The physician's Achilles heel-surviving an adverse event.

Area of Science:

• Medical research
• Healthcare quality and safety
• Physician well-being

Background:

• Adverse events (AEs) affect 7.5% of hospitalized patients in Canada.
• Physicians are often 'second victims' of patient AEs, experiencing significant emotional distress.
• This study is the first to examine how Canadian physicians cope with patient AEs.

Purpose of the Study:

• To evaluate coping mechanisms of physicians in Canada following patient AEs.
• To assess the prevalence of post-traumatic stress among physicians experiencing patient AEs.
• To explore the relationship between coping strategies, post-traumatic stress, and institutional culture regarding AEs.

Main Methods:

• Surveys administered to oncologists, surgeons, and trainees at Foothills Medical Centre, Calgary.
• Utilized validated instruments: Brief Cope Inventory, Impact of Event Scale-Revised (IES-R), Causal Dimension Scale, and Institutional Punitive Response scale.
• Analyzed 51 responses to assess coping strategies, PTSD prevalence, and perceptions of institutional support.

Main Results:

• Over 50% of respondents (54.9%) scored 24 or higher on the IES-R, indicating clinically concerning post-traumatic stress.
• Higher self-blame (p=0.00026) and venting (p=0.042) were associated with elevated IES-R scores.
• Physicians perceiving poor institutional support reported significant post-traumatic stress (p=0.023).
• Self-blame was a significant predictor of post-traumatic stress on multivariable logistic regression (p=0.0031).

Conclusions:

• A significant proportion of physicians experience emotional distress and post-traumatic stress following patient AEs.
• Self-blame, venting, and perceived lack of institutional support are critical factors influencing physician mental health.
• There is an urgent need for robust institutional support systems to address the emotional toll of AEs on healthcare professionals.