The Physician as a “Second Victim”

Today, my colleagues Dr. Judi Turner and Dr. Anahat Dhillon (UCLA)  joined me to give a workshop at the Society for Education in Anesthesia Fall Meeting on the aftermath of perioperative catastrophe and the concept of the physician as a second victim.   The idea of the “second victim” isn’t new – people have long understood that family members and friends are second victims when harm befalls their loved ones.  We presented evidence that physician involvement in perioperative catastrophes (such as deaths or significant complications) has profound psychological effects that are lasting.  This can occur whether an error has been made or not.  Some develop signs and symptoms consistent with clinical depression or even post-traumatic stress disorder (PTSD), which may take months or even years to resolve.  We discussed the potential impact of these effects on subsequent patient care, and what resources and departmental responses might best support these physicians.  We also talked about debriefing teams, and whether optional or mandatory debriefing should occur, who should lead it, and who should be present.  It was a lively conversation, and the group generated a lot of great ideas, some of which I’ll be sharing when I go to Yale this winter as a Visiting Professor.  I’ll be giving a resident lecture on this topic, and a departmental Grand Rounds about my favorite topic – cognitive error in decision making.

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