The 'bystander effect' in crime also applies to medicine

by Helen Dodson
The ‘bystander effect’ in crime also applies to medicine
Credit: Shutterstock

(Medical Xpress)—The "bystander effect," which refers to people standing by and doing nothing while an emergency situation takes place, can also apply to medical care, according to two Yale doctors. Their "Perspectives" piece appears in the Jan. 3 issue of the New England Journal of Medicine.

The "bystander effect" became widely known and studied after the murder of a young Queens, New York woman, Kitty Genovese, who was returning home from work in the pre-dawn hours of March 13, 1964. Early reports suggested that nearly 40 people either observed the attack or heard her cries for help, but did not intervene. This case prompted significant research into this pattern of collective , in which everyone assumes someone else will come to the rescue, also known as the "Genovese syndrome."

The authors assert that this phenomenon may exist in medical care as well. They say that increasingly stringent limits on resident work hours, born of concern about physician fatigue and patient safety as well as increasingly complex patient conditions, may be contributing to unintentional lack of coordination of care among well-meaning physicians.

The tendency to refrain from offering help in emergencies may manifest most significantly, the authors write, when many others are present. People assume that someone else will take responsibility, or that others already have. In fact, the researchers write, the larger the group of people, the more likely the bystander effect may occur.

They give an example from their own dermatology service, which was asked to evaluate a patient with multiple and accompanying skin problems. Their team was one of nine specialty services tending to the patient in the , resulting in frequent physician-to-physician handoffs and numerous active care providers.

At one point, the authors write, more than 40 doctors were participating in the patient's care in the ICU. "Our inability to easily name his disease process quickly created ambiguity about 'ownership' of the patient," according to co-author Dr. Jason Lott, postdoctoral fellow in dermatology and internal medicine at Yale School of Medicine, and a Robert Wood Johnson Foundation Clinical Scholar.

Eventually decisive action was taken and the patient recovered, but the crisis – and the confusion surrounding it – provided an important lesson in how the bystander effect can impact and how it might be minimized through heightened efforts to improve coordination of care, note the researchers.

"Psychological research on the bystander effect suggests that individuals may be more likely to act when they are friends with one another," explained co-author Dr. Robert Stavert, dermatology resident at Yale. "Therefore, systems which encourage structured cooperation and collaboration across specialties within a hospital may reduce the likelihood of this tendency. Additionally, reimbursement models which reward collaboration may be beneficial in improving coordination of care and limiting the impact of this potential pitfall."

Related Stories

Doctors who share patients may provide lower cost care

date Aug 01, 2012

Patients with diabetes or congestive heart failure who receive care from doctors with high levels of patient overlap have lower total health care costs and lower rates of hospitalization, according to a new ...

UnitedHealth unveils patient info service for MDs

date Feb 14, 2012

(AP) -- UnitedHealth Group's Optum business is launching a service that allows doctors to share information about patients over the Internet, as health care companies continue their push to improve care with better coordination.

Restricted working hours have had little effect in US

date Mar 22, 2011

Reducing doctors' working hours from over 80 a week does not seem to have adversely affected patient safety and has had limited impact on postgraduate training in the United States, finds a study published in the British ...

Living wills have an impact on pre-hospital lifesaving care

date Feb 24, 2009

A new study conducted at the Hamot Medical Center in Erie, Pennsylvania, and published by Elsevier in the February 2009 issue of The Journal of Emergency Medicine shows that there is a lack of education and understanding in wha ...

Recommended for you

Noise from fireworks threatens young ears

date 14 hours ago

(HealthDay)—The Fourth of July weekend is a time for celebrations and beautiful fireworks displays. But, parents do need to take steps to protect their children's ears from loud fireworks, a hearing expert ...

Many new teen drivers 'crash' in simulated driving task

date 14 hours ago

(HealthDay)—Around four in 10 newly licensed teen drivers "crashed" in a simulated driving test, suggesting that many adolescents lack the skills they need to stay safe on the road, according to a new study.

Insurer Aetna to buy Humana in $35B deal

date 15 hours ago

Aetna will spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul.

Feeling impulsive or frustrated? Take a nap

date 17 hours ago

Taking a nap may be an effective strategy to counteract impulsive behavior and to boost tolerance for frustration, according to a University of Michigan study.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.