Brian Goldman

Host, White Coat, Black Art, CBC Radio One
Toronto, Canada

About Brian

Bio

I've been a staff ER physician at Mount Sinai Hospital for more then twenty years. I've been a writer broadcaster almost as along. Since 2007, I have hosted White Coat, Black Art on CBC Radio One in Canada. WCBA is a provocative show about the culture of health care. My specialty is getting inside the heads and hearts of health care professionals. In 2010, my first book, 'The Night Shift' was published by HarperCollins Canada. The book has me writing about what it's like to work in the ER during the graveyard shift. I use the book as a jumping off point to talk about what I think ails modern healthcare and how to fix it.

An idea worth spreading

Making doctors and nurses feel bad about errors doesn't make them safer; it makes them want to cover up their mistakes.
You don't need a family doctor or an internist to diagnose and treat a bladder infection.
Instead of building a practice, doctor should aim to get rid of their patients by teaching them how to look after themselves.

I'm passionate about

I want to make health care safer for patients by obliterating the culture of shame about making all medical mistakes. I also want to make health care more efficient, accountable and more human.

Comments & conversations

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Brian Goldman
Posted over 1 year ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Dear Lizzie, Thank you so much for commenting on my talk. You are not alone. Physicians are often burdened by the fear of making mistakes. Perhaps knowing that you are not alone will help you. Try to think about how much better you will be as you process mistakes and learn from them. From time to time, I remind myself to think about the lives I've saved by learning from the mistakes I have made. Dr. Brian Goldman
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Brian Goldman
Posted over 1 year ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Teresa, thank you so much for a succinct and masterful analysis of the shame dilemma facing health professionals. In my arc following a mistake or a calling out, I usually journey from distress to eustress. In other words, I go from paralysis to action - from feeling bad about myself to figuring out what I can take from what happened and what I can learn. I find that apologies help me regain a sense of balance. An apology followed by the reaction of the person harmed helps remove from me a sense of having transgressed absolutely and replaces it with a more realistic assessment of the impact of my mistakes. I would love to read your dissertation. Dr. Brian Goldman ER Physician Mount Sinai Hospital, Toronto
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Brian Goldman
Posted over 1 year ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Dr. Brian Goldman says: I am so gratified that TED.com has featured my talk so prominently. Since it was posted, I have heard many stories from health professionals who have learned that talking about mistakes can make the system safer. I have met extraordinary people like Dr. Teodor Grantcherov, a surgeon in Toronto who is building a flight data recorded or 'black box' to record events including errors in the operating room. We CAN make health care safer for patients.
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Brian Goldman
Posted about 2 years ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Tom R: You are one of hundreds of reasons why I'm so glad I did my talk. I love your firm but supportive approach to errors - and especially your systematic approach to investigating, correcting and mitigating the error as quickly as possible. Your approach as a supportive yet responsible supervisor stands in marked contrast to that of many a Dep't head seems capable only of blaming and shaming underlings. That is a dereliction of duty. In the "let's find the guilty party" approach to medical errors, the system gives many supervisors free pass. You get it, and I salute you for it.
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Brian Goldman
Posted over 2 years ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Thanks to all of you for this thread. Patrick's point bears repetition. Health professionals may feel bad inside for perceived mistakes. But that does not in any way prove or even imply an actionable case in court. In fact, many health professionals rush to "take the blame" simply because the system seems to want that. It is easier for the system to put the bad outcome behind it if it can chalk it up to a human lapse. I would suggest to you that some of the fixes - cradle to grave electronic health records, automated medication reconciliation, real tine decision support, and systematic elimination of on the job distractions - are available yet are likely considered too expensive to implement. In other words, the system is most certainly not the safest system money can buy.
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Brian Goldman
Posted over 2 years ago
Brian Goldman: Doctors make mistakes. Can we talk about that?
Dr. Kim, thanks for your comments. I have indeed heard of and participated in many M&M rounds, so it's not quite the devastating criticism that you make it out to be. Studies have shown that M&Ms under report surgical complications and deaths http://www.ncbi.nlm.nih.gov/pubmed/17084322 M&M tends to be biased because it is largely retrospective. The people who run M&M are obliged to find things that were done wrong without necessarily being able to find a causative link between the injury and what was done wrong. Furthermore, M&M is more emotion-laden and shame-inducing because it is driven by bad outcomes. As a result, I much prefer the concept of the debrief, a routine, systematic yet efficient analysis used in aviation. We're just starting to incorporate debriefing in various medical environments. http://www.ncbi.nlm.nih.gov/pubmed/18792656 I'm glad you're getting better by learning through the experience of your senior residents' triumphs and challenges. I disagree with your assertion that everything in medicine is obsessively documented. My colleague Dr. Teodor Grantcharov is one of the first to study error rates of surgeons in laparoscopic procedures. He says direct observation is not a part of surgical practice.