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Doctor Offers Five Reforms for Preventing Medical Errors

Surgeon Marty Makary made headlines last week with an eye-opening article about medical errors from the perspective of a respected medical professional. He also offered five reforms for preventing medical errors by increasing transparency and accountability.

In his Wall Street Journal article, Makary recounts several statistics that we have referenced on this San Diego medical malpractice blog, but are worth repeating. The most startling—medical mistakes kill enough people each week to fill four jumbo jets.

Makary also acknowledges that the culture of the medical community contributes to the number of medical errors as well as the lack of reporting. “As doctors, we swear to do no harm. But on the job we soon absorb another unspoken rule: to overlook the mistakes of our colleagues,” he writes.

To help increase patient safety, Makary proposes the following five reforms:

  • Online Dashboards: Makary wants every hospital to create an online informational “dashboard” that includes its rates for infection, readmission, surgical complications and blatant medical errors. The dashboard should also list the hospital’s annual volume for each type of surgery that it performs and patient satisfaction scores.
  • Safety Culture Scores: Makary also believes that patients should have access to information about the culture of teamwork and communication, as it can often have a dramatic effect on the quality of patient care. As he highlights, the best way to obtain this information is to survey staff about the culture of the hospital, i.e. would nurses feel comfortable raising concerns to a surgeon in the operating room?
  • Cameras: Makary cites cameras as a way in which technology can help improve safety and compliance. For example, reviewing tapes of cardiac catheterizations, arthroscopic surgery and other procedures could be used for peer-based quality improvement.
  • Open Notes: Allowing patients to access the notes taken by doctors during their consultation and treatment can improve care, according to Makary. The practice, referred to as “open notes,” can involve reading back the notes taken during an appointment or providing patients with online access. In either case, patients are given the opportunity to correct or supplement the information recorded by their doctor.
  • Stop Gag Orders: As Makary notes, patients are increasingly being asked to sign legal documents preventing them from taking badly about their doctors, even if they make mistakes. He believes, “We need more open dialogue about medical mistakes, not less. It wouldn’t be going too far to suggest that these types of gag orders should be banned by law. They are utterly contrary to a patient’s right to know and to the concept of learning from our errors.”