An Exploration of Healthcare Culture

The Ted Talk “Doctors make mistakes: can we talk about that?” was given by Dr. Brian Goldman, an emergency medical physician, at the TEDx Toronto 2010 conference. When I was assigned a Ted Talk analysis, I immediately remembered this Ted Talk I had stumbled across several year ago on Facebook. I re-watched the Ted Talk and experienced chills for a second time. Dr. Goldman discusses the taboo of talking about medical mistakes. Doctors are conditioned to deny or avoid their mistakes. Dr. Goldman argues that avoiding the discussion of medical mistakes is a mistake in of itself. People are led to believe that we should weed out the medical professionals who make mistakes in order to make the healthcare system better and safer, but if every time a doctor made a mistake was fired, we would be left with no one to give us medical care.

The audience was at a Ted Talk conference, therefore, I would infer that they are an educated audience, but that they are not all doctors, nor are they experts on the ins and outs of the medical field and healthcare system. To aid in his audience’s understanding, Dr. Goldman opens with an analogy to baseball. He compares a baseball player’s batting average to a medical professional’s success rate or patient outcomes.  He establishes with the audience that a perfect batting average is 1,000 and then engages the audience by asking them, theoretically, what a surgeons batting average should be. No one was surprised when a few audience members chimed in with “1000.” Dr. Goldman uses the baseball analogy and following discussion to make a base for his argument. He establishes the cultural expectation and then passionately and rationally tears it down.

Dr. Goldman uses his own experiences working in emergency medicine to describe the shame of making mistakes in his line of work. He describes the first time he ever cost someone their life and introduces the idea of “Do you remember” being the most gut wrenching words a physician could ever hear. He explains how he recalls the nurse asking, “Do you remember Mrs. Drucker?” before telling him that she had returned to the emergency room in a coma due to irreversible brain damage after he had sent her home. He returns to his “Do you remember?” theme each time he addresses one of his mistakes, and in his final sentence, the mic drop moment, he closes with “I do remember.” With a pause between each word and with the purpose in his tone, the weight of those words in the room is palpable. He is saying he remembers his mistakes and he admits them, that mistakes should foster learning and improvement of oneself, not ignorance of fault.

If I have one criticism of Dr. Brian Goldman’s speech, it is that his use of humor seems misplaced. Here he is, trying to persuade his audience that mistakes should be discussed, not to be skirted under the rug, giving personal examples of trying to discuss his own mistakes while other physicians make jokes and change the subject in the midst of awkwardness, but he jokes about his own topic to the very audience he is trying to persuade to do otherwise. This, to me, seems counter-intuitive. All in all, Dr. Goldman delivered a very clear message with passion. I think he made his point and I hope he continues to try to make a change in the convoluted spectrum of medicine. 

Doctors make mistakes. Can we talk about that?