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Re: heads up- malpractice insuranceFrom: Barbara Nicol MD (BLNICOL@IX.NETCOM.COM)Sun Jan 27 09:54:02 2002
At Sun, 27 Jan 2002, DoctorJoe@aol.com wrote:
>Well, let's get philosophic for a sec... Yes, of course. But think of all that could happen when a mistake is made (and doesn't under the tort system of compensation.) If a mistake is made but by a stroke of luck causes no harm, it isn't technically malpractice. So no suit. There is no motivation for turning oneself in and announcing the mistake so as to help others avoid it. I understand that air traffic controllers analyze every near-miss. Couldn't we reward that behavior in medicine (instead of creating every possible motivation to hide errors and deny their existence)? If an obvious mistake causes obvious harm, this commonly leads to suit and settlement, which hides everything in the deep security of "confidential terms". Confidential terms, as far as I can tell, tend to be purely financial and rarely include remedies which might prevent the mistake from happening again, such as focused re-training of the practitioner, changes in staffing patterns, etc. Granted, there is at least some motivation to change for the individual or organization involved, but no motivation at all to help others avoid the same mistake. Yes, we get to read those exciting legal case reports in Contemporary Ob/Gyn, but they contain mostly advice about how to avoid suits (document every breath, informed consent for Tylenol) and little info about how to improve care. Interestingly, obvious mistakes causing obvious harm often lead to no suit (the rapport factor) which means that nicer doctors get sued less but are not necessarily doing a better job. I'm actually not talking about maloccurence much, except that it increases the ineffectiveness of the tort system by punishing those who made no mistakes as well as those who did. Philosophically yours,
-- Barbara Nicol MD Everett WA USA
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