Question: I was in psychiatric treatment for 4 years for panic attacks with little success until another psychiatrist discovered that I actually had a prolapsed mitral valve in my heart. Is it possible that such errors are made today? Johanna Z. Rafetti. CABA
Since the beginning of medicine, it has been proven that doctors can inadvertently harm patients and even do so by applying their own therapy.
About the year 400 a. C. Hippocrates already recommended as a basic principle “help or at least no harm”. Later, it would become “the first to do no harm”, “the first to do no harm”, which is attributed to Galen.
Iatrogenicity is understood (“iatro” = doctor; “geno” = production and “ia” = quality, as any negative consequence that occurs in a patient due to the intervention of a health professional, be it a doctor, psychologist, or psychiatrist, nurse, pharmacist, dentist).
Iatrogenicity refers to negative effects that may arise from proper medical care. /Shitterstock.
The most serious concept – and what distinguishes it from malpractice – refers to the fact that harm occurs even when the professional has applied treatment in an adequate, ethical manner, without negligence, errors or omissions.
Iatrogenicity refers to negative effects that may arise from legitimate medical care, but the environment involves negligence, recklessness, or illegal action on the part of a health professional.
In psychiatry, it is difficult to establish an exact figure on the frequency of iatrogenicity, since its negative effects can vary according to the treatment, the disorder and the unique characteristics of the patient, although it is assumed that it affects many.
Diagnostic errors, lack of adequate follow-up and poor communication between professional and patient can play a role.
Research carried out by M. Makary and M. Daniel in the US established that medical error was the third leading cause of death in that country in 2016. Norberto Abdala, psychiatrist.
These are the most frequent causes;
1) Demonstration of treatment that does not respond. For example, when it treats the healthy, with normal problems without illness (due to blindness, lack of work, relationship problems, finances).
Some researches have estimated that almost a quarter of patients who attend a mental health center do not present any mental disorder and even receive psychopharmacological medication to medicate normal aspects of their lives.
In psychiatry it is difficult to establish an accurate figure on the frequency of iatrogenesis. /Shutterstock
2) Excessive use in time and quantity due to psychotropic drugs.
3) Technically insufficient treatments such as unexcused combinations of drugs, insufficient prescription, improperly made suspensions.
4) Insufficient complementary studies.
5) Divorce of psychiatric knowledge in terms of internal medicine and confusion, for example, hypothyroidism with depression.
6) The tendency to an exaggerated organic approach without weighing the possible psychological factors that suggest psychotherapeutic and non-psychopharmacological treatment.
Rapid diagnosis and treatment is common. /Shutterstock
In our environment, the therapeutic capacity of mental health care (public or private) is generally limited and hasty diagnoses and treatments are often carried out without critical consideration of the benefits they can provide or the harm they can cause.
For example, a study conducted in the USA by M. Makary and M. Daniel determined that medical error was the third cause of death in that country in 2016.