Medical Errors Report #21

A Four-Year Solution Implementation Study

Physicians Should Play Important Roles in Fixing Medical Errors

Physicians need to play an integral role in working with hospitals to fix systemic failures. Lack of response by some medical staff to new initiatives or new process design has contributed to slow progress in some hospitals. Some physicians have been very helpful in some respects in fixing medical errors, but a great number of them refuse to support the hospital in fixing medical errors and reducing cost. They are the same group raising hell over increased malpractice insurance, failing to realize the role medical error is playing in raising operational costs of everything in health-care. This is no longer a time when a physician can just ignore the system and do whatever he or she wants. Systems are becoming more operationally complicated, and a lot of money and teamwork will be needed to operate them. Lack of cooperation from physicians in reducing errors and cost may be a major problem of the future. For example, there was a physician in a particular hospital that used to order neurological blood tests costing over $1,000 on each of his patients, despite the fact that insurance was not paying for the tests. Later, the medical director stepped in to stop the ordering of such tests since they were costing the hospital a lot of money and did not contribute to better care for the patient.

 Physicians Need to Police Other Physicians

The situation of physicians ignoring the errors of other physicians is becoming a problem. A silent code like this is detrimental to quality improvement. Physicians need to start policing other physicians. The hands-off process in which one physician sees mistakes and refuses to intervene remains a big problem in most hospitals. If other physicians are unwilling to intervene, then the chief of medical staff must get involve. Many times when physicians are about to perform useless procedures or order ridiculous tests that waste hospital revenue and decease the quality of patient care, health-care workers have no place to report such problems. In some hospitals, monitoring of better patient care is being done primarily by nurses. To make programs more clinically effective, physicians and other health-care workers should join nursing committees to make monitoring of clinical outcome a collaboration between other health-care professionals.

 Steven G Schwarz, in his article, “Reduce Medical Errors to Cut Malpractice Insurance Rates” (Rochester Democrat and Chronicle, May 27, 2003), stresses that physicians are more interested in blaming the insurance companies for increasing rates more than working to improve the quality of care. He indicates that many physicians refuse to accept that medical malpractice is a real problem, killing thousands. Schwarz states that a few physicians making major errors continue to practice medicine while other physicians refuse to report them. He cites a report by Public Citizen group in March 2003, stating that 7 percent of New York’s licensed doctors are responsible for 68 percent of all medical malpractice payouts. At the end of his article, he stresses that if physicians would spend more time holding negligent physicians responsible than lobbying their insurers and state agencies, both doctors and patients would benefit.

 Misinterpretation of physicians’ bad handwriting continue to be a big problem leading to medical errors. Matt Leingang in his article, “Seminar Will Coach Medical Pros on Penmanship” (Democrat and Chronicle, Rochester NY, May 14, 2003) he states that poor handwriting among physicians rooted as bad habit due to busy work schedule has been responsible for wrong prescriptions and treatments. He cited one case where a 42-year-old man who had a heart attack after receiving the wrong medication. The physician wrote Isordil and the pharmacist misread it for Plendil. Isordil is prescribed to relieve of angina pectoris (suffocating chest pain).  Plendil is used as an anti-hypertensive drug.  The biggest problem is created by those physicians with bad handwriting who refuse to accept correction.

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