Pennsylvania Doctor Says Medical Schools Must Teach Future Doctor How To Make Mistakes

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A Pennsylvania doctor says its is important that medical schools teach future doctors how to make mistakes. In a blog on philly.com, Neha Vapiwala, Associate Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, says that for physicians and physicians-in-training, the consequences of a serious mistake could be life-ending or life-altering for the patient, and possibly career-ending for the doctor.

“The question is, how do we, as a medical community, always strive to avoid mistakes while simultaneously fostering a culture that makes it OK to admit fault and learn from mistakes, rather than being devastated by them,” she questions.

Vapiwala notes that while some health systems have employed “error-relief” measures to promote honesty and transparency among physicians, these are mostly in place to help mitigate the financial and legal ramifications, and don’t account for the emotional fallout from errors.

“The effect of a medical error on one’s reputation can be a far more daunting barrier to transparency,” she writes.

Decades of medical training and career-building efforts can be leveled by some bad online reviews from patients, even if they reflect personality clashes, not medical errors, she continues.

Psychological factors of shame, guilt and denial add further complexity and pose hurdles in the path to “doing the right thing.” The patient is the primary victim of a medical error, but the physician will also experience emotional fallout even if the mistake never becomes public.

Vapiwala says the medical industry can take a look at the airline industry – another field where risks and the pressure to be infallible are extremely high – to help create a model for medicine and inspire a critical shift in culture. This is especially so for medical students and residents, who are both the most vulnerable and the most impressionable members of our workforce, she says.

Vice Chair of Education in the Department of Radiation Oncology at University of Pennsylvania, Vapiwala specializes in the management of patients with genitourinary cancers, and serves as the department’s GU service chief, working collaboratively with members of the Departments of Urology, Medical Oncology, Pathology, Diagnostic Radiology and Nuclear Medicine, her bio data on the university website says.

Her work focuses on biological and technological improvements in the delivery of photon – and proton-based radiation, and she currently serves as the Principal Investigator of multiple therapeutic trials for prostate cancer patients. She has been a project leader on a Department of Defense program project grant investigating proton therapy, and has received extramural funding to develop prognostic and predictive biomarkers for novel radiosensitizers in conjunction with radiotherapy, as well as to explore the effect of yoga as a therapeutic intervention on disease-and treatment-related symptoms in prostate cancer patients undergoing external beam radiation.

She is a member of several national scientific committees dedicated to GU cancer research and education, including the American Society of Clinical Oncology Scientific Program Committee, the ASCO Genitourinary Maintenance of Certification Working Group and the American College of Radiology’s Appropriateness Criteria Panel for Prostate Cancer. Outside of clinic, she was appointed as an advisory dean in the Perelman School of Medicine at University of Pennsylvania, and is president-elect of the national Association of Directors of Radiation Oncology Programs.

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