pick and choose who we allow ourselves to look “weak” in front of because we know not all of our colleagues will be supportive and. Instead, will quickly become uncomfortable with the conversation. Dr. Goldman discusses “error-prone” medical professionals in the video and discusses sleep deprivation. Recently, this has become a big topic in relation to residency programs and the amount of hours interns and residents are allowed to work. I’ve read reports that discuss the dangers of driving after being awake for 24 hours, but it is not uncommon to work more than 24 hours with no sleep. Not only is this a danger to patients, but also the overall health of the physicians. The principle of non-maleficence in medicine needs to be the root of making this change. How can we be expected to make sound medical decisions, when we aren’t even fit to drive a car? How do we even begin to approach the problem of high physician suicide rates when we know this is the culture. We also know adequate sleep is crucial for mental health and critical thinking, but somehow doctors are expected to be better than that. If we want to decrease errors in medicine, it has to start from the beginning, not only with medical school, but culturally, changes need to occur across the board to lessen this feeling of shame and guilt, which will lead to better patient outcomes.
This was beautiful. Medicine is so incredibly hard and its the fear of making mistakes that carries such a heavy burden. Your honesty and strength is exeptionally admirable.
As a patient with chronic illnesses i found this very comforting. Mistakes doctors have made with my care seem a bit less hopeless now, and not systemic of the medical system. I realize doctors can and do make mistakes, especially in emergency medicine. That said, I would be more comfortable with a doctor who knows mistakes happen and approaches things with consults (as mentioned in the video, the two mistakes that he missed, but that other colleagues caught) than someone who just assumes they're right. I also think doctor/nurse accountability helps. Example: I was diagnosed with diabetes recently. I am obese with family history and you can check off every single risk factor and symptom of the disease on me except for losing weight. The doctor was dismissive and generally rude, first implying that I was just a hypochondriac and 'thought' I had something that I didn't really have, and then outright dismissing my case. I asked for a glucose test- I was shaking and sweating. He suggested wearing more deoderant for the maple syrup/fruity smell and walked out of the room before the nurse brought in the glucose monitor. I came in at 317. If it wasn't for the nurse, it wouldn't have been caught. I like having more than one seasoned health professional. Helps a lot.
That sucks that you've had to deal with that. My grandma's health is very complicated and my mom knows more about it than anyone else, so I've heard plenty about miscommunications and whatnot. It's human. Especially with all the complications that she has, bringing up paradoxical issues about medicines that interfere with each other and necessary surgeries but is she really in the state for a surgery? and so on, and so on. Doctors make mistakes. They're human. That needs to be acknowledged, not only for the doctors' sakes but also so that patients are willing to speak up for themselves if they're not sure about something. My mom does that all the time.
I support Brian Goldman's perspective on the acceptance of doctors making mistakes.
+Bubbles 007
We are all human. As Goldman noted, we all live in a world of imperfections and flaws. Yet, society builds the idea that doctors must excel and be completely perfect in everything that they do. Clearly, this is not possible in reality. Many doctors live in fear of making mistakes because of the pressure society exerts on medical practices. The fear that exists promotes physicians to “put up a wall.” This wall then leads to defensive medicine and more tests than needed for patients because doctors have to practice in society’s concept of perfection and no mistakes. As a society, we have to accept the flaws and mistakes in order to learn from them. If we punish doctors for making occasional mistakes, we are only hurting ourselves as a whole. We need to create an environment in which doctors and medical staff
can talk about their mistakes and reason through their flaws in order to prevent the same mistakes from happening again. It is about time we put ourselves in their shoes to understand the pressure that medical staff undergo in a world that wants to attain perfection. As I mentioned earlier, we can strive for perfection, but we cannot truly attain it as human beings. Therefore, we need to rethink the way we enforce the practice of medicine. By improving our healthcare system, we can make fewer mistakes by learning from previous imperfections. From that ability to learn, doctors can improve their practice and well-being in order to save even more lives in the future. Instead of criticizing doctors for imperfections, we need to look at all aspects of our society and learn how to grow and improve from there.
Bubbles 007 Most patients accept doctors make mistakes. The problem is how they deal with them. They often don't rediagnose properly to fix the damage caused by the physician to avoid a lawsuit. They lie in the chart so your second opinion is thrown off so you can't get the care you need too. Also they cover up for other doctors because they know they all make mistakes and don't want one of theirs to come to light. 1 documented mistake ends a physicians career. And if a doctor testifies at trial against another doc, they will most likely be blacklisted.
I wish you were my doctor.
The doctor is costing the tax payers millions of pounds and the kids are still retarded.
I went to countless doctors and hospitals for 17 years in unbearable pain before I could finally get a simple CT scan that showed what the problem was. This is after I had a surgery that was unneeded. I want all that money back from every doctor that got paid for either not doing their job properly or doing more harm than good! That should easily pay for the $120,000 neurosurgery that I need to remove the mass from my brain that causes headaches and hydrocephalus.
amazing talk, quite a message.
Excellent talk! Learning from mistakes is such a basic part of being human, it's almost frightening to think mistakes are buried to this extent because of shame.
This was phenomenal. Truly worthy of the TED-title!
Holy cow so freaking powerful. One of the best ted talks I've ever seen!!
Fantastic talk Dr. Goldman! That took a great deal of courage to do what you did. Absolutely commendable
Great talk, he makes great points. We need to acknowledge the potential for error, and this will allow us for medicine to progress.
I applaud you for your honesty and for listening to the small voice within. Everyone knew this anyway, it's nice to hear from a doctor. You and other doctors are only human. We all make mistakes. If all shared like you did, maybe we will make lesser. Bravo!!
@silimas
I agree with you. The whole point of his presentation, is that everyone makes mistakes.
His telling his own story, is for the purposes of getting the ball rolling, letting people know "we all make mistakes, here i'll talk about mine first'.
Honestly, who the hell would choose that method of telling their mistakes "just to feel better"? Fricken' nobody, if they could help it, because mistakes are not something to be proud of, and we don't usually like talking about them (doctor or no).
I think this is very important for Brian to talk about this because I feel as if no doctors have ever really had the courage to talk about situations where they have actually failed. I thought it was interesting when he compared the medical doctors success rate to baseball, and a batting average. How baseball is a game of failure and how even with all this failure, they can still be looked at as being a great ball player with 40% failure. When it comes to doctors they feel as if they have to be perfect, rightfully so because they're dealing with human lives. The fact of the matter is that doctors make mistakes everyday but Brian is the man that has actually come out and say that these doctors fail to accept the fact that doctors make mistakes. I thought it was really interesting because when you think about it, even though errors happen everyday in the medical field, nobody talks about it, as if its just shoved under the rug and left to never be talked about. I think it is amazing how this story comes out and brings all those stories out from under the rug and reveals the fact that mistakes are inevitable. He says that if you take all the doctors out of the profession that make mistakes, well then there would be no doctors left. With the culture that we live in is defined as not being able to make a mistake, but he feels as if we need to redesign the culture as one that its okay to make mistakes. The fact that human beings run the system, and I think this is amazing because these mistakes will be made but we need to make more backups for these human errors. I appreciate this video because he is owning up to the fact that mistakes happen, but unlike a lot of doctors out there, he wants to make it so even though mistakes do happen, it will still be okay. Finally I was most moved by the way he ended the video to make sure the audience knew that he does, and will always remember the mistakes he has made in his career. This made me take a step back and think about the mistakes that I've made just in life, and realize that it will happen, but the type of person you are is determined how you accept those mistakes and bounce back from them.
Amazing talk.
This video brings closure and insight to not only to Doctors but also Nurses and Psychiatric Nurses. I am proud to have been able to view this video. Sometimes I feel there is alot of stigma from public about healthcare professionals being untrustworthy, irresponsible and just overall bad because of a mistake. For I understand the loss behind these mistakes. And its tragic. I am genuinely sorry that we make mistakes and it costs people their lives. But I genuinely ask in a clam and understanding way, please see our side. I just wanna genuinely ask... where is it in your profession where you have to make a decision and its someone's life? Nurses and Doctors have to make those decisions everyday. Mistakes are Ubiquitous unfortunately we will all make mistakes no matter what. But talking about them is crucial to support our emotional beings as individuals, families, Doctors And Nurses and to create knowledge that helps guide us to quality care
I completely agree with everything that you said and thank you for sharing your viewpoint as a medical professional. I think this Ted Talk is great because Dr. Goldman opens the conversation up for something that is so difficult for any healthcare professional to talk about. I think talking about one’s own failures is very important for physicians because it not only helps them feel less alienated but also helps colleagues and future doctors not make the same mistakes. Doctors are oftentimes sleep deprived, over worked, and shoulder a lot of responsibility. Unfortunately, that can lead to negligence on their part. For those that don’t know, medical negligence occurs when a doctor has a duty to a patient and breaches that duty to the patient and it causes harm to the patient. However, it doesn’t necessarily mean that the physician is doing it maliciously or on purpose. Dr. Goldman’s story of the mistake that he made as a resident when he discharged his patient who was in congestive heart failure and that patient later suffered irreversible brain damage and died is a great example of medical negligence. This patient died because Dr. Goldman made a mistake in discharging her early and missed a critical piece in diagnosing her. However, I completely agree with his sentiment that “doctors are only human”, they make mistakes. I understand that some people have only every had negative experiences in the healthcare field and that causes them to mistrust physicians and have little faith in their abilities. The costs are definitely higher for physicians than other fields when a mistake is made because they have lives that are depending on them and as such, they are held to a higher standard than others. But I also think that they are bound to make mistakes occasionally and they shouldn’t be faulted too harshly for that. The first step to getting rid of this stigma is talking about the mistakes that are made, learning from them, and moving forward.
best ted talk I've ever watched. we /should be able to talk about this.
Thank you Dr Goldman
One of the best and most desperately needed TED Talks of all time.
Awesome speech!
Brian, I have complete respect for your honesty and courage you aspire in bringing up this crucial topic in healthcare. First, I would like to say physicians do make mistakes and it is inevitable because as human beings we are not perfect. Brian mentioned that physicians are not robots and every case is addressed differently because every patient is different. Although it’s aware that as human beings we make mistakes, it still makes us negligent for our actions. Being negligent is the absence of giving appropriate care to prevent harm to your patient. In Brian’s first mistake, he talks about how he sent his patient home without contacting his attending first. By doing this, he was not giving his patient the appropriate care. This action led to the death of his patient. Physicians may make mistakes but they are still being negligent. Negligence can be intentional and unintentional. Brian’s stories are obviously unintentional. He did not mean to look over symptoms or cause his patient to die. Doctor’s mistakes deal with the principle of nonmaleficence. The principle of nonmaleficence is an obligation we have to prevent causing harm to others. To conclude, yes mistakes are inevitable but be aware that for every mistake you were negligent either intentionally or unintentionally and that you are not fulfilling your obligation to your patient according to the principle of nonmaleficence.
Excellent. Thank you Dr. Goldman for your honesty and willingness to be real and vulnerable about something so painful to talk about. Medical errors are the NUMBER ONE cause of death and disability in the United States (most people think it's cancer and heart attacks). This video should be required viewing for all practicing physicians and medical students. Standing ovation for you sir!
Thank you so much. Honesty is a beautiful thing. I think if people in medicine could talk about mistakes it would also help some doctors not to be dismissive and listen to their patients. I have Lupus. When I had my first bad flair up, I went to a clinic and described my symptoms to the doctor there. He was an older man and I assumed that he had lots of experience. But his attitude was very dismissive and he said, “ It’s just an unusual flu, lots of it going around right now.” I didn’t know I had Lupus, but I knew it wasn’t the flu. I said to him, “ I don’t think so.” I understand that people make mistakes but it’s the dismissiveness attitude that is not ok. He didn’t even think about what I was telling him and that patronizing little smile made me mad. Patients can tell when a doctor is listening to them. The next day I was worse and went to a different clinic. Lupus is difficult to diagnosis. This doctor didn’t diagnose it either, but she listened to me and examined me. I could tell by the look on her face that she was thinking about it. She gave me a prescription for an inhaler (I had pain in my chest and shallow breathing). She said, “If it’s not better by tomorrow, make sure you come back.” I really appreciated the way she treated me.
Deeply, greatly touching... i find this inspiring
Damn i love this, humanity has to learn this in so many fields of life!
Dr. Goldman should be honored for his honesty and for bringing up an important topic that is downplayed in medicine. The ethical element that I am mentioning is beneficence. Doctors are supposed to act in a manner that will provide the most upmost care to every one of his/her patient’s. To do so, a physician must kind, attentive, and doing “good.” Dr. Goldman recounts many times in his career that he did not practice beneficence because he made mistakes that were very much preventable. One story he brings up is when he sent home a patient that was feeling better after his treatment plan because he felt good about her recovery. As a resident, this physician was supposed to consult with his attending before signing off any discharge papers. In the same day, the patient came back to the ED after collapsing, went into shock, and died. I believe that in medicine, doctors are not trained to be beneficent, and this leads to a sense of arrogance. Instead of making it the goal of the physician to treat patients and open up beds via discharging them, we need to be thorough by making sure that the patient is fully stable. Dr. Goldman also brought up another point that I fully agree with, which is the idea of how to cope with emotions. Many doctors have made mistakes that have led to unwanted emotions. For most physicians, these emotions are brushed under the rug and uncomfortable to talk about in front of other healthcare providers. However, the healthcare system needs to do a better job at understanding how to cope with these emotions of guilt and frustration. By allowing physicians to heal from trauma mentally, then he/she can practice beneficence in an adequate manner. I also hated that when Dr. Goldman tried bringing this issue up to his colleagues at a party, they were dismissive and uncomfortable with the issue. If health care workers cannot work together to help each other overcome obstacles that is relatable, then that, to me, is unethical.
thank you Dr. for your truth. it is appreciated. bless you again....
THANK YOU VERY MUCH FOR SHARING YOUR WISDOM WITH US DR.GOLDMAN
The way that Brian begins with relating baseball to the medical field. He relates by explaining batting averages and comparing it to a surgeon who will perform a procedure on someone. Brian states that he thought if he knew everything he would never make mistakes. He quickly learned that although he may have thought that, it is not possible. He uses an example of a case he had during his residency where he sent the patient home and that was his own mistake. The way that Brian explains the mistakes he made shows that he remembered this mistake forever. The thoughts shared by Brian are very influential because he explains that doctors are not supposed to make mistakes. I believe that Brian’s story can be related to Aristotle’s Virtue Ethics. Aristotle says that people will not be perfect all of the time, but they should strive for perfection. This statement relates exactly to the point that Brian is trying to come across; he is trying to prove that although doctors should not make mistakes, they will. The doctors strive for perfection, which in Aristotle’s point of view is exactly what they should be doing. Although Brian has made a few mistakes, he is striving for perfection and that is the end goal in Aristotle’s thoughts.
Great presentation, Dr. Goldman
This might be one of the best TED talks of all time.
This is pure gold!
I am also internal medicine physician.
2 years ago in my emergency shift I saw a young female patient with dysphagia, I sent her to otorhinolaryngology and then she went home, same night she came back needed Endotracheal intubation and ventilation. She turned out to be a variant of Guillain Barre syndrome.
Could not sleep for days.
This is an awkward, surreal, yet still a great talk. One of the best talks I've seen in a long long time.
amazing i have chills...
I need to re listen to this, kinda fell asleep in the middle so I missed alot without noticing..
Powerful and moving. I completely agree, the culture of denial has troubled me for quite some time for a number of reasons. Partially because medical ethics explicitly teaches dishonesty, and I find that intrinsically and practically unethical. How can we expect doctors to learn not to make mistakes if we teach them to never admit of any? Or expect people to be able to forgive and move on with their lives either?
From Paramedic to Physician. Happy he mentioned Paramedics as a part of his speech.
I thought the same as a nurse practitioner. And I also noted he mentioned paramedics. 😊
Time to change the concept of complete denial of mistake to the acquaint of mistake and learn from it. I ADORE YOU DOCTOR BRIAN
This should be the first lecture of medical school all around the world and I hope, one day, all doctors can discuss their mistakes with each other without feeling ashamed or fear of malpractice. I believe this could reduce burnout and increase level of satisfaction within the profession, this level is low at present throughout the world...
If I would be a doctor I`d support him totally and talk about my mistakes because it`s very important not to repeat the mistakes.
I'm in my first year of cardiology residency and I feel like I needed this video so much. I feel like I make mistakes so often and a part of me tells me it's normal, I've just begun. But even my youngest colleagues show such a low tolerance, that I feel a gut wrenching feeling for every small mistake, a huge fear to even show up the next day or to ever try to do that thing again. I wonder when will I gain enough confindence not only to practice medicine, but to face my own mistakes.
On the other end of the spectrum; a problem is that patients expect doctors to never, ever make mistakes and are trigger happy at suing when a problem does arise. Their expectations of the medical staff treating them is excrutiating and easily leads to a culture of fear of openly acknowledging mistakes.
this talk is so important in medical culture.
My hat goes of to you sir. Much needed discussion.
I am amazed by this speech by Dr. Goldman, I was glued to the screen the entire time. I loved his comparison at the very start of baseball to being perfect. I especially related to this because of my experience playing baseball in high school. Of course you can't expect a baseball to get on base with a batting average of 1.000! To anyone who has any experience in baseball, that is an absolutely ridiculous expectation to have for anyone. It is extremely difficult to hit the ball and get on base every single time. You have to give yourself grace. All of us have to give that baseball player grace. We all know it's impossible to be a perfect hitter. How is it any different to being a doctor? Of course, doctors go to school and training for so many years many of us probably don't know how long school is for them. Apart from 4 years of undergraduate education, there are an extra 4 years of medical school, and after that an extra 3-7 years of training in residency. That's nearly 15 years of learning and training after high school. But we forget that doctors are also humans that have feelings, hopes, dreams, maybe some insecurities as well! Plato himself said that the real true form of perfection lies behind the realm of reality. None of us can be perfect everytime. I believe we can have moments of perfection, but to be perfect is impossible. On the flipside, I have been a patient and have been absolutely disgusted when my doctor has made poor judgment or acted so full of themselves without worrying about my illness or worries I may have. It hurts to have a doctor that doesn't do everything perfectly, because your physical health (and in some cases, mental health) are very important to you! But I digress. Overall, I want to say thank you to Dr. Goldman for this wonderful speech and for helping me increase my understanding of normalizing imperfection.
Thanks
I love this topic! It is something I have always stood behind; and will continue to do so! It amazes me just how cruel society can be towards authority figures (Police, Doctor, Lawyer, etc.) when it comes to them making mistakes. If Sally from down the street makes a mistake it is not as frowned upon if a Doctor mis-diagnoses a patient. Doctors are humans, just like everyone else. They make mistakes, and it happens. I love Goldman's perspective on it, and it took courage for him to own up to mistakes he has made. I am not saying that if a Doctor constantly makes mistakes that should not be made; then that is unacceptable. For example, there are stories in the news where Doctors will over prescribe medicines to make more money, and etc.; I will not stand behind that. However, it takes great courage as a Doctor to admit to your own mistakes. There was a statement in this article where he talked about how after a patient dies you will remember that name forever; and how he will remember that ladies name. While he was discussing that, it hit me, he knows he made a mistake, and is owning up to it. If only it was that easy for the rest of society to get it. Next time you or anyone else wants to get mad at a Doctor, take a step back and realize that everyone makes mistakes, we just need to live and learn from them.
Достойное выступление, достойное признание!
i think you can apply this to any job, or live situation. too many ppl pretend to be perfect.
wonderful speech. Mr Goldman needs to be congratulated.
Excellent talk - I could not agree more with every one of his points - yes there is a certain aspect of practicing defensive medicine and trying not to get sued - however what was so impressive and liberating about Dr. Goldman narrative - is how he accurately portrayed how we physicians live "alone in a crowded room" when it comes to both medical error and deficiencies in knowledge. I believe he speaks more to the culture that we doctors create for ourselves and for our students.
Thank you for sharing your experience.
I am currently a resident in internal medicine. and this guy is right.
Denial and shame is a good concept. In medicine, denial and shame should not come forward. As a doctor or healthcare staff member, the training is to make sure there is no denial or shame. There should be no errors. There should be no room for the feeling of anything less. That is what I think about when I think of denial and shame. There is no time for it. I am a registered nurse and that is my perspective. Thank you.
Excellent I know and feel what he saying. I have been there before. Thanks a TON.
I got chills
thank you DR.
@Raxarax it's also different. the amount knowledge in medicine is immense. it doesn't help if it's knowledge that's constantly changing. engineering projects can span on for weeks of careful planning and modeling. diagnosis is often on the spot and requires quick thinking. not to mention that every single patient is different than others. it's the sorta thing you have to be in to understand. i was an engineer. and now I'm in med school. not a doctor yet and it's already driving me on the edge.
@platinummediauk I'm a physician and there are some existing forms of this now. Most perform at or less than the average clinician's judgement when studied. A problem is that the variables are too many, and we don't know them all. Experts, physicians in this case, thin slice (Ref. Blink by M. Gladwell). They use the information they say they use, and then some more information they might not know their using (based on circumstances, experience, trends, stereotypes... etc.). I hope this helps
what a legend, i just made my first mistake PGY1, family made me feel terrible and colleagues were not great. However, pt not harmed
V. Nice talk, Dr. And one of the most needed, but non- addressed topic ever for Doctors. Thank you. Great talk.
There is so much cultural change needed in medicine and society. Medicine at the crossroads of two phenomenon, fallibility and complexity. Healthcare is incredibly complex, and doctors are human. Add to that demanding workloads. This automatically means that a lot of errors are made. They are not spoken about as it weighs so heavily on doctors, and then add patients who file lawsuits and the hefty settlement amounts. Society should support doctors in being honest, and hospital leadership should create a culture where failures are reflected on as systemic failures. That is the ONLY way you can fix a system where mistakes are made. A punitive system which is what we have would result in silence and expensive lawsuits. What we need ate systems that work.
My doctors' office expects me not to question their doctors instructions even though I've already caught them making mistakes and I've had doctors make life threatening mistakes in the past. It's annoying, but my doctor is still better than many I've had, so I just deal with it and keep questioning them even if they don't like it.
Elaborate please. What kind of mistakes?
As the medical system covers up mistakes some doctors made on me, one Dr. with a kind soul explained with sorrow that any doctor that would help me now would lose his or her ability to practice.
Although I have MRI reports that I have osteomyelitis of the mandible,sinus tracts to my face, a cystic lesion in my brain, etc, all doctors (but the one with a heart) tell me that the reports were in error and the sores through my skull and face and the terrible dizziness are nothing to worry about.
masterfully said. Beyond the weight and truth of the content, he makes one helluva speech!
Great talk! Thank you!
In his TED Talk, Dr. Brian Goldman highlights an important issue in healthcare - the fear of talking about medical errors. He argues that by acknowledging and discussing these mistakes, doctors can learn from them and prevent similar errors from happening in the future. This is an important ethical principle known as non-maleficence, which requires healthcare professionals to do no harm to their patients. By addressing and learning from medical errors, doctors can uphold this principle and improve patient safety. Additionally, discussing medical errors can also promote transparency and trust between healthcare providers and patients, which is essential for effective healthcare delivery. Overall, Dr. Goldman's talk emphasizes the importance of open communication and learning from mistakes in healthcare, in order to provide the best possible care to patients while upholding ethical principles
Brilliantly presented.
If you are not already a perfectionist, it is likely that your training during medical school will force you to become one or instill behaviors that will make you feel like one. Medicine is a beautiful vocation, because while you get to connect with the most vulnerable people who are trusting their own life in your hands, you also get to use the most intricate scientific knowledge to solve problems of the human body. As a second year medical student, I can relate with the fact that throughout our training we are taught that when things go well, our jobs will be incredibly rewarding and fulfilling. Although what happens when things go wrong? We are trained to not miss a thing, to be so meticulous that we won’t be able to misdiagnose or mistreat the patient in front of us. Although it is a great thing that we are trained to do all these things, it is also terrifying to know what others will think of us when we make a mistake. In appreciate when Dr. Goldman says that we are only human, and as humans we should be comfortable communicating with each other about our mistakes. We should also be able to hold space to listen to others with a loving and understanding heart, so that we can promote other doctors and clinicians from opening up about their own mistakes. Believe me, in a field were perfection is an unsaid expectation, it is incredibly difficult to share with others when things don’t go very well, or when you think you had made a mistake. I want to practice in a clinic or hospital where our prides don’t get in the way of our practice. This is perhaps an idealistic and unrealistic expectation, but the concept holds true that even in a hostile environment I want to feel comfortable with others sharing my stories and listening to theirs so that we can grow together as humans and clinicians. Another beautiful part of medicine, is that more often than not, it does not occur in isolation. From the beginning, we all recognize that it takes a village of people to make a doctor. We rely on multiple professors, faculty, friends, family, loved ones to educate us, support us, or even hold us when we are in our high’s and low’s. So during our practice let’s continue to remember that we still need people and that we can rely on our colleagues and peers to open up when things get hard. On an ethical stand point, of course, when we violate the principle of maleficence because we missed a symptom and prescribed the wrong medication, we ethically committed a mistake. Although I think it is more powerful to come to terms with the fact and use our experience as a learning lesson to move forward to prevent the same mistake from happening again. Admitting to our own mistakes goes a long away, and I think it even inspires those around us to do the same thing. This is an incredible talk and a very encouraging one that should promote more open communications in the medical field about error and mistakes. Normalizing mistakes and reminding each other that clinicians are also human is a movement I want to be a part of.
Its 2024 and I'm using this powerful message for an evaluative essay in College.
Couldn't agree with this more!