It sounds like a good idea in theory. But half of doctors surveyed say they do not report incompetent colleagues or serious medical errors.
The startling revelation appears in the Annals of Internal Medicine.
In the survey 3,504 practicing doctors were asked whether they understand and support professional standards. 93 percent of doctors responding believe one should always alert authorities when facing potential medical errors or malpractice. But in reality only 55 percent said they always did so. Cardiologists were the least likely to tell others when they observe a serious medical error or an impaired or incompetent doctor. Next least likely were family practitioners. Other specialties surveyed include anesthesiologists, surgeons, internists and pediatricians.
Jack Lewin, CEO of the American College of Cardiology, tells USA Today that because most cardiologists practice in groups they are more likely to deal with problems internally. And he says lawsuits are a real concern if it results from spilling the beans. "We probably need some kind of whistle-blower protection for doctors," he tells USA Today.
When reports are made it offers an opportunity to improve services. That is exactly what happened last month in Rhode Island.
After a resident ( a doctor in training) began drilling into the wrong side of a patient’s head, he realized the mistake and closed the 82-year-old patient’s head. But The Rhode Island Hospital reported the error to the health department which made a surprise inspection a few days later.
The teaching hospital for Brown University, is now under investigation after three botched wrong-site surgeries. One person died last August when a surgeon went into the wrong side of his head. His death may not be connected to the surgery and that is still under investigation. The other two patients are fine.
Now the chief of the neurosurgery department is stepping aside.
Dr. John A. Duncan will still oversee patients but he has been relieved of the duty of running the department, that decision made by the hospital’s parent company Lifespan.
Jay Wolfson, a professor of public health at the University of South Florida tells IB News that wrong-site surgery is often performed by the same doctor. When different doctors are making the same mistake, it indicates a systemic problem. “The chief of staff has a special obligation to say we need to put in place rules governing surgery, otherwise who is not minding the shop?”
The hospital has been fined $50,000 and will have all intra-cranial neurosurgery procedures monitored by another attending physician. In addition, the “time out” required to double-check patient’s name, side of surgery and procedure will be attended by a physician, nurse and resident as well as the surgeon.
Since 1998, the Joint Commission on Accreditation of Healthcare Organizations has studied why wrong-site surgeries occur. It blames a myriad of problems including incomplete patient intake information, distraction, basic communication problems among those in attendance and the failure of operating room policies.