Medical Errors and Doctor Accountability

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The NY Times published an article today about the current status of patient safety. The article, written by a doctor, notes that there are still issues that are unresolved some ten years after the publication of the groundbreaking study “To Err is Human: Building a Safer Health System”. That study concluded 98,000 patients die each year from preventable medical errors.
In her NY Times article, Pauline W. Chen, M.D. notes that the “To Err is Human” study prompted a review and focus on system errors in hospital settings that lead to medical malpractice. Ten years after the study, some doctors are calling on their own colleagues to be accountable for their own human errors that lead to medical errors.
One of those doctors,Dr. Robert M. Wachter, a professor at the University of California, San Francisco and a leading health safety expert, has been critical of the safety movement for its failure to recognize the human element in medical errors.
“A blame-free culture carries its own safety risks, he writes, “As we enter the second decade of the safety movement, while the science regarding improving systems must continue to mature, the urgency of the task also demands that we stop averting our eyes from the need to balance ‘no blame’ and accountability.”
In his interview with the NY Times, Dr. Wachter is clear on the role fellow doctors play in patient safety. Here’s an excerpt from the interview:
“If I were a patient or a loved one, I would do what everyone recommends — have a loved one by your side, look for signals that a hospital is safe, check that a physician is board certified. But I am also intensely ambivalent about how responsible patients should be for safety and the prevention of error. Medical mistakes are our bad. Why should patients bear the responsibility to receive the right medication or to have the correct leg amputated? When I get on a plane, I don’t worry about safety and errors.
As for doctors, patient safety can’t happen if physicians aren’t smack in the middle of it. We can either facilitate safety or we can stand its way. We will stand in its way if we embrace our historical approach to these problems, if we instinctively engage in finger-pointing, if we aren’t willing to listen to others.
We have a huge role in creating the kind of environment where people will feel comfortable questioning anything that seems strange or out-of-place and where doctors are open to different opinions from others.
As doctors, we have to admit first that we don’t deliver care that is of the quality and safety our patients deserve. Then we have to get past our professional arrogance. We don’t have the answers to all of these issues, and we have to be open to others who may have the answers or who can approach it from different angles.”

Mark Abramson
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