Every day, a 727 jetliner crashes and kills all the people on board.
Not really. But every day in America, the same number of people in American hospitals lose their lives because of preventable errors. They don’t die from their disease. They are killed because of hospital acquired infections, medication errors, procedural errors, or other problems that reflect the poor design of how work is done and care is delivered.
Imagine what we as a society would do if three 727s crashed three days in a row. We would shut down the airports and totally revamp our way of delivering passengers. But, the 100,000 people a year killed in hospitals are essentially ignored, and hospitals remain one of the major public health hazards in our country.
There are a lot of reasons for this, but I’d like to suggest that one reason is a terrible burden that is put upon doctors during their training and throughout their careers. They are told that they cannot and should not make mistakes. It is hard to imagine another profession in which people are told they cannot make mistakes. Indeed, in most professions, you are taught to recognize and acknowledge your mistakes and learn from them. The best run corporations actually make a science of studying their mistakes. They even go further and study what we usually call near-misses (but perhaps should be called “near-hits.” ) Near-misses are very valuable in the learning process because they often indicate underlying systemic problems in how work is done.
If you are trained to be perfect, it is very hard to improve.