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Dealing With Medical Error Together

The “Running A Hospital” blog has another discussion of dealing with medical error. This time, the hospital has opened up an error of its own (a “wrong side” surgery) for examination by the Open School of the Institute for Healthcare Improvement (IHI).

Sample comments:

— From IHI’s Jim Conway: “Our systems are too complex to expect merely extraordinary people to perform perfectly 100 percent of the time. We as leaders must put in place systems that support great practice by people who suffer from being human and will make mistakes.”

— From a patient who had two surgical errors in ten months: “After years of suffering through our incredibly brutal tort(ure) system I finally had the chance to talk to the surgeon. The most meaningful words he spoke were the descriptions of how badly he suffered also from the event we shared in that OR. Finally I was not alone!”

As we’ve often said, participatory medicine brings a new kind of partnership between patient and caregiver. Neither denial nor a Wall of Silence (famous book) has any place in a healthy relationship. It breaks my heart to think of the good lives that are ruined by our cultural inability to deal with honest errors in complex situations.

Yes, as Linda Kenney of MITSS mentions in a comment, some employees (in any industry) are reckless and must be weeded out. That too can be a denial issue. But first, we need open discussion.

*This blog post was originally published at e-Patients.net*

“Medical Self-Care” And The Doc Tom Interview

Next in our series of posts about our founder Doc Tom. Previous time capsules: 1980 and 1985.

Come, ye economics buffs and algebra fans: Get out your pencils and solve for x, n, and XX:

Whatever else the year 19XX is remembered for, it will — without a doubt — go down in history as a record year for medical expenses here in the United States. All indications are that before the calendar year is out, Americans will have spent $x (n% of the Gross National Product) on drugs, X-rays, surgery, physicians’ fees, laboratory tests, hospital overhead, health insurance, etc. That’s up from the [$0.3x] ([.7n%] of GNP) just 13 years ago.

Clearly, the medical establishment has become a threat to the average American’s budget (if not his health).

Ready? That was…1978. Check the tiny numbers:

Whatever else 1978 is remembered for, it will—without a doubt—go down in history as a record year for medical expenses here in the United States. All indications are that before the calendar year is out, 216 million Americans will have spent $139 billion (8.6% of the Gross National Product) on drugs, X-rays, surgery, physicians’ fees, laboratory tests, hospital overhead, health insurance, etc. That’s up from the $39 billion (5.9% of GNP) medical care cost in 1965 . . . just 13 years ago.

Tom Ferguson was a medical student, and in the self-reliant era of the Whole Earth Catalog, he saw that patients could help heal healthcare by taking better care of themselves. In 1976 he’d started a magazine called Medical Self-Care. The text above appeared in Mother Earth News in May 1978, as the introduction to an 8,000-word interview with Tom. Read more »

*This blog post was originally published at e-Patients.net*

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