The difference between Complications and negligence

There is an urgent need to 'educate' people about the difference between complications and negligence. I have used the word 'educate' in inverted commas to reiterate the fact that i do not intend to be supercilious. Everyone of us has to try and make people aware of certain basic facts of medical care; when this awareness is clear, all parties concerned -  patients,  hospitals and doctors - will approach 'problems' and conflicts in the right spirit.

The facts are as follows:

1. Medicine is an inexact science - I spite of all big advances in our understanding of the disease process, the excellent diagnostics that are available and the modern technology that goes into our tools, there is always a 'grey' area when doctors treat patients. Unlike in mathematics and computers, 2+2 is not always 4 in medicine!!
2. Working diagnosis - When a patient is seen first, the doctor takes a history, does a clinical examination and based on these orders some tests. Putting findings from these three aspects of a workup, the doctor makes a diagnosis. This is a provisional diagnosis, also called a working diagnosis; this is subject to change!! When such a change is made later, the doctor is accused of 'misdiagnosing' the condition.
3. Vagaries of investigations - Test results are dependant on many factors - collection of samples, standardization in laboratories, observer dependence of the personnel in laboratories and diagnostic centres and most importantly, the limitations of the test itself!! The clinician has the unenviable task of interpreting these results, making sense of conflicting results and integrate them with the clinical impression. These steps are taken not because the doctor 'does not know what he is doing' but because the nature his work is such.
4. There is more than one way of doing things correctly - the goal is to get the patient right. Many times this is achieved in different ways by different doctors. When patients approach other doctors for an opinion, the method he recommends may be different. That does not mean that the first opinion was a wrong opinion.
5. Complications are a part of health care delivery - the human body is a very complex 'machine'.Outcomes of the same treatment  for the same disease seen in two different patients can be very different.One may be completely cured and the other may end up in complications. The endeavour of the doctor is to keep the failures and complications to a minimum level - this level can never be zero.

If these basic facts are understood, all 'failures', 'misdiagnosis' and 'negligence' can be addressed in an objective and a scientific manner. We tend to approach all issues in healthcare in an emotional manner. The inevitable anxiety aroused by a near or dear one going through a complications, makes people see through 'coloured' glasses. Society must educate itself to try and get over this limitation and 'see' things in the right light.