Make Patients Responsible for Reporting Medical Errors? Really?
Karen Wolk Feinstein, president and CEO and the Pittsburgh Regional Health Initiative, channeled the Saturday Night Live Weekend Update segment “Really!?!” in this recent op-ed titled “Don't put this on patients: Sick people are supposed to monitor medical errors? Really??”
I'm all for patient engagement and I certainly believe that patients should be aware of risks and dangers in the hospital, but I think the hospital is abdicating its responsibility, and it's setting unrealistic expectations, if they are expecting patients to report (or even know about) medical errors or unsafe practices.
Why is it voluntary in most settings for doctors to mark a surgical site before cutting, for staff to wash their hands, for hospital and examining rooms to be thoroughly cleaned, for safety checklists to be employed? Why do whistleblowers get marginalized? Why are interns and residents afraid to report mistakes they witness? Why are clinicians who often over-treat with unnecessary interventions and tests or who routinely under-treat and fail to perform evidence-based best practices allowed to continue doing these things? What if a patient isn't even aware that medical mistakes are occurring? How could they tattle on their docs?
She draws parallels to restaurants, asking why a person would eat at a restaurant that gives them a 25% chance of getting food poisoning. Do we rely on restaurant customers to report unsafe conditions in the kitchen or refrigerators?
I've made a parallel argument before, pointing out that airline passengers aren't expected to double check the work of the pilots and, when you buy a new car, you aren't expected to double check if the lugnuts on the wheels are tightened properly. My graphic that's indicative of campaigns that encourage patients to ask doctors and nurses if they've washed their hands:
I think the primary responsibility needs to be taken by hospital leaders and physicians… not the patients. Let the patients focus on their own health and recovery and comfort, not policing the system that is supposed to take care of them.
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