Tag: mistakes

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Making Silly Mistakes- Not The End Of The World!

silly mistakes

As I sit here writing late at night, my silly mistakes on radiology reports cross my mind. I can laugh about them now. But, when you first hear about them, they feel somewhat awkward. And I’m sure that you know what I mean. That prostate gland can become a uterus. Or, you pronounce a pregnancy on a patient with ascites. Maybe you say you saw a gallbladder in a patient with a prior cholecystectomy. It’s just a matter of time before it happens to you. If it doesn’t, you probably have not read enough scans! So, how can you make this experience a bit more comfortable? Here are some of my main words of advice to prevent you from being too hard on yourself.

Don’t Take Yourself Too Seriously

In the medical profession, many physicians tie their identities to perfection. Many of us encounter these physicians in medical school and our residency training. They tend to be miserable people. However, self-aware physicians will never make this mistake. We have to be able to admit that we will have our errors. And, if you do not make your identity perfect, you will look back and figure out how you made the silly errors you made. You might even laugh about them and enjoy the irony!

Realize Mistakes Will Happen

It’s not just a perfection issue. When you interpret enough films or perform more than your fair share of procedures, statistics say you will make a silly mistake. We can’t beat the numbers. And, the sooner we get through that notion, the happier we will be.

Silly Mistakes Are Learning Experiences

I found that each mistake is a learning experience, silly or not. When I think about how, when, and where I made a mistake, I understand the conditions that caused the problem. Did I go through a case too fast because it was the end of the day? Under what circumstances did I forget to look at the patient’s sex? Was I interrupted or too tired? Did I miss a finding because I neglected my search pattern, or was it a lack of knowledge in a particular area? Each of these questions allows us to delve deeper into the circumstances of an error and forces us to confront the truths so that it won’t happen again.

Silly Mistakes Can Be Teaching Tools!

Instead of covering up my silly mistakes, I use them as teaching points for others. These moments can be some of the most fun teaching tools. Moreover, they can make great stories. Who doesn’t like an excellent allegory to make that point stick? I would have been much less likely to do the same if I heard one of these ridiculous errors.

Yes, You Are Allowed To Talk About Your Silly Mistakes!

We are all human. When you dictate 10,000 reports containing 100 words, that’s a million. Just by sheer statistics alone, it’s only a matter of time before you say something ridiculous in one of those million words. So, get off your high horse and own your silly mistakes. At least make them into something useful!

 

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How Not To Incriminate A Fellow Radiologist For His Mistakes

 

 

One major theme in many of my blogs is that radiology residents and radiologists do make mistakes. We see them all the time in prior reports. We hear them from our fellow radiologists and clinicians. It is just part of the normal ebb and trough of the radiology resident or attending. I still remember one of my attendings from residency sagely saying we slowly get less sensitive over time. Then, we miss a finding and become overly sensitive until we become less sensitive again. And, this process continues throughout our radiological lifetimes, hopefully, as we try to reach perfection. Bottom line. If you are not making mistakes, you have not read enough films and you are not getting better. We acknowledge that. It’s who we are.

More importantly, we as radiologists have to protect each other from our mistakes. It is important that we don’t throw our radiology colleagues “under the bus”. Politically and ethically, treating our fellow colleagues well is just as important as writing good reports. We all need to be team players in order to protect our practice of radiology. So, what are some general rules for protecting our colleagues from their own mistakes? Well, that is the theme for today. A mini-instructional, if you will.

Contact Your Colleague Immediately

Contacting your colleague is probably the most important step in reducing the issues that ensue from a miss. Often times, I will read a bone scan and find the corresponding metastatic lesion on CT scan that can be very hard to detect prospectively. Immediately, I contact the physician who recently dictated the CT scan, usually on the same day. As a courtesy, this step allows this radiologist to create an addendum if warranted and prevents any harm from coming to the patient due to an incorrect report as well as the possibility of a lawsuit.

Sometimes, however, you may detect a miss from a while back, maybe months or years. In this situation, the offending physician can contact the caring physician or patient and/or make an addendum to his/her report to right the mistake. It may not prevent a lawsuit, but it certainly prepares the physician for the possibility. And, it also happens to be good patient care.

Don’t Highlight Mistakes On Prior Reports

This may seem obvious, but radiologists commit this offense one too many times.  When your fellow radiologist misses a finding on a previous report, the last thing that you want to do in any way, shape, or form is to say explicitly that he/she missed the finding. If the patient catches wind of this miss, you will see dark clouds brew and lightning flicker through the air, about to target this unsuspecting radiologist and your practice too. You are asking for a lawsuit to strike down all those involved in the construction of the prior report!

Phone The Clinician Directly To Discuss The Case

Instead of adding the miss directly to the report, another good idea is to pick up the phone and call the clinician. The issues behind a radiologist miss can be better expressed sometimes by mouth than on paper. It allows you to guide the physician toward what he/she has to do next without having to state it officially on a report. Also, the less incrimination on paper, the less likely the radiologist with a miss will have to answer for his/her sins.

Use The Words New, Stable If Possible

Especially in mammography, the kiss of death for a radiologist with a miss on a prior report is to write that a mass has enlarged compared to his priors. In no uncertain terms, what you are really saying is that the radiologist missed the finding. Lawyers love this stuff! Not that you should lie, but many lesions cannot be seen prospectively because they are really too small to catch. So instead, if you can, use the word new. Or, just say a mass is present with a comparison date to the previous study. Even better, if the lesion was present and unchanged, you can safely say the lesion is stable without incriminating anybody. Stability is usually the radiologist’s friend!

Summary

A radiology practice is a team and if you don’t think like a team player, your team will break apart. Incriminating one’s colleagues for mistakes made (that we all make at times) is a selfish act and is one of the most unsporting behaviors out there. So, be a team player and think long and hard about what you will finally place in your report. It potentially can save your colleague from a lawsuit and allow you to earn respect from your practice as a team player!