Malpractice and Health Quality
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“First, do no harm.” What happened to medical malpractice and what does health quality have to do with it? The Institute of Medicine rocked the health care world in 1999 with its sensational report, “To Err is Human: Building a Safer Health Care System.” The report revealed that up to 98,000 people were killed by adverse events related to errors in medical care per year, with a conservative estimate of deaths due to errors at 48,000 people killing more than breast cancer, motor vehicle accidents, and AIDS. The malpractice system in the United States was designed to provide compensation to victims of medical errors and punish physicians who made mistakes. In reality, most victims of errors are not compensated, many high-risk specialties have become rare in certain localities due to unaffordable malpractice costs, and malpractice has grown to 1-1.5% of all health care spending with no appreciable improvements in safety. The IOM approach to medical errors was one of the first to suggest that most errors result from a combination of multiple system failures. For example, physician orders medication patient is allergic to without realizing it because it is not marked on the chart, medication does not come from pharmacy because hospital tubing system is down, RN borrows medication from another patient as medication was not delivered, RN gives medication to which the patient has an allergy, adverse reaction occurs. Who is to blame? Would punishing this nurse or physician prevent similar future errors? Seemingly not. David Beckwith, MD, is credited for coining the new mantra of health quality improvement efforts, As physicians, we have the responsibility to not only provide the best care we can, but also to improve the health care system by pushing for health quality improvements. Improvements in patient safety and quality of care have the potential to improve the public trust in health care, improve our own patient outcomes and our efficiency, and to reduce our liability. As Malpractice and Health Quality Coordinator, my goal is to get the word out about patient safety efforts to students, to the public, and to our colleagues. Towards that end, I am working on creating a database of health quality and malpractice speakers who understand the nuances of our legal system and our health care system. It is also my goal to have local chapters organize a talk on the health quality subject of their interest. I am also working with our Congress to improve and pass national legislation on hospital safety. Finally, I am creating a project in a box to have an interactive session for students in which they practice taking the role of a physician who has made an error and caused harm and a patient who has been under that physician’s care and then experiences the error. If you have interest in these projects, want to debate, ideas for other work in this area, expertise in malpractice or patient safety, or just questions about the topics, please let me know! RESOURCES
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RESOURCES AMSA's Medical Malpractice Primer (PDF 98KB) deMystifying Medical Malpractice Presentation (1.4MB 2003) Alternative Methods of Dispute Resolution Med Mal Fact Sheet Web Links Cartoons |
