Marty Makary | WSJ.com | September 21, 2012
We trust our doctors with our lives – literally. This is why it is always so disheartening to learn about the extremely high rates of medical errors that occur in the US. This is why, as medical malpractice attorneys, we try to hold hospitals and healthcare providers accountable for patient safety. Luckily, we’re not the only ones.
Dr. Marty Makary speaks out on the highly unnoticed issue of preventable medical errors. Not only does this issue go highly unnoticed, but the medical community has little to no incentive to learn from them, despite the statistic that roughly 25% of all hospitalized patients will be harmed by a medical mistake of some kind. According to the article, if medical errors were a disease, they would be the sixth leading cause of death in America.
Not only are innocent people harmed by these medical mistakes, but they are costing the US health-care system tens of billions of dollars a year. The rising cost of US Health-care has been a hot topic during this election season, with many policymakers claiming that the solution lies in caps on medical malpractice awards and other “remedies” that would result in taking away patient’s rights. However, according to Makary, 20% to 30% of all medications test and procedures are unnecessary, based on research done by medical specialists surveying their own fields. Clearly the problem and solution lie with healthcare providers.
What contributes to medical mistakes? The culture of silence fostered among medical care providers in the health field; most doctors will overlook mistakes made by their colleagues. Makary gives the example of the “Dr. Hodad” that many hospitals have. Hodad is a nickname that stands for “Hands of Death and Destruction.” Further contributing to this culture of silence is the isolation of tattle-tale doctors. Doctors who call out other doctors are suddenly assigned to more emergency calls, given fewer resources or simply badmouthed and discredited in retaliation. When faced with the conundrum of whether to call out Dr. Hodad or stay silent, Makary admits early in his career he kept his mouth shut lest he risk his career.
Makary criticizes not only doctors, but hospitals as well, saying that as a whole, hospitals tend to escape accountability. Very few patients publish statistics on their performance, leaving patients to choose hospitals based on arbitrary factors such as proximity to home.
Makary gives us 5 crucial steps to reforming the system:
1. Online Dashboards:
This would be similar to consumers checking a restaurant’s Zagat or Yelp rating before choosing a hospital. Makary urges hospitals to have public “dashboards” that include its rates for infection, readmission, 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.
2. Safety Culture Scores:
Giving hospitals scores based on the culture of teamwork and safety so that the patient can make an informed choice.
According to Makary, the installation of cameras would not only help physicians review procedures, but would enforce safety procedures, such as washing hands.
4. Open notes:
Makary found that dictating the notes he was taking about a patient not only helped establish transparency, but helped the patient understand the doctor’s methodology and allowed the patient to correct any misunderstandings the doctor might have.
5. No more gagging:
This refers to the increasing number of doctors who require their patients to sign a gag order, promising never to say anything negative about their physician online or elsewhere.
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