Too Many Doctors Can Threaten Patient Safety

A phenomenon known as the “bystander effect” could cause patients to become sicker or even die if they are treated by too many physicians. In a study published in the New England Journal of Medicine, the authors argue that problems regarding coordination of care and diffusion of responsibility can adversely affect patients in certain settings. Trends in health care make it more likely that multiple specialists will become involved in a patient’s care which increases the risk that there will be a breakdown in the coordination of care. Basically, a patient can be harmed when a group of doctors fails to act decisively, whereas a single doctor would be more likely to take action on behalf of a patient in trouble.

The bystander effect is more commonly associated with groups witnessing a crime or experiencing an emergency together. The presence of other people makes everyone in the group less likely to step forward. People either assume that someone else will act to resolve the situation, or they are simply afraid to be the first person to speak out and put themselves on the line. In terms of medical decisions, a large group can become paralyzed and ineffective because no one is willing to take charge and choose a course of action.

Research provides several clues for how to overcome the bystander effect. When doctors are friends with one another, they may be more willing to act on a patient’s behalf without fear of the group’s response. Better communication among teams of doctors can also go a long way towards reducing the bystander effect.

Source: Good Morning America, “Too Many Doctors Can Hurt a Patient,” by Susan Donaldson James, 2 January 2013