“Talya Miron-Shatz, on medical misunderstandings” (A Moment with, March 17) admirably addresses the importance of providing patients with information in an understandable format, so that they may best make decisions when “there isn’t a right answer.”
Of equal importance, but shamefully receiving much less attention, is the urgent need for development of medical fail-safe mechanisms to ensure that in the many cases in which there is a “right answer,” it is that answer that is chosen.
Consider the recent New York Times articles detailing inexcusable and sometimes fatal errors in the provision of radiation therapy to cancer patients, when there would presumably be 100 percent agreement that the right answer is to provide the correct dose. Formal checklists to prevent such errors were not followed.
Less dramatic, but far more common, is the scenario in which a physician chooses a medication based on what free samples recently have been provided by a pharmaceutical representative, rather than on what has been demonstrated to be most effective.
Imagine what might happen if pilots did not go through their routine pre-flight checklists, or if airline mechanics chose replacement parts based on which manufacturer had gifted them with free samples and taken them out to dinner. If we ran our aerospace industry the way we provide medical care, planes would be dropping out of the sky with unfortunate frequency.
Much of the fault lies with the myth of the all-knowing physician. We doctors must be much more willing to acknowledge when we are unsure of the best approach, even when all agree on the desired outcome, and must accept the professional ignominy of developing fail-safe checklists rather than pretending to an infallible intuition. Equally, patients must learn to appreciate doctors’ candor in this respect, rather than gravitating to those physicians who seem to know everything. None of us do.