perhaps the biggest single impediment to real progress in designing a new medical regulatory system.
2. Regulation by state medical boards is also a failure. The medical boards,
for the most part, are complaint driven. If no complaint is raised, there is no
recognition of problems. As Dr. Lucian Leape pointed out, only 1 out of
approximately 8 cases of medical error ever sees the light of day. And, it is
well-known to Victims that the state boards go out of their way to protect
physicians and hospitals, most likely to reduce their exposure to civil suits.
These are broad generalizations, admittedly. However, neither the civil court system nor the state medical boards have served to bring definitive reform in diminishing the extent of medical error. In fact, there is sort of "schizophrenia" to a system in which certain cases (almost always those that will make money for the lawyers) go the route of tort law and others go into the administrative law of the state boards.
It is generally agreed that the theoretical deterrent value of civil litigation has been a failure in controlling the malpractice epidemic Physicians well know that skilled lawyers can often "get them off". And the state board system (which does not regulate but rather responds to complaints) is seen by physicians as a nuisance rather than a regulator of their activities.
Our website was the first to draw the comparison between safety in Medicine and safety in the Airline Industry. Yet, the comparison only goes so far. One reason air travel is so safe is that when accidents occur, the pilot goes down with the plane. This has encouraged responsibility.
By contrast, when a patient is injured or dies, there is often no accountability. Imagine how quickly the issue of medical error would be addressed were the responsible medical provider to suffer the same fate as a negligent airline pilot who makes a fatal mistake.
In all seriousness, it is true that "To Err Is
Human". Standards of care must be developed in medicine, far more effective
than exit today, to provide responsible regulation.
Fifty years ago, in "Reason and Law", the famous teacher of philosophy Morris Raphael Cohen stated, "punishment must fit the crime, not the criminal."
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