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By Todd
A. Smith*
In the debate
over how to reduce the cost of medical malpractice insurance
for doctors, President Bush and Congress are ignoring an obvious
and effective solution: The best way to reduce medical malpractice
lawsuits is to reduce medical malpractice in the first place.
Lately we’ve
been hearing a lot of numbers about the costs of lawsuits, but
here are some other numbers to keep in mind. As many as 98,000
Americans die every year from preventable medical errors,
more than are killed by highway accidents, breast cancer or
AIDS, the Institute of Medicine of the National Academy of Sciences
reports.
So before
we rush to pass so-called “tort reform” that will
limit the rights of all Americans in the court room, we should
first examine how patient safety reform and greater openness
in the medical profession might result in fewer medical errors
and fewer lawsuits.
First, to
improve patient safety we should improve nursing staffing, and
reduce the shortage of qualified nurses that has a demonstrably
harmful effect on the care hospital patients receive. The federal
government spends hundreds of millions of dollars to research
cures for disease but less than $5 million to prevent deaths
from medical errors. That needs to change. And Congress needs
to finally pass a real Patients Bill of Rights, to put medical
decisions back into the hands of doctors, nurses and patients,
not HMO bureaucrats.
Another
important part of the solution is full disclosure of medical
errors when they occur.
Few hospitals,
doctors, or pharmacists volunteer information about their records
on medical mistakes. Most states have laws – called “peer
review privilege” statutes – that allow medical professionals
to keep information about the medical mistakes they’ve
made a secret from the patients they’ve injured.
Some in
the health care system argue that these laws are necessary,
because if patients knew about the medical errors that injured
them, they would sue.
Patients
deserve to be told of medical errors that affect their health.
Not only would it ensure prompt and appropriate treatment to
correct the error in treatment and save lives, but the experience
of a Veterans Affairs hospital in Kentucky shows that hospitals
and insurance companies shouldn’t necessarily fear additional
legal costs.
A study
reported in the Annals of Internal Medicine tells how
the staff of the hospital decided that instead of trying to
hide mistakes from patients, they would promptly and fully disclose
all errors. Instead of fighting patients when it erred, the
hospital offered fair compensation to them – and even helped
file claims.
The hospital
adopted the policy out of a moral and ethical duty to be honest
with its patients. But it had an unanticipated side effect –
it greatly reduced the amount of money the hospital had to pay
to litigate claims of medical malpractice.
When the
hospital was honest with its patients, those patients were less
likely to take their claims to court. The study concluded that
because the hospital’s staff was honest about its errors,
the patients felt no betrayal of trust, and the hospital and
the patients didn’t become adversaries.
Insurance
company and HMO executives, as well as many in Washington, will
tell you the problem with the medical malpractice system is
all the lawsuits filed by patients injured through no fault
of their own and their lawyers. But in the face of the huge
number of deaths due to medical errors, and the experience of
the hospital in Kentucky, it’s time we asked some simple
questions.
Don’t
patients deserve the truth about their health and common-sense
reform to make hospitals safer? Shouldn’t we first do everything
we can to eradicate preventable medical errors and provide a
degree of openness regarding doctors and their mistakes and
only then debate whether to drastically restrict the
rights of those Americans killed or maimed by medical negligence?
In the
discussion about medical malpractice, every American concerned
for the safety and well-being of his family should hold our
elected officials accountable for the answers.
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