Difficult Conversations: Nine Common Mistakes

Mistake #1: We fall into a combat mentality.
When difficult conversations turn toxic, it's often because we've made a key mistake: we've fallen into a combat mentality. This allows the conversation to become a zero-sum game, with a winner and a loser. But the reality is, when we let conversations take on this tenor – especially at the office – everyone looks bad, and everyone loses. The real enemy is not your conversational counterpart, but the combat mentality itself. And you can defeat it, with strategy and skill.

Mistake #2: We try to oversimplify the problem.
If the subject of your argument were straightforward, chances are you wouldn't be arguing about it. Because it's daunting to try and tackle several issues at once, we may try to roll these problems up into a less-complex Über-Problem. But the existence of such a beast is often an illusion. To avoid oversimplifying, remind yourself that if the issue weren't complicated, it probably wouldn't be so hard to talk about.

Mistake #3: We don't bring enough respect to the conversation.
The key to avoiding oversimplification is respecting the problem you're trying to resolve. To avoid the combat mentality, you need to go further – you need to respect the person you're talking to, and you need to respect yourself. Making sure that you respond in a way you can later be proud of will prevent you from being thrown off course if your counterpart is being openly hostile.

Mistake #4: We lash out – or shut down.
Fear, anger, embarrassment, defensiveness – any number of unpleasant feelings can course through us during a conversation we'd rather not have. Some of us react by confronting our counterpart more aggressively; others, by rushing to smooth things over. We might even see-saw between both counterproductive poles. Instead, move to the middle: state what you really want. The tough emotions won't evaporate. but with practice, you will learn to focus on the outcome you want in spite of them.

Mistake #5: We react to thwarting ploys.
Lying, threatening, stonewalling, crying, sarcasm, shouting, silence, accusing, taking offense: tough talks can present an arsenal of thwarting ploys. (Just because you're trying to move beyond the combat mentality doesn't mean your counterpart is.) But you also have an array of potential responses, ranging from passive to aggressive. Again, the most effective is to move to the middle: disarm the ploy by addressing it. For instance, if your counterpart has stopped responding to you, you can simply say, "I don't know how to interpret your silence."

Mistake #6: We get "hooked."
Everyone has a weak spot. And when someone finds ours – whether inadvertently, with a stray arrow, or because he is hoping to hurt us – it becomes even harder to stay out of the combat mentality. Maybe yours is tied to your job – you feel like your department doesn't get the respect it deserves. Or maybe it's more personal. But whatever it is, take the time to learn what hooks you. Just knowing where you're vulnerable will help you stay in control when someone pokes you there.

Mistake #7: We rehearse.
If we're sure a conversation is going to be tough, it's instinctive to rehearse what we'll say. But a difficult conversation is not a performance, with an actor and an audience. Once you've started the discussion, your counterpart could react in any number of ways – and having a "script" in mind will hamper your ability to listen effectively and react accordingly. Instead, prepare by asking yourself: 1. What is the problem? 2. What would my counterpart say the problem is? 3. What's my preferred outcome? 4. What's my preferred working relationship with my counterpart? You can also ask the other person to do the same in advance of your meeting.

Mistake #8: We make assumptions about our counterpart's intentions.
Optimists tend to assume that every disagreement is just a misunderstanding between two well-intentioned people; pessimists may feel that differences of opinion are actually ill-intentioned attacks. In the fog of a hard talk, we tend to forget that we don't have access to anyone's intentions but our own. Remember that you and your counterpart are both dealing with this ambiguity. If you get stuck, a handy phrase to remember is, "I'm realizing as we talk that I don't fully understand how you see this problem." Admitting what you don't know can be a powerful way to get a conversation back on track.

Mistake #9: We lose sight of the goal.
The key in any tough talk is to always keep sight of the goal. Help prevent this by going into conversations with a clear, realistic preferred outcome; the knowledge of how you want your working relationship with your counterpart to be; and having done some careful thinking about any obstacles that could interfere with either. (Remember, "winning" is not a realistic outcome, since your counterpart is unlikely to accept an outcome of "losing.") If you've done the exercise described in Slide 7, this should be easier. And you'll be less likely to get thrown off course by either thwarting ploys or your own emotions.

When we're caught off-guard, we're more likely to fall back into old, ineffective habits like the combat mentality. If you're not the one initiating the tough conversation, or if a problem erupts out of nowhere, stick to these basics: keep your content clear, keep your tone neutral, and keep your phrasing temperate. When disagreements flare, you'll be more likely to navigate to a productive outcome – and emerge with your reputation intact.

http://hbr.org/web/slideshows/difficult-conversations-nine-common-mistakes/1-slide

Recovering From Postdoc Mistakes

"The best thing you can do in a postdoc is to do things that you enjoy," urges Doon Gibbs, deputy director for science and technology at Brookhaven National Laboratory, who has overseen the supervision of many postdocs over 25 years. Ensure those tasks are noticeable, such as publishing papers and presenting at conferences, he adds. But possessing a passion and self-promotion prowess alone does not a successful scientist make. Too often postdocs end up making mistakes along the way that can sideline them from the vocation they desire. Whether it is spending too long in a postdoc appointment, relying too much on their advisor, or simply not taking ownership of their career, there are many possible ways that early-career scientists can blunder. But luckily, there are clever means and methods to remedy even the most serious of slip-ups. By Alaina G. Levine

Why Am I Here?

The postdoc appointment is meant to serve as the stepping-stone to victory in academic science and certain positions in industry, says Harold Myron, former director of education programs at Argonne National Laboratory. The job is designed as a training program to instill certain skills, techniques, tools, and tactics for pursuing advanced research. Ideally, a postdoc should sharpen their innovative problem-solving abilities and learn to manage research group resources, such as employees and grant money.

Too often graduate students take a postdoc appointment for the wrong reasons, which of course, can be a mistake in and of itself. There is a decades-old tradition that "the postdoc is a training ground for a tenure-track position, that this is the metric for success for young scientists," saysCathee Phillips, executive director of the National Postdoctoral Association (NPA). "Postdocs have heard this for years, which causes them not to think about their own strategic career plan, because they think the postdoc will naturally flow into a tenure-track position." But with only 20 percent of postdocs advancing to tenure-track employment, many find themselves realizing too late, or waiting too long, to make a career plan with tangible contingency options.

Sebastian (not his real name), who works as an administrator at a medical school in the southern United States, admits he made a number of mistakes in his two postdocs, not the least of which were going in naively and staying too long without a concrete career plan. "If you don't want a tenure-track position, then there's no reason to do a postdoc," he declares, and reveals that his lack of planning led to miscommunication with his bosses and wasted time.

In his first appointment, which only lasted a year, Sebastian's principal investigator (PI) needed someone experienced in a particular biomedical technique, which he did not have. The mentor did not have time to train his protégé, which led to arguments. "It was the wrong lab for me, and my naivety led me to accept bullying [from my advisor]," he says. "My mistake was that I stayed as long as I did."

Ultimately, Sebastian recovered from what could have been a costly career blunder by forging his own path into academic program management. "It is vitally important for postdocs to be aggressive and take charge of their careers," he cautions.

All The Doctorates Are Doing It…

When deciding whether to accept a particular postdoc, it is paramount to confirm that you are proceeding with the appointment for the right reasons.

However, frequently, graduate students venture into a postdoc out of a feeling of desperation for a job, resulting in a lack of inquiry about basic elements of the appointment and little or no negotiation for benefits. "When you're finished with your Ph.D., people look into what postdocs they want," confesses Jimmy Weterings, whose appointment took place at Vrije Universiteit Amsterdam in the Netherlands, and who is currently seeking an academic position. "There are some people, and I count myself among them, who will take anything—it's a safety feeling. You finished your Ph.D., you know you will have income, but I didn't think beyond the two years."

Weterings, who did not possess a strategic plan, neglected to bargain for essentials that would have bolstered his career progression, such as teaching his own course. "In hindsight, I learned a lot about negotiation and talking with people," he says. Weterings advises you can prevent this common mistake by relinquishing the feeling of desperation that you have to take a job without asking vital questions about it from the start. And "don't take the first one that comes along," he adds. "Think if it's the right opportunity, ask yourself 'what will I accomplish'?"

Fiona (not her real name), who recently finished a two-year biology postdoc at a state university in the western U.S., had been thinking of leaving academia after earning her Doctorate. She decided to pursue the postdoc anyway because finishing her thesis left her "on a high," and she thought "it might be rash" to depart the tenure-track too soon. Her gaffe was that she did "not question people enough" about what she would be doing day-to-day. "I was so excited about getting a job,…I didn't think to ask how people in the lab generally felt," she says.

Within the first year of her appointment, her project lost funding. There was no financial support to attend conferences. And with a PI who was close to retirement and on sabbatical, Fiona discovered difficulty maintaining motivation.

But Fiona was lucky in one respect: Although she did not have a crystallized career plan when she entered her postdoc, she did have ideas about where she wanted to go next. She leveraged her postdoc experience to launch a fulfilling career in medical writing.

Help! I'm In a Postdoc And Can't Get Out!

Although the number of years one spends in a postdoc differs depending on the chosen field, specialty, and career choice, most advisors agree that three to five years should be the cut-off point. Yet, some postdocs stay much longer, languishing with seemingly no end in sight—a big mistake, stress some experts. "The postdoc experience is not meant to be limitless," saysTrevor Penning, who served as associate dean for postdoctoral research and training at the University of Pennsylvania School of Medicine from 1997 to 2005.

Some stay because they don't know what else to do. "Knowing you have x years, a postdoc must develop a timeline and goals," continues Penning. "Go home every night and ask yourself 'what did I accomplish today that furthered my career?' If every day you accomplish nothing, you need to take action…it's a warning sign of bad things." With improper planning and a lack of assertiveness, early-career scientists can get stuck in a seemingly endless hamster wheel of postdoc appointment after appointment. After not landing a tenure-track position the first or second time around, some postdocs simply stay put where they are while others pursue another postdoc.

Gibbs is concerned that a postdoc who stays too long could be taken advantage of by their supervisor. Sebastian for example, feels he was treated as a technician during his postdoc. According to other associates and even PIs, it is not uncommon for some postdocs to be looked upon as an extra pair of hands and be charged with less complex routine tasks, as opposed to more creative, scientifically driven endeavors.

"If you find yourself in a situation that is untenable, [ask yourself] 'is it in my best interest to stay in the lab?'" suggests Penning. Identifying the problem early is critical. "It's much better to lose one year than five."

The Medium Is Me (And My Mentor)

Your mentor has the potential to heavily influence your career. But it is your career. Mary (not her real name), who received her Ph.D. in the biological sciences, proffers serious counsel regarding the all-to-frequent misstep of allocating complete control of your livelihood to another person, especially your supervisor. "Never expect your mentor to only be looking out for you. You have to look out for yourself," she says. After all, "your boss's priority is their own career."

There is so much riding on your relationship with your PI, so "choose your postdoc mentor carefully," warns Mary. In addition to serving as your advisor, and ideally as a coach and champion, a good mentor should help orchestrate pathways for you to advance to the next stage of your career. So examine his or her track record of training associates, and pick "someone who moves people on to successful positions," she says.

Mary made the mistake of not checking on this before securing her appointment. Her PI had never gotten anyone through a Ph.D., let alone on to a good job, she claims. As such, her career has progressed at a very slow pace. She is now in her second postdoc at the same institution where she received her Doctorate.

"Postdocs have to be realistic about what to expect from their mentors," says Phillips. "These are busy people, and just because they hired postdocs doesn't mean they will automatically be good mentors, particularly if you are looking at a career outside of academia." Moreover, "the [appointment] is a two-way street with the mentor," notes Penning, "but the postdoc has to take ultimate responsibility for their own career success or failure."

Pedigree Is Not Always Key

Another classic conundrum is the sometimes misguided conviction that in order to progress in academe, you must spend your postdoc in a big, well-funded research group, says Carla (not her real name), a biologist who completed a five-year postdoc at a prestigious private university. But a large lab run by a famous scientist doesn't guarantee direct value for the postdoc, as she found out the hard way.

Carla, who is an assistant professor at a medical school in the eastern U.S., divulges that her postdoc was complicated by lack of face time with her PI. The supervisor was well-known and traveled extensively. He directed an enormous lab, consisting of a score of postdocs who were all jockeying for time with their advisor. Upon returning from his trips, the PI "would only talk to those whose projects meant the most to him or to people close to submitting a paper," she says.

But her research was not the group's main focus, so she did not receive substantial opportunity to meet with her mentor. Carla recommends staying on the supervisor's "radar screen" by making a careful decision to work on a project that is the highlight of the lab, she says.

"The largest labs may not give you the skills to be a professional scientist," warns Penning. And selecting your mentor "is not just about the lab's pedigree," he adds. "Choosing the wrong person to be a mentor can make an experience go south from the beginning."

But by networking and seeking out other mentors besides their PI, a postdoc can remedy a difficult situation. "They can't depend only on the PI for points of contact," says Philip S. Clifford, associate dean of the Graduate School of Biomedical Sciences at the Medical College of Wisconsin.

If there is confusion as to whether your supervisor is actively participating in your professional advancement, "it boils down to good communication between the mentor and the postdoc," states Penning. "When you ask for help, if help is not forthcoming, your decision is easy: you find another mentor."

When Another Postdoc Takes Over

There is great internal competition among postdocs that is often not acknowledged, admits Carla. She describes how another person in her lab "liked my project and usurped it," and the PI, whose management skills were subpar, did nothing. Carla was then faced with the decision of whether to leave the lab, start something fresh, or partner with someone who seemed like the enemy. "I decided to collaborate," she recalls, "but I ended up suffering because the other person ended up talking about it on job talks," which she felt limited her ability to use it in presentations for academic positions.

Carla's solution was to recognize that there was enough room in the job market and in the research field for her to differentiate herself from the other party. But "the onus was on me to distinguish myself," she says. "I took the hard road, but in the end, this gives the most meaning in science."

If you find yourself in a situation where you are faced with an internal rivalry that could backfire, Carla suggests speaking with the PI and the other person to find ways to partner together. For example, there might be an angle that allows both people to co-first-author a manuscript. Communication is crucial, she says, "so everyone maxes out the benefits." The bottom line is you don't want to burn any bridges.

There is great internal competition among postdocs that is often not acknowledged, admits Carla. She describes how another person in her lab "liked my project and usurped it," and the PI, whose management skills were subpar, did nothing. Carla was then faced with the decision of whether to leave the lab, start something fresh, or partner with someone who seemed like the enemy. "I decided to collaborate," she recalls, "but I ended up suffering because the other person ended up talking about it on job talks," which she felt limited her ability to use it in presentations for academic positions.

Carla's solution was to recognize that there was enough room in the job market and in the research field for her to differentiate herself from the other party. But "the onus was on me to distinguish myself," she says. "I took the hard road, but in the end, this gives the most meaning in science."

If you find yourself in a situation where you are faced with an internal rivalry that could backfire, Carla suggests speaking with the PI and the other person to find ways to partner together. For example, there might be an angle that allows both people to co-first-author a manuscript. Communication is crucial, she says, "so everyone maxes out the benefits." The bottom line is you don't want to burn any bridges.

The Portal To Success

Every vocation has potential pitfalls and every professional has made their share of mistakes. Whether it's spending too much time in "PostdocLand," choosing the wrong mentor or lab, or not having a targeted career plan with flexibility for unforeseen twists, there will always be opportunity to err in academic science. Fortunately, as sources say, if you recognize that you are in the driver's seat, acknowledge a problem's existence early on, and focus on finding a resolution, you can recover and discover success. There are plenty of resources to aid you on your adventure, (see " It Pays to Plan: Why You Need a Career Map," DOI:10.1126/science.opms.r1000098), and best of all, if you learn from your mistakes, some might argue they were never mistakes in the first place. As James Joyce wrote, "A man of genius makes no mistakes. His errors are volitional and are portals of discovery."

This article was published as an advertising feature in the March 18, 2011, issue of Science.

http://sciencecareers.sciencemag.org/career_magazine/previous_issues/articles/2011_03_18/science.opms.r1100101

Top 10 Science Mistakes

1: The Circulatory System

You don't have to be a doctor to know how important the heart is...but back in ancient Greece, you could be a doctor and STILL have no idea how important the heart is.

Back then, doctors like second-century Greek physician Galen believed (no kidding) that the liver (not the heart) circulated blood (along with some bile and phlegm), while the heart (really) circulated "vital spirit"(whatever that is).

How could they be so wrong? It gets worse.

Galen hypothesized that the blood moved in a back-and-forth motion and was consumed by the organs as fuel. What's more, these ideas stuck around for a very long time. How long?

It wasn't until 1628 that English physician William Harvey let us in on our heart's big secret. His "An Anatomical Study of the Motion of the Heart and of the Blood in Animals" took a while to catch on, but a few hundred years later, it seems beyond common sense -- perhaps the ultimate compliment for a scientific idea.

2: The Earth Is the Center of the Universe

Chalk it up to humanity's collectively huge ego. Second-century astronomer Ptolemy's (blatantly wrong) Earth-centered model of the solar system didn't just stay in vogue for 20 or 30 years; it stuck around for a millennium and then some.

It wasn't until almost 1,400 years later that Copernicus published his heliocentric (sun-centered) model in 1543. Copernicus wasn't the first to suggest that the we orbited the sun, but his theory was the first to gain traction.

Ninety years after its publication, the Catholic Church was still clinging to the idea that we were at the center of it all and duking it out with Galileo over his defense of the Copernican view. Old habits die hard.

3: Germs in Surgery

Laugh or cry (take your pick), but up until the late 19th century, doctors didn't really see the need to wash their hands before picking up a scalpel.

The result? A lot of gangrene. Most early-19th century doctors tended to attribute contagion to "bad air" and blamed disease on imbalances of the "four humors" (that's blood, phlegm, yellow bile and black bile, in case you weren't familiar).

"Germ theory" (the revolutionary idea that germs cause disease) had been around for a while, but it wasn't till Louis Pasteur got behind it in the 1860s that people started listening. It took a while, but doctors like Joseph Lister eventually connected the dots and realized that hospitals and doctors had the potential to pass on life-threatening germs to patients.

Lister went on to pioneer the idea of actually cleaning wounds and using disinfectant. Remember him next time you reach for the Purell.

4: DNA: Not So Important

DNA was discovered in 1869, but for a long time, it was kind of the unappreciated assistant: doing all the work with none of the credit, always overshadowed by its flashier protein counterparts.

Even after experiments in the middle part of the 20th century offered proof that DNA was indeed the genetic material, many scientists held firmly that proteins, not DNA, were the key to heredity. DNA, they thought, was just too simple to carry so much information.

It wasn't until Watson and Crick published their all-important double-helical model of the structure of DNA in 1953 that biologists finally started to understand how such a simple molecule could do so much. Perhaps they were confusing simplicity with elegance.

5: The Atom Is the Smallest Particle in Existence

Believe it or not, we weren't actually all that stupid in ancient times. The idea that matter was composed of smaller, individual units (atoms) has been around for thousands of years -- but the idea that there was something smaller than that was a bit harder to come by.

It wasn't until the early 20th century, when physicists like J.J. Thompson, Ernest Rutherford, James Chadwick and Neils Bohr came along, that we started to sort out the basics of particle physics: protons, neutrons and electrons and how they make an atom what it is. Since then, we've come a long way: on to charmed quarks and Higgs bosons, anti-electrons and muon neutrinos. Let's hope it doesn't get too much more complicated than that.

6: The Earth Is Only 6,000 Years Old

Once upon a time, the Bible was considered a scientific work. Really. People just kind of assumed it was accurate, even when it didn't make much sense.

Take the age of the planet, for example.

Back in the 17th century, a religious scholar took a hard look at the Bible and estimated that creation happened around 4004 B.C. (you know, approximately). Add in nearly 2,000 more years to get to the 18th century, when Western, Bible-reading geologists started to realize that the Earth was constantly shifting and changing, and you get about 6,000 years.

Hmm ... those biblical scholars may have been a bit off. Current estimates, based on radioactive dating, place the age of the planet at around, oh, 4.5 BILLION years.

By the 19th century, geologists started putting the pieces together to realize that if geologic change was happening as slowly as they thought it was, and if this Darwin guy was at all right about evolution (which was also a slow process), the Earth had to be WAY older than they had thought. The emergence of radioactive dating in the early 20th century would eventually prove them right.

7: The Rain Follows the Plow

If only it were so easy. It's actually kind of shocking that humanity held on to the idea that land would become fertile through farming for so long. Didn't anyone look around and see that all this farming of arid land wasn't doing much?

So much for observation.

In reality, this quite erroneous theory (popular during the American and Australian expansions) may have stayed alive in part because it did sometimes work -- or at least it seemed to work.

What we know now is that the plow wasn't actually bringing the rain; long-term weather patterns were. Arid regions (like the American West, for example) go through long-term cyclical droughts, followed by cycles of wetter years. Wait long enough and you'll get a few wet ones.

There's just one problem: wait a few more years and all the rain just goes away - only now, you've got a civilization to support.

8: Phlogiston

What? You've never heard of phlogiston? Well, don't beat yourself up about it, because it's not real.

Phlogiston, proposed in 1667 by Johann Joachim Becher, was another element to add to the list (earth, water, air, fire and sometimes ether); it wasn't fire itself, but the stuff fire was made of. All combustible objects contained this stuff, Becher insisted, and they released it when they burned.

Scientists bought into the theory and used it to explain a few things about fire and burning: why things burned out (must have run out of phlogiston), why fire needed air to burn (air must absorb phlogiston), why we breathe (to get rid of phlogiston in the body).

Today, we know that we breathe to get oxygen to support cellular respiration, that objects need oxygen (or an oxidizing agent) to burn and that phlogiston just doesn't exist.

9: Heavier Objects Fall Faster

OK, trick question: do heavier objects fall faster than lighter ones? Today, we all know that they don't, but it's understandable how Aristotle could've gotten this one wrong.

It wasn't until Galileo came along in the late 16th century that anyone really tested this out. Though he most likely did not, as legend holds, drop weights from the tower of Pisa, Galileo did perform experiments to back up his theory that gravity accelerated all objects at the same rate. In the 17th century, Isaac Newton took us a step further, describing gravity as the attraction between two objects: on Earth, the most important being the attraction between one very massive object (our planet) and everything on it.

A couple of hundred years later, Albert Einstein's work would take us in a whole new direction, viewing gravity as the curvature that objects cause in space-time. And it's not over. To this day, physicists are ironing out the kinks and trying to find a theory that works equally well for the macroscopic, microscopic and even subatomic. Good luck with that.

10: Alchemy

The idea of morphing lead into gold may seem a little crazy these days, but take a step back and pretend you live in ancient or medieval times.

Pretend you never took high-school chemistry and know nothing about elements or atomic numbers or the periodic table. What you do know is that you've seen chemical reactions that seemed pretty impressive: substances change colors, spark, explode, evaporate, grow, shrink, make strange smells - all before your eyes.

Now, if chemistry can do all that, it seems pretty reasonable that it might be able to turn a dull, drab, gray metal into a bright, shiny yellow one, right? In the hopes of getting that job done, alchemists sought out the mythical "philosopher's stone," a substance that they believed would amplify their alchemical powers.

They also spent a lot of time looking for the "elixir of life." Never found that, either. 

http://science.discovery.com/top-ten/2009/science-mistakes/science-mistakes.html

Types of Medical Mistakes

There are many ways that your medical care can go wrong. All of the phases from diagnosis to treatment can have some type of error.

Studies of error types: An Institute of Medical report ¹ attempts to quantify the types of medical errors that occur in healthcare settings. One cited study lists causes of error as follows:

·             technical errors (44%),

·             misdiagnosis (17%),

·             failure to prevent injury (12%),

·             medication errors (10%).

About 70% of all errors were believed to be preventable. The remainder were presumably non-preventable errors such as a patient reacting to a drug who had no previous history of an allergy to the drug.

National Patient Safety Foundation Survey: The National Patient Safety Foundation (NPSF) commissioned a phone survey in 1997 to review patient opinions about medical mistakes. The findings showed that 42% of people believed they had personally experienced a medical mistake. In these cases, the error affected them personally (33%), a relative (48%), or a friend (19%). Of these people, the type of mistake they had experienced was:

·             misdiagnosis (40%),

·             medication error (28%),

·             medical procedure error (22%),

·             administrative error (4%),

·             communication error (2%),

·             incorrect laboratory results (2%),

·             equipment malfunction (1%), and

·             other error (7%).

Unfortunately, the wording in the study for misdiagnosis was "misdiagnosis or wrong treatment", so it is unclear exactly how many were true misdiagnoses or wrong condition treated versus the wrong treatment for the correctly diagnosed condition. In other questions, people reported that they believed their doctor failed to make an adequate diagnosis in 9% of cases, and in another question 8% cited misdiagnosis as a causal factor in the medical mistake.

The location where the medical error was experienced was

·             hospital (48%),

·             doctor's office (22%),

·             operating room (7%),

·             clinic (5%),

·             emergency room (5%),

·             pharmacy (4%),

·             home (3%),

·             medical laboratory (1%),

·             nursing home (1%), and

·             other (5%).

When asked to cite what they believed primarily caused the error, NPSF survey respondents mentioned

·             carelessness/negligence (29%),

·             untrained staff/incompetence (14%),

·             communication (12%),

·             misdiagnosis (8%),

·             overworked staff (8%),

·             misread prescription or pharmacy error (6%), and

·             other (14%).

Diagnosis mistakes: there are various mistakes that can cause a misdiagnosis of a condition. Misdiagnosis can be one of the most costly of medical errors, leading to delayed, omitted, or inappropriate medical treatments.

·             Self-diagnosis mistakes: when you diagnose yourself, mistakes are very common. Always seek professional medical advice. Do not rely on internet health information.

·             Not diagnosed: some conditions are not obvious and may be missed, especially if they have no major symptoms.

·             Wrongly diagnosed: you might be diagnosed as having the wrong condition.

·             Wrong subtype of disease diagnosed: the diagnosis might have the correct overall disease, but the wrong subtype.

·             Complications not diagnosed: the diagnosed disease may have various complications that also need to be diagnosed and treated.

·             Underlying disease not diagnosed: there may actually be an underlying hidden disease causing the already diagnosed disease.

·             Associated diseases not diagnosed: some types of conditions cluster together, even though they do not cause each other.

·             Failure to diagnose others: infectious diseases need to be checked in family members and other exposed people; genetically associated diseases indicate family members may be at higher risk and may need screening.

Treatment mistakes: There are numerous ways that an error can occur in medical treatment.

·             Self-treatment mistakes: if you try to treat yourself, mistakes are very common. Always seek professional medical advice.

·             Wrong condition treated: i.e. from a misdiagnosis of the condition

·             Wrong choice of treatment plan: the overall strategy used to treat your condition might not be the best one.

·             Wrong type of treatment given

·             Wrongly delayed treatment: there might be an undesirable delay in your treatment, by choice or through non-diagnosis.

·             Wrongly performed procedures: all medical events such as surgeries and tests can have things go wrong.

·             Wrong medications: see below.

Prevention mistakes: The failure to prevent a condition is another type of medical failing. In certain cases, it is clear that preventive actions should be taken and failure to do so is a medical mistake.

·             Failure to prevent known complications of a diagnosed disease.

·             Failure to treat family members or others exposed to an infectious disease.

·             Failure to address clear risk factors for various conditions

Surgery mistakes: Surgical procedures are often complex and subject to various errors. Administration of surgery can also lead to errors. In some cases, there are known complications or risks of surgery than are often unavoidable.

·             Surgery administration mistakes: wrong-patient, wrong-site, wrong-organ, equipment left inside.

·             Surgical mistakes: the surgeon might make a wrong cut or other mistake.

·             Anaesthesia mistakes: too much, too little (waking up).

·             Complications from surgery

·             Infections from surgery: called "iatrogenic infections"

·             Wrong blood type transfusion

Hospital mistakes: A hospital can make errors in any of its varied activities. There are many staff who can make human mistakes and overall system problems can also lead to errors.

·             Hospital-caused infections: called "nosocomial infections"

·             Medication errors in hospitals: ordered medication not given, wrong medication, wrong dosage, wrong combinations, wrong patient given medication, and so on.

·             Wrong procedures: failure to do ordered tests, wrong procedures or tests.

Medication mistakes: Errors in medication are a major source of medical mistakes. Medication errors can occur in hospitals or pharmacies, and the error may be made by any of the staff involved with choosing or dispensing medication.

·             Inappropriate medication: the wrong medication given for a disease

·             Wrong medication: the patient gets the wrong medication despite the doctor prescribing the correct one.

·             Drug name mix-ups: several medications have similar-sounding names and can be mixed up by doctors or pharmacists.

·             Wrong medication combinations: there are numerous types of medications that should not be mixed, because of side effects and cross-reactions when combined.

·             Adverse reactions to medication: Some people have allergic or other adverse reactions to certain medications. These are risks and not necessarily avoidable mistakes if the person has no previous history of a particular adverse reaction.

·             Side effects of medication: Almost all medications have some types of side effects. Some are mild, some nasty. It is almost impossible to know up front whether a person will have side effects from a medication.

·             Non-compliance: the failure to follow your medication regimen can be a mistake made (usually by the patient).

Pharmacist errors: The dispensing of drugs by the pharmacy is a complex and busy activity. Various errors can occur at the pharmacist.

·             Wrongly filled prescriptions

·             Wrong drug supplied

·             Wrong dosage supplied

·             Drug name mix-ups: various drugs have similar names.

Pathology lab errors: Diagnostic testing done by a pathology laboratory can be subject to various errors. Some are administrative or human mistakes; other "mistakes" are inherent to the limitations of the type of test.

·             Wrong biopsy results: visual inspection of cellular slides

·             Administrative errors: mixing samples, etc.

·             Known test errors and risks: almost all tests have a small percentage of unavoidable errors (false positives, false negatives).

·             Known limitations of tests

Equipment failure errors: Physical failures with medical equipment can occur.

·             IV drips dislodged

·             Dead batteries in equipment

Unnecessary medical treatment: Excessive medical care can be a form of "mistake" for medical professionals and institutions. This can occur with good intentions (to ensure correctness) or for cynical reasons (to increase income).

·             Unnecessary procedures

·             Unnecessary tests

·             Unnecessary visits

http://www.wrongdiagnosis.com/mistakes/types.htm