By October 26, 2009 3 Comments Read More →

"McDreamy" Fights the Blame Game on "Grey’s Anatomy"

Grey’s Anatomy : I Saw What I Saw

I’m not normally a Grey’s Anatomy watcher (yeah, right, some of you might say… but I’m not). My wife watches the show every week. I paid close attention to this past weekend’s Tivo showing because my MIT friend Aaron tipped me off that this episode dealt with issues of blame…

I’ll try to summarize the story in my layman’s terms (both as a non-doctor and a non-Grey’s watcher). You can watch the whole episode online (for a few weeks, anyway) and I’m posting a clip below.

A young MD was examining a woman in the E.D., a burn victim from a hotel fire, a mass casualty event. To say it was hectic in the E.D. would be an understatement.

She was about to look down the patient’s throat with a scope and was distracted (a patient was wheeled by with axe in his chest – yikes!!). She turned back and said “you look great.” The patient ended up dying after respiratory distress and multiple organ failure… the investigation was a series of individual interviews that seemed like a witch hunt. In the very first scene of the show, the chief foreshadowed at the start of the investigation that he was looking for “who” was responsible.

The investigation panel fired the MD when they realized she hadn’t looked down the patient’s throat.

This scene toward the end is an exchange between the Chief of Surgery and Dr. Shepard (aka “McDreamy” — not my nickname for him).

Dr. Shepard says “It’s not the doctor… they’re all good doctors.”

The Chief said he “needed to know WHO finally was responsible… at least I was able to do that.”

Drew a big sigh from McDreamy.

“Maybe it’s not one doctor… maybe it’s too many doctors who don’t know each other and who don’t trust each other. When I got to that room, it was chaos. Because that’s the system now — chaos. That’s the system that’s been in place since this merger, your system. I’m saying you should look again at who’s responsible.”

Dr. Deming (not a medical doctor) would be proud. Who is responsible for the system? Top leadership Why fire an individual for a mistake that could have happened to any of them in those conditions?

Dr. Yang makes this exact same point, that it was a systemic error — “our patients didn’t die, that’s why we didn’t get caught.” The process was bad for all, but the only one who got punished was the one with the bad result pinned on them.

To those of you working in situations like this, how realistic was the portrayal on the show? It leads to a great discussion topic — would you have fired the physician? What would you do instead of focus on fixing the system and preventing a similar error in the future?


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

3 Comments on ""McDreamy" Fights the Blame Game on "Grey’s Anatomy""

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  1. Brian Buck says:

    Outstanding Mark.

    This made me think how important the principle of direct observation is. If those who were looking to blame a person went and actually saw the chaotic system, hopefully they would change their tune. Maybe the chaos would have died down by the time they arrived, but talking with the people involved could have helped before blame was placed. It looks like nobody spoke with McDreamy until AFTER the blame was done.

    We never want to blame a person but it is even worse if you blame from a conference room far away in space and time from where the problem happened.

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