Wednesday, March 9, 2011

Health-Care System Misdiagnoses Problem, Prescribes Wrong Solution

FOR PATIENT SAFETY WEEK


   Hospitals are dangerous places.
   In 1999, the Institute of Medicine issued a shocking report, which found that as many as 98,000 hospital patients are killed every year by preventable medical errors —nine times more than are killed by drunk driving. Unfortunately, experts everywhere agree that hospital deaths from medical mistakes haven’t gone down since the blockbuster IOM study. Compounding matters, growing numbers of incurable infections contracted by patients inside hospitals now claim another 100,000 lives each year.
   This carnage caused by our so-called “health-care” system must stop, but the overwhelming majority of health-care providers remain dangerously determined to promote an agenda that misdiagnoses the problem and prescribes the wrong solution. While pockets of progress do exist, the path to safer health care is being systematically blocked by a big money coalition that places legal reform, rather than real patient safety reform, at the top of its priorities. The coalition is fronted by hospitals and physician groups but gets generous funding from insurers, drug makers, big tobacco, oil companies and other powerful corporate interests that stand to benefit handsomely by restricting the ability of ordinary citizens to hold them accountable in court. Tort reform benefits insurance companies and big corporations, not ordinary people whose lives and rights remain at risk.
   Three recent reports illustrate both the failures and dangers of tort reform. In November, the New England Journal of Medicine published a study from North Carolina, which found that over a six-year period, injuries and deaths in hospitals had not decreased. This was attributed largely to a willing failure to implement proven, commonsense strategies such as electronic record-keeping, employing more nurses, and curtailing excess hours to prevent fatigue. Even simple steps such as washing hands were not monitored or enforced.
   Faced with these facts, North Carolina’s medical establishment chose instead to invest in lobbying to limit injured patients’ legal rights and avoid accountability for their deadly mistakes. Unwilling to change their dangerous ways or accept the consequences, the tort reform coalition chose, as it does now in Pennsylvania, to focus its efforts on attacking victims, lawyers and juries.
   A just-released report from New York City has a more encouraging message for advocates of prevention. There, obstetricians at a single hospital cut their lawsuit exposure by 99 percent simply by doing things that hospitals virtually everywhere have ignored. They began using electronic charts to improve communication, they hired a safety nurse to educate staff on protocols, and they hired additional physician’s assistants to reduce excessive on-call hours. Despite the demonstrated success of such a program aimed at the problem (errors) rather than the symptom (lawsuits), New York’s health-care and insurance lobbies are pressing for tort reform instead of real reform.
   Finally, a report last month from California − a state that has long had the most draconian lawsuit limits − shows how tort reform primarily benefits the insurance industry. Records from several medical liability insurers revealed that some companies incredibly paid out as little as 2 to 3 percent of the premiums they collected from doctors to deserving victims of malpractice. The largest malpractice insurer paid out only 10 percent. That means the insurance companies pocketed most of the benefits from not having to pay for mistakes. Meanwhile, thousands of legitimate victims of malpractice have been left without any hope of seeing justice done.
   In Pennsylvania, since a host of lawsuit restrictions were imposed in 2002, insurance companies have charged our state’s doctors $1.5 billion more in premiums than they paid out in compensation, but have offered only minimal rate relief.  Meanwhile lawsuits have plummeted more than 40 percent, but patient errors remain on the rise. Last year, Pennsylvania hospitals admitted to nearly a quarter of a million “adverse events” where patient safety was compromised.
   This is Patient Safety Awareness Week. So when you pass a billboard or see a large  paid advertisement claiming that a certain hospital is better at one procedure or another, ask yourself why no hospital will ever tell you how it’s doing on reducing medical mistakes or unnecessary deaths. And ask yourself why they spend so much time, money and effort trying to limit your rights rather than limiting the harms and suffering they so often cause.