“Monday Mornings” – Not Just for Doctors

David E. Kelley

David E. Kelley (Photo credit: Wikipedia)

David E. Kelley, a lawyer by training, left the law and became a Hollywood writer, producer and creator of many hit TV series. His latest is a medical drama based on Dr. Sanjay Gupta’s book of the same name: Monday Mornings on TNT.  This new series is centered around so called morbidity and mortality conferences in which the Chief of Staff “leads a harsh, closed-door review of the complications encountered and mistakes made during the course of patient care.”  In other words, the doctors are put on trial.

In the pilot episode, the first doctor to face the “M&M” inquiry (Dr. Martin) is called out for failing to perform a full physical examination, order x-rays or order blood work on a runner who presented with a sore hip.  Instead he prescribed extra strength Tylenol and discharged her.  The young woman returned to the hospital four months later with a broken hip.  This time, tests revealed she had stage four bone cancer.  She died within three weeks despite aggressive cancer treatments.

The other doctor on trial in the series pilot is a neurosurgeon (Dr. Wilson) who fails to ask for a full medical history of a seven-year-old patient before operating on him to remove a brain tumor.  The child had uncontrollable bleeding during surgery and died on the operating table.  On cross examination in the M&M meeting, the Chief of Staff asks Dr. Wilson whether he thought to ask for a medical history for the father who was “out of the picture.”  After admitting he did not, Dr. Wilson is handed the father’s medical history, which states the father suffered from von Willebrand’s Disease, a primary symptom of which is uncontrollable bleeding.

The Chief of Staff in the Monday Mornings pilot quite eloquently summed it up:

The boy had a 50/50 chance of being an uncontrollable bleeder. . . . This boy was likely to die soon, but he died yesterday because of a doctor’s arrogance, his unwillingness to seek a consult, his neglecting to get a full and thorough history.  Arrogance.  We are clinicians, scientists.  We observe time honored procedures and analyses, that’s how we are trained.

And this is what happens when we subjugate that training to arrogance.

These morbidity and mortality conferences are not fiction, they actually occur.  And as is portrayed in the TV show, all of the doctors in attendance learn from their colleagues’ cautionary tales.

If only law firms had similar conferences where attorneys’ performance could be examined.  Lawyers get little if any feedback, and poor performances can be easily hidden from colleagues.  Even clients often have no way of knowing whether their attorneys have performed well, much less adequately.

Such conferences would force lawyers to learn from their own mistakes and allow them to learn from other attorneys’ cautionary tales.  If such conferences existed, perhaps some attorneys would be less arrogant, and all attorneys could be better lawyers.

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One Response to “Monday Mornings” – Not Just for Doctors

  1. wheresmykid says:

    If only the public who endure the results of M&M reality had a voice….

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