Medical errors are rampant in American health care, particularly in physician and hospitals services. The human and economic costs are extraordinary. And because these mistakes are virtually 100 percent avoidable, so are the deaths, injuries, pain, and cost.

A diverse range of players – policy makers, thought leaders, researchers, consumer groups, purchasers, and clinicians – are working to reduce error rates and promote the use of safer systems and practices. However, reformers continue to hit the great blue wall of medical secrecy. Physicians, hospital administrators, and other health professionals are extremely reluctant to disclose or discuss a harm-causing mistake.

This is not surprising, of course. No one likes to talk about his or her mistakes, especially mistakes that result in injury or death. These conversations are awkward and painful for all concerned. What’s more, disclosuring the truth can lead to lawsuits, disciplinary action, embarrassment, self-doubt, and diminished status in society and among peers. But ethically, all this is beside the point. Patients and their surviving family have a right to the unvarnished truth, something they rarely get absent costly and protracted lawsuits. And the health care system cannot fix what it cannot see.

Medical Errors and Medical Narcissism – a groundbreaking book by John Banja, PhD, assistant director of health services and clinical ethics at Emory University – examines the concept of “medical narcissism.” Specifically, Dr. Banja explains why a health professional’s need to preserve his or her self-esteem often robs patients and their families of the truth and perpetuates high-error medicine. He describes the “common psychological reactions of healthcare professionals to the commission of a serious harm-causing error and the variety of obstacles that can compromise ethically sound, truthful disclosure.”

In Medical Errors and Medical Narcissism, Dr. Banja explains how and why talented, hard working medical professionals often fall into narcissistic traps. Living in a world of intense stress, long hours, and high, often unfair expectations, the “medical narcissist” works hard to maintain the respect of patients and colleagues. As Dr. Banja says:

When a medical error occurs, that world of competence, adequacy, and ability is turned upside-down. It is no wonder that even when such persons want to do the right thing and disclose error, they might do it clumsily and make an already bad situation worse.

This fascinating, thoughtfully researched book includes detailed recommendations, including advice on how to:

  • Disclose errors “artfully and ethically,” including words and phrases helpful in these delicate conversations.
  • Create a “moral atmosphere” in clinics and hospitals.
  • Reform tort laws to promote full, appropriate disclosure of medical errors.Medical Errors and Medical Narcissism is available at Amazon.com.

    To learn more about the issues involved in medical errors and quality, please check out my lists of recommended books on:

  • Health care quality and patient safety.
  • Medical errors.
  • Medical malpractice.
  • Evidenced-based medicine.