Medical malpractice rates are at epidemic proportions. Yet, the culture of medical negligence is alive and well. What does this mean, a “culture of medical negligence”? For starters, it is easy to understand that medical malpractice did not become the sixth leading cause of death in the U.S. by accident. No, forces are at work that lead to an excess of preventable medical errors and mistakes that happen over and over again. Of course, any for-profit enterprise is prone to abuse and corruption. Now add to the mix a lack of regulation and the cloak of secrecy, and you have a culture that does not learn from its mistakes, but instead protects those who make them.
Every American business is subject to regulatory oversight in some fashion or another. However, hospitals and physicians are largely self-regulated, and then, only loosely so. Further, mistakes are kept secret by the lack of reporting requirements and the so-called “peer review” privilege which maintain confidentiality over internal investigations into mistakes. Hospital and physician groups lobby for these special privileges and many others.
They have also developed practices aimed at avoiding responsibility, while portraying a false image of care and concern. For example, many States have enacted “I’m sorry” laws that permit a physician to apologize for mistakes but prevent patients from using these admissions to hold the physician accountable. Likewise, hospitals have started to use ombudsmen to address patient’s concerns about bad outcomes. But again, these ombudsmen have no real medical power or training. Instead, their real purpose is to identify disgruntled patients so hospital administration can attempt to dissuade legal action.
In a Wall Street Journal article entitled “How to Keep Hospitals From Killing Us,” the author suggested some simple reforms to reduce medical errors: “Every hospital should have an online informational ‘dashboard’ that includes its rates for infection, readmission (what we call ‘bounce back’), surgical complications and ‘never event’ errors (mistakes that should never occur, like leaving a surgical sponge inside a patient). The dashboard should also list the hospital’s annual volume for each type of surgery that it performs (including the percentage done in a minimally invasive way) and patient satisfaction scores.”
These proposals would be a good start. At a minimum, healthcare consumers should be allowed to make informed decisions about caregivers based on the caregivers’ track record. But this is not currently possible. Instead, consumers are left with multimillion dollar marketing campaigns and hospital rankings that have nothing to do with outcomes or patient satisfaction. Until hospitals are held accountable by the public for ongoing deficiencies, these deficiencies will continue and patients will continue to be harmed by medical malpractice as a result.
