NYT: Holding Doctors Accountable for Medical Errors

From the article:

"Q. Has this erosion of trust had a detrimental effect on the patient-doctor relationship?

A. The chaos of everyone doing things their own way is incredibly dangerous, and it is that chaos which gets in the way of the relationship. You can make health care better, safer and less expensive while strengthening the core of the patient-doctor relationship. You can standardize certain parts of care based on clear evidence, which will free up doctors to focus on those pieces of the health care puzzle where there is no data — those issues that are uniquely human and that require judgment, expertise and empathy.

The challenge, though, is to standardize care in a way that will improve safety while retaining the parts that make medicine human. The last thing we want to do is to regiment empathy or to create something so regulated that doctors cannot do something nuanced or innovative for patients.

Q. What are the roles of patients and of doctors in the patient safety movement?

A. 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."

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