MMA Viewpoint
The Importance of Humility in Quality Care
During the last year, I’ve used this column to discuss the five pathways to quality identified by the MMA’s committee on quality medical care. This month, I’ll address the fifth—humility. In the practice of medicine, we frequently encounter high-stress situations and deal with strong personalities and large egos. Too often, conflicts arise and communication breaks down. As a result, the quality of medical care suffers and our patients suffer. A humble spirit can help us prevent this from happening by allowing us to understand the other person, address the issues, and improve communication.
When an error has been made, the most powerful form of communication is an apology. An apology nearly always brings people closer together. Sometimes a leader needs to apologize if a group of people is to blame for a mistake. Acknowledgement by someone at the top often does much to move parties in conflict toward harmony and issues toward resolution.
In medical practice, as in all endeavors, errors occur. When the outcome of practice is less than we would hope for, we must have the humility to fully acknowledge and analyze the problem—and then apologize, even though it may be difficult. In an editorial in the May 25 issue of the New England Journal of Medicine, Sen. Hillary Rodham Clinton of New York and Sen. Barack Obama of Illinois pointed out how difficult this is in our litigious society: “The current tort system does not promote open communication to improve patient safety. On the contrary, it jeopardizes patient safety by creating an intimidating liability environment.” During the 2006 legislative session, the MMA supported the passage of an “I’m sorry” law, which would have allowed physicians to offer a full apology without assuming the risk that this disclosure would increase their liability. Even though this law did not pass, expressing empathy for the patient and expressing sorrow for the medical outcome is possible. Many malpractice carriers now encourage physicians to offer apologies and do not view them as increasing liability exposure.
Humility requires us to truly contemplate the quality of our medical practices. It takes humility, along with concern and confidence, to listen to our patients’ as well as our colleagues’ ideas for change. This, however, is precisely what is needed when we are setting up systems that will ensure that our patients get the care they need and deserve every time they enter our clinic or hospital. I am aware, as I finish this series of articles on the pathways to quality, that it is truly humbling to work in a fulfilling profession that improves the lives and health of our fellow human beings and that evaluating our practices as we move toward quality is well worth our time and effort.