Humans versus machines Print E-mail
News - Rubrieke
Monday, 15 November 2021 13:36
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Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr Liesel van der Merwe

Recently we lost a patient due to human error. The discovery and realisation is horrific. You go cold and a pit opens up in your stomach. And then follows the task of informing the owner – whose world is going to come crashing down.

I always teach that we tell the truth – if it was our mistake, we own up to it. But that phone call is always a terrible one, as it is so unexpected for the owner. After the phone call comes the retrospective evaluation of why it happened, what went wrong, what could you have done differently and where did the system fail. 

I will not be able to sleep for several nights and wake up in a sweat after making a mistake – even if it was not a fatal one. Vets in general don’t accept failure easily. My husband and I sometimes watch air crash investigations on television at home while eating a late supper, and one thing they say with those investigations is that it is never just one thing that results in an accident, but a constellation of smaller slip-ups, which in themselves would not be critical. It is the same in medicine. 

In veterinary medicine, human medicine, any profession – mistakes will happen. No matter how much we create safety checks and systems to eliminate the possibility, fundamentally we are humans and humans will make errors.

We make decisions based on information provided and may sometimes not double check. We assume someone is going to do something because they normally do, but don’t check that it is in fact so. We are tired or stressed and don’t always think as logically or clearly as we should. 

For the client who loses his pet, this is of little comfort. In these situations though, it is important to differentiate between lack of appropriate care and negligence from human error. There is a difference between cases where insufficient time and care was taken due to a neglectful uncaring attitude versus an honest mistake or error. Once again, this is of little comfort to the client in the immediate aftermath.

Consider, however, the alternatives. Sufficient staff members to apply and manage multiple double-checking protocols for each step of a patient’s treatment and diagnosis – as we have in private hospitals?

This is costly and still does not eliminate human error, but will make it less frequent. I mention machines as lots have been said about AI and using computer algorithms to solve medical cases. Some say the accuracy is better than with human doctors. Robotic surgery is already a reality.

But do we really want a machine to be our doctor? Doctors bring more than just a diagnosis for their patients and vets do more than just give their clients a diagnosis or perform a procedure. They provide care for the pet, they handle the pet gently with care when hospitalizing, they will play with or give the pet a kiss when taking him or her out of the cage to treat or anaesthetise.

The nurses may decorate the bandage with pictures or bling. They also provide a shoulder for the client when they need support and listen when a client needs to complain or just talk about things related to their pets. You cannot get this from a machine.

We have to be prepared for a balance – humans aren’t perfect. If we are happy that our vets or doctors have the knowledge required and are honestly doing their best and utilizing resources available, then we trust them. They will still make some mistakes, but as clients or patients we have to remember that they provide us with more than just a 100% accurate diagnosis rate.

If you do not have faith in your doctor or vet, change to another doctor or vet. You need to trust them. That doesn’t mean that nothing will ever go wrong, but it means that you can know that they tried their best.

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