Medical Errors Issue Hits Capitol Hill
McEachern's wife had anger for her attending physician, with whom she settled in a malpractice action. "He let a resident do the procedure without my approval," she said. "The resident didn't know what he was doing."
Debra Malone told the panel a tragic story of her father, a 64-year old doctor who died after an error-filled night in an intensive care unit. The ICU, she said, was staffed only with an intern and float nurse who was unfamiliar with the unit. "The attending physician was at home sleeping."
And Diana Artemis described an orthopedic surgeon's "incompetent after-care" from a total hip replacement, resulting in multiple corrective operations. "It is time the medical industry opens its books," she said.
But AMA immediate past president Nancy Dickey, MD, asked, "Is the surgeon responsible for a fall after surgery?" Dickey testified against the creation of a mandatory error-reporting system. That effort, she claimed, would backfire and establish an environment hostile to "trust and open communication." The AMA backs voluntary error reporting, she said, although it believes those who step forward must have a full guarantee against liability.
The AHA also had qualms about reporting requirements. Moreover, Jefferson Health System chief medical officer Stanton Smullens, MD, testified for the association that a patient could take more initiative in screening for the best care. For example, a patient could ask a doctor whether he's been sued and request that a resident not treat them. But Specter rejoined that only an "extraordinary patient" would ask those questions.
In contrast to the doctors and hospitals, the American Nurses Association said it backed a mandatory error-reporting system.
Meanwhile, health experts testified that ensuring health professionals won't be sued is central to battling system weaknesses that result in errors. "The best physicians and the best institutions make mistakes," said John Eisenberg, MD, administrator of the Agency for Healthcare Research and Quality. "We must change the culture of secrecy," he said, and avoid a reaction to errors he characterized as "name them, blame them, and chain them."
Martin Merry, PhD, a health management professor at the University of New Hampshire, agreed: "The root cause [of medical errors] is not incompetent doctors," he said, arguing that the institute's report was "long" on regulation. He recommended that health care build its delivery system "around our patients rather than our doctors and hospitals."