THE EMOTIONAL IMPACT OF MISTAKES ON FAMILY PHYSICIANS

Objective: To explore the emotional impact of the most memorable mista ke on family physicians, the support they needed and received, and the ir response to a hypothetical scenario in which a colleague's decision was associated with a fatal outcome. Setting and Participants: Random ly 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 audiotape d interviews with each of the physicians in their offices. Two medical sociologists and I first independently, and then consensually, catego rized the data based on the frequency with which a word or idea appear ed in the text. Results: Thirty (75%) of the 40 physicians originally contacted participated in the study. Twenty-three (77%) of the 30 phys icians admitted to making a mistake. The physicians experienced emotio nal adversity. Of 27 physicians, 17 (63%) needed someone to talk to, 1 3 (48%) needed to review their case management, 16 (59%) needed profes sional reaffirmation, and eight (30%) needed personal reassurance. Hav ing someone to talk to was the support that 12 (44%) of the 27 physici ans valued most. Eighteen (67%) of 27 received this support from someo ne other than their peers. Although all subjects recognized their coll eague's pain and need for support in the hypothetical scenario, only n ine (32%) of 28 physicians would have unconditionally offered support. Conclusion: Malting mistakes unfavorably affects family physicians an d creates a strong need for support. Family physicians may benefit fro m sharing experiences that diminish perfectionism and recognize mistak es as a natural part of practicing medicine. Further research needs to address how physicians can be encouraged toward therapeutic self-disc losure and peer support.