When it comes to medical errors, doctors are not likely to tell their patients the truth. Typically, a physician will keep his/her patient in the dark by using euphemistic medical-speak to explain an error, such as referring to an avoidable surgical injury as an “unanticipated complication of the procedure.” But a recent study in the Journal of Health Affairs suggests that doctors cloud the truth in many other ways: http://content.healthaffairs.org/content/31/2/383.abstract.
What is most disturbing about the Health Affairs article is that many doctors do not agree that they should disclose serious medical errors to patients. In fact, a culture of secrecy has long been promoted by physicians and their professional organizations. Most States have enacted laws to cloak bad outcomes in secrecy, so that patients cannot learn whether a physician’s colleagues or hospital administration found that the physician committed a serious medical error. These laws assert a so-called “peer review” or “quality assurance” privilege over internal inquiries into physician misconduct.
Doctors have long argued that their self-policing must be conducted in secrecy or physicians will not be honest about their mistakes. This argument is seriously flawed. First, as the Health Affairs article points out, doctors are resistant to full disclosure in any setting, including the setting of an anonymous survey. Second, in the setting of a secret meeting among peers, a physician may be especially unlikely to admit to mistakes due to embarrassment and fear of losing his/her hospital privileges. Third, no other profession or trade is afforded such blanket protection, so it is purely a concoction of the medical community to protect itself from outside review.
The fact is that medicine is one of the least regulated industries in America. The lack of both oversight and transparency removes incentives for physicians to develop safety standards, quality measures and remedial training programs. As a result, nearly 100,000 patients die unnecessarily each year from medical negligence. Countless others are seriously injured. Healthcare should not be a game of roulette, especially one played in the dark.
