Quote:
Originally Posted by Archaea
Mike and ER represent the spectrum in med mal.
The Medical Establishment takes the line that med mal almost never happens and that sufficient safeguards are in place to avoid all but the rarest of mistakes.
I would agree that if all physicians followed their training all of the time, very few mistakes would result in med mal harming a patient.
OTOH, with workloads and income expectations, mistakes occur in larger percentages than the medical establishment is wont to admit, yet not in the proportions the plaintiff's bar would have you believe.
ER arguing that nurses will alway catch the obvious mistakes is simply not true. With rushes, foreign nurses and the sometimes subservient attitude of nurses you can find nurses who won't question a doctor's orders. But plenty will question them and many mistakes are caught.
Mike is correct that hospitals especially and many physicians work immediately to cover up mistakes once something awful has happened. There are sincere, conscientious physicians who will self-examine upon a bad result, but the consequences of being too forthright are severe and militate against total honesty even with peer review protections in place.
It is a complex problem, but not aspect of the health care establishment encompasses enough of the issues for a universal review to be possible. In short, no matter who performs the study, it's likely to be slanted one way or another.
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I probably did overstate in saying that all mistakes are either minor or caught before causing problems. But I am pointing out some of the objections to that study that cited the 100,000 number, and the objections to the methodology are valid.
I also never claimed that nurses catch all mistakes. They most certainly don't. But the morphine/magnesium example is a total farce and is most certainly made up. Also illustrates how inept JCAHO is by their continual citing of it as justification to their silly requests.
I also have to object to your characterizing hospitals and doctors' efforts to cover up their mistakes. There is a major push that has occurred recently towards acknowledging and apologizing to patients when errors are made. Studies have shown that legal costs go down when you follow this method; more and more hospitals have found it beneficial to do this. Malpractice reform efforts are also underway to protect hospitals and doctors from "admissions of guilt" during an effort at acknowledgement of an error--this should further improve the situation.
I'm all for improved systems in medicine to reduce error. It's worked in anesthesiology. The problem is that those who are in charge of the process have no clinical experience and institute requirements with serious costs and no proven benefit.