Doctors are not infallible
IN an increasingly litigious society, it would be foolhardy for any doctor to claim infallibility.
As a famous Malay proverb goes, “No matter how good a squirrel is at jumping, it will still fall occasionally.” Therefore, George Bernard Shaw’s quote in The Star of June 14, penned in 1906, no longer holds true. The question is whether society at large accepts that there is a limit to what doctors can do.
Doctors themselves need to undergo this paradigm shift. In general, doctors are perfectionists. In the days when the entrance requirement for medical schools was more stringent, candidates were often straight-A students who probably did not fail any test in school. Medical schools provided a rude awakening where they experienced failing an examination for the first time. In a class of straight-A students, one has to be first and another the last. This message is reinforced when the new graduate encounters the first patient to die under his or her care.
There is not a single doctor in this world, past, present and future, who has a 100% survival record. If a doctor doesn’t undergo this paradigm shift, he will end up with depression.
When a doctor does any invasive medical procedure, informed consent must be obtained. The patient has to be informed of the procedure, any alternatives and possible complications. Even a simple intravenous sedation for a tooth extraction may be complicated by over-sedation and acute allergic reaction (anaphylaxis).
How a doctor obtains informed consent and not deprive a patient of a life-saving procedure is down to tact and experience. This brings me to the oft quoted saying, “To Cure Sometimes, To Comfort Always, To Hurt The Least, To Harm Never”; again recognising that a doctor cannot heal all the time.
Patients tend to sue or complain, in this day and age, through social media, when they are dissatisfied. “Satisfaction” is a parameter with “Outcome” as the numerator and “Expectation” as the denominator. Doctors must ensure that patients’ expectations are realistic and not hyped up in order to prevent dissatisfaction. On a positive note, in the presence of low expectations, a patient’s family will be very satisfied if the outcome is good. This is known as managing expectations.
Doctors have learnt that there is a limit to what medical science can do but at the end of the day, nature has to take its course. When this happens please do not treat us like common criminals, or even worse, defame us through social media, where we have no course for redress.