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Sunday, June 3, 2012

What Medical Mistakes?

Privilege rules at U.S. hospitals and patients are at the mercy of powerful players who operate with impunity.
If you survive
What made you ill,
Mistakes by docs
Can get you still.


Estimates vary, but every year an average of 195,000 Americans die from medical errors. These acts aren't done on purpose — they are screw-ups, often dealing with medication. Other hundreds of thousands are annually injured. Surely, you say, Washington and the state capitals must be working feverishly to sort all this out.
Wrong. The last thing hospitals, doctors, insurers, and pharmaceutical companies want is to get this mess sorted out. That would mean inadequate doctors would lose their licenses, inattentive hospitals would get bad publicity, and insurers and Big Pharma would have to shell out some big bucks.

To protect against such calamities, the medical industry has worked out an impenetrable defense. State licensing boards rarely discipline anyone, and they make it painfully difficult either to find out what actions they have taken or to file a complaint. 

Insurers, in their fine print, don't let victims sue, only arbitrate, in kangaroo settings. Doctors won't testify against one another. And in perhaps the cutest wrinkle of all, hospitals, which autopsied around half their deaths 50 years ago, now only do 5 percent. Thus medical mistakes do indeed get quietly buried.
Other research, published in Health Affairs, found thatone in three hospital admissions results in a medical mistake. The growing use of electronic medical records should blessedly cut into this avalanche of foggy paper data that today receives discreet burial in office filing cabinets. More prying eyes should soon get to see the electronic variety.
Otherwise, prospects for improvement are dim. Healthcare in this country is, after all, largely a business venture. Corporate ownership of hospitals is spreading and non-profit hospitals each day act more and more like corporations. 
Doctors are mostly entrepreneurs with payrolls to meet and rent to pay. Savvy groups of them invest in specialized clinics, fueling our nation's chronic over testing. 
Big drugmakers offer incentives to doctors to prescribe their own patented brands. And perhaps most importantly, the bigger players retain fleets of lobbyists to make sure that no rogue legislature cracks down seriously on all this waste and error.
There's also the reality that in our society doctors are hallowed figures. After all, they had to pass organic chemistry. Further, while the vast majority is just out to help people, they do remain human. 
They make mistakes, and some suffer from avarice. All seek to avoid embarrassment. 
They fear lawsuits. In other words, in addition to America's basic healthcare system being an expensive mess, the systems that run, monitor, and discipline it are also a mess. 
Privilege rules and the patient is at the mercy of powerful players who operate with impunity.
OtherWords columnist William A. Collins is a former state representative, and a former mayor of Norwalk, Connecticut. otherwords.org

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