“Doctor Error”
Makes me blink,
Much more common
Than you think.

We all know who the real bad guys are in the health biz. They’re the insurance companies, the drug companies, and the lawmakers who serve them. Those are the easy ones. After them it’s murkier. Some doctors and hospitals also cheat and steal or are incompetent, but most do the best they can to try to cure us.

Unfortunately “best they can” often isn’t that good. A lot of serious mistakes happen. Then the white coats try to hide within the system. But as consumers, we need to know which docs and which hospitals are the worst offenders. Good luck. State medical authorities keep track of “physician errors” or “adverse incidents,” but they rarely share that information with us.

One problem is that even perfectly competent physicians don’t want reports to be available about their incompetent colleagues. That’s because if someday the good guy screws up, he too craves secrecy to assure that searchable information on his error never gets out. It’s only human. If the price of that secrecy is that incompetents go unexposed, well, no one ever said life was fair. Anyway, bad docs generally get squeezed out quietly after they kill just a couple of patients.

Hospitals are more dangerous because of their scale. Even the nonprofit ones have big bucks at stake. Their CEOs make a bundle and can’t afford to have the good name of their place besmirched by the facts. Their boards wouldn’t understand. The chiefs of their medical departments each enjoy very pleasing incomes too, and likewise can’t afford to have word of screw-ups get out. Patients might start decamping to Hospital B if they hear the true infection rate at Hospital A. Better keep it quiet.

In my own town, censorship is especially easy because our hospital runs a daily ad across the bottom of the front page of the local newspaper. Don’t expect any investigative reporting of “adverse incidents” here.

The courts aren’t much help either. Malpractice cases are enormously difficult to win because local doctors won’t testify against one another. You have to drag in experts from out of state. Thus the trial lawyers are reluctant to get involved unless the physician error is egregious and they have a good shot at earning a big fee.

Meanwhile drug companies do what they can to make the situation worse. Their salesmen pester doctors’ offices, provide “free” lunches, and offer handsome honoraria to physicians with some special expertise. They’re invited to speak at classy soirées. One popular doc from Harvard Med School, when challenged over potential conflict of interest, simply quit the university and kept up his speaking gigs with several pharmaceutical companies. Good riddance. But this is the way inappropriate drugs, tests, and treatments often get recommended and prescribed.

Nor are doctors and general hospitals the whole problem. Specialized long-term care hospitals, nursing homes, and chiropractors all have their own dangerous secrets. Silence prevails for all and few regulators pine to enter into messy investigations. The public, as usual, is left holding the bag.

But at least one common myth has now been laid to rest. Texas recently tried malpractice insurance “reform;” that is, limiting patient awards for pain and suffering as a means to hold down premiums. It didn’t work. Patients suffered as expected, but premiums went up anyway.

No one has yet tried publishing medical performance records. It’s about time.

OtherWords columnist William A. Collins is a former state representative and a former mayor of Norwalk, Connecticut.

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