4
‘‘Screw-ups’’
External Obstacles Faced in Becoming Patients
‘‘I’ve made terrible mistakes,’’ Harry murmured, shaking his head and
glancing down. ‘‘I’ve killed people.’’
Medical errors occur, yet now, for the first time, many of these phy-
sicians became fully aware of, and reflected on, the range of problems and
lapses in health care—from fatal flaws to poor communication. They faced
challenges, too, in how to respond to these shortfalls, either as patients or
as fellow doctors. As patients, they now faced hurdles due not only to their
illness and self-doctoring, but also to deficiencies in the wider medical
system. They evaluated their treatments as patients from the perspectives
of fellow doctors. Lay patients need to be aware of these issues as well—to
prepare for these tensions and inform their expectations, even if they do
not lessen their hopes for optimal care.
Institutional Obstacles
Though most of these doctors encountered problems and disappoint-
ments with ‘‘the system,’’ a rare few were pleased with their treatment,
and had few, if any, complaints. As mentioned earlier, several received
VIP care. Given well-known problems in health care, such special treat-
ment could cause surprise, even embarrassment. Bradley first noted chest
pain when he could not hit a drop shot in tennis. Well-respected at his
institution, he had his operation performed the next day. ‘‘My treatment
was unbelievably, embarrassingly good. I got cared for in minutes to hours.
Other people have to wait longer.’’
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