Irony – When An Advocate for Healthcare “Transparency” Hides Who They Are


I received a tweet the other day from what appears to be a patient safety advocacy group. That's always great to see.

However, I am usually curious to see who the group is, who their leaders are, etc.

The website is “Just Ask” or They raise serious issues about the lousy (my word, not theirs) level of patient safety that we see in the U.S. (and this is a global problem – see the statistics).

Their website has a page full of serious patient safety concerns, including:

  • What are safe patient/nurse ratios?
  • Nurses are often overburdened

Screen Shot 2014-06-23 at 10.31.10 AM

With deeper exploration of the site, it seems they really primarily advocating for a Massachusetts law that would set legal maximums for how many patients a nurse can have. California is currently the only state with such a law, I believe.

I'm wondering how a site and a page about patient safety can ignore crucial problems like:

  • Medication errors
  • Surgical errors
  • Hospital-acquired infections

Sure, having overburdened nurses and staff can lead to those problems, but nursing ratios aren't the only lever that can be pulled.

Patient Safety or Politics?

The website seems MORE interested in highlighting issues like hospital profit levels and high CEO pay. This is the same approach taken previously by the Minnesota Nurse's Association, an approach that's heavier on political rhetoric than concern for patients.

The site is not only advocating for a nursing ratios law, but they're also advocating for something called the “The Hospital Profit Transparency And Fairness Act.” They want to cap CEO and they want to cap profit levels at 8%.

Most hospitals would LOVE an 8% profit margin, actually. The averages in the industry are far lower. The anonymous Twitter account responded to my article about how it's silly for hospitals to spend more on marble and fancy buildings than they do on patient safety. If the profit margins were somehow capped at 8%, then the hospitals will just find ways (some wasteful) to spend money to make sure their profits aren't “too high.”

I'm all for patient safety, but I don't think it can be legislated and I don't think those particular laws are good ideas.

Who Owns & Runs the Site?

So who is behind the website? There's no “About Us” page.

Doing a “whois” search of public internet records shows a guy listed on LinkedIn as working in “Public Relations and Communications” and there's no tie to any healthcare advocacy organization.

There is a physical address on the site.

340 Turnpike Street
Canton, MA 02021

Doing a Google search on that address turns up… the Massachusetts Nurses Association. I guess that isn't too surprising.

Are they looking out for patients and/or looking out for their own best interests as a union? Those aren't always going to be in alignment.

Shame on the creators of the website for hiding behind anonymity and for not disclosing their apparent connections to the union.

It's also questionable, if not shameful, that the group is soliciting donations for this anonymous group

To their credit, they do disclose:

I understand that contributions to the Committee to Ensure Safe Patient Care are not tax deductible.

If they want to be political advocates and have a political discussion, then fine… but I don't think they should wrap themselves in the flag of patient safety.

Patient-Focused Organizations I Support

I prefer to support non-profit groups that aren't pushing a political agenda, such as:

This is a human issue, not a partisan issue. It can be addressed through better systems, better processes, and better management. I'm more optimistic making progress that way than I would be through legislation.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Mark – Good on you for doing the research before providing support. I completely agree that there are many moral and ethical reasons to improve processes, and that good leadership is better able to make those changes than legislation. Legislation will only set a ‘minimum standard’, while good leadership will always look for a better way.

    • I’d be curious if the unions who are pushing for legislating nurse/patient ratios can provide data that shows that patient safety has improved in California and, if so, how we know that it’s the result of the ratios.

      Don’t get me wrong… I certainly understand that nurses are overburdened and they are often put in really bad situations. I think most hospitals are UNDERSTAFFED given today’s poor processes. We can either throw people at the problem (at best, a short-term solution) or we can improve systems and reduce waste.

      • I agree with you Mark!

        I think one thing that would reduce the pressure on ratios is the utilization of other health facilities besides hospitals. There needs to be MORE discussion on this topic, and I think it is imperative in today’s health care environment. Many patients with minor health needs, such as flu shots or blood-pressure checkups, are now going to local “retail clinics” largely because they’re found at retail outlets such as pharmacies, and reserving hospitals for more serious conditions. This is a great way to allocate health care more efficiently and thereby relieve some of the pressure on the hospitals. I think Kaiser Permanente has really understood this component well as their model is clinic centric.

        There is a place for the hospital and certainly there’s a time. But we need to make sure that it’s used appropriately and that there are alternatives out there so that patients who don’t need hospital care can get their needs met at places outside the hospital setting.


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