When I get it wrong…
There are certain professions where failure just isn’t an option. Doctors, like pilots, are in an industry space where risk tolerance is very low. Everyone wants (and needs) us to get it right, 100% of the time. I wish that were possible.
Unfortunately, it’s just not human to be infallible. I’m sure there’s a team of software engineers in a caffeine fueled craze trying to sort out how exactly to use AI to solve this problem. But alas, we’re not there yet.
So where are we? We use a mix of patient subjective report, diagnostic criteria, tests, patterns, imaging, response to treatment, prior clinician experience, and research to settle on the best possible diagnosis. We test and then retest, second guess and never assume, always working towards a firmer understanding of the problem. Every step in this process is aimed at getting our risk of being wrong as low as possible.
Over the years we’ve gotten pretty good! We’ve got antibiotics and the ability to replace joints (think about that for a second). And we advance every, single, day.
But no matter what you make of it, medicine is well educated guess work. It’s guaranteed that sometimes myself (and every other doctor ever) are going to get it wrong.
Thankfully I work in an environment that’s rarely strewn with emergencies. With a fair amount of explanation on my part, combined with patient trust, I usually have the luxury of time to solidify my understandings of the body and its dysfunctions.
But not always. Just the other week, I got it pretty wrong. That’s life, well to be human. But it feels absolutely awful. People don’t expect you to get it wrong, at least not for them. I end up playing back the sessions in my head both consciously and unconsciously looking for the moment when I could have made a different choice. Looking for my opportunity to be right, to be perfect.
I understand the disappointment and frustration of mis-diagnoses so well because I spent years on the patient side of that experience. It’s why I became a physical therapist. All I’ve ever wanted to do was be different, to be healing.
I need to quiet the little voice that screams imposter and settle myself to offer my best. I need to reconcile with my own humanity, limitations, and skills.
I got it wrong. And that sucks. But it also happens. So, what next?
Tell me. I try to make sure everyone knows that this is a give-and-take, trial-and-error process. If I get it wrong, we’re not out of options. We just need to pivot. One thing I can always promise, you’ve at least got my best.
