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Some Lessons Are Given the Hard Way

By Michael J. Schreck, MD, FAAOS

Bad outcomes and complications happen to us all as surgeons. If you don’t have complications, either you don’t operate or you have your head buried in the sand. I am still fairly early in my career, however I have certainly had my share of poor outcomes. My range of emotions has been from anger and frustration, to sadness and guilt. I take bad outcomes very personally, as I want every patient to do well. However, I handle them much differently now as compared to when I first started in practice. In the very beginning, I took complications very hard. I felt that I was a failure as a surgeon. My wiser senior partners explained to me that these things happen to the best of surgeons, and that a bad outcome is not an indictment on you as a surgeon. Over time, I have still found it difficult to fight back negative feelings, but I have come to a place of not so much acceptance, but an understanding that not every surgery can be perfect. Be that as it may, it is extremely disappointing when a surgery or post-op recovery does not go well. Sometimes it’s a technical error, sometimes the patient didn’t follow instructions, and sometimes it’s something beyond anyone’s control. At this stage of my career, I have found that the most helpful responses to a poor outcome are to acknowledge the outcome, come up with a solution (if there is one), and in certain cases, offer a simple “I’m sorry this happened.” The bad outcomes that I have experienced in my career have allowed me to develop a sense of humility, which I feel is a very important quality for a surgeon to have. I have found that my patients who have experienced poor outcomes have taught me a great deal about being a surgeon; these cases have often been the ones that have taught me the most in fact. Additionally, I have found that some of the most meaningful relationships that I have developed with patients, have been with those who have suffered poor outcomes.  I think that being humbled by undesirable outcomes, acknowledging what went wrong, and continuing to press forward has helped me to mature as a surgeon. Some lessons are given the hard way, but our response to these lessons is what shows us who we truly are.

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