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It's a path

Errors are the symptom, not the problem.

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patient safety symbol - a chalk outline of patient

There are many patient safety sites and organization, but none of them are official institutions charged with the duty and the authority to advocate for patients before the government and the press and the healthcare industry.

State after state passes liability limitations and what institution knocks on the doors of legislators to make them aware of the patients' view on that issue? When medicine feels inclined to get government to create another law or regulation unfriendly to patients, there needs to be an official representative of patients to speak for them in the matter.

Doctors have medical boards. Nurses have nursing boards. Hospitals have hospital associations. Anesthesiologists have guilds. Patients have nothing.

The religious right united and organized to lobby the government to influence legislation. Why don't patients? What constituency is larger than "patients?" If you are not a healthcare professional, you are a patient. That means almost everyone is a patient. And yet patients have no comparable institutional support.

Patients need professional institutional support that advocates for and supports them. That organization needs to have a phone number that journalists can call to get the patient's view. Currently journalists can not do much more than call three doctors and accept whatever self-serving paradigm it suits healthcare to believe on any given issue. When they call injured patients, invariably they reach someone with limited knowledge and experience and little or no experience in articulating such concerns to the press.

The organization should advocate for patients not just before the government and the press, but also by being there when patients become victims of adverse events. They need to be the institution that patients can telephone to reach professionals who are on their side when they need to find out things like how to get iatrogenic injuries treated (usually no one in healthcare will tell them how) and to explain things like the fact that they can file suits against "unknown John Does" in order to get subpoena power to get records when a hospital will neither identify their caregivers nor give them their records. That's only the beginning of the list of questions injured patients need to have answered.

The organization also needs to have a legal response team. 97% of patients with legitimate grievances cannot get lawyers. Their lives are no less ruined than the 3% who can. It's not that they all need to get a day in court or get a settlement. But they do need legal help, in part just to know what they can say and do without getting sued, but also to help with things like getting records when providers refuse to give them. Medicine has risk management departments dedicated to and experienced at defeating patients. Few lawyers have the expertise or the will to figure out how to help patients in the face of that. And the few who do are willing to represent only 3% of the patients.

There also needs to be a phone number to call to register complaints other than at an organization run by and for healthcare professionals. Those other organizations have agendas that compete with the interests of patients. On their boards they have doctors and nurses, not injured patients, and the way they handle complaints shows that. Even efforts like the Department of Health and Human Service's "Hospital Compare" site (www.hospitalcompare.hhs.gov), although it is welcomed and appreciated, is not going to help patients overcome the obstacles that stop injured patients from getting treatment and/or justice. And they are the government. They cannot lobby the government for patients. Rather, they are influenced by lobbies one way or the other eventually. One of those lobbies needs to be this one, the institution suggested on this page, the organization that follows legislative proposalspatient safety symbol - a chalk outline of patient and that advocates for the interests of patients.

Healthcare professionals are not likely to fix a problem they don't think exists. Patients need to fix it. Patients need to spend less time shouting at healthcare about what needs to be changed and more time creating the means to change it.

Muckraking - sometimes fiction is the only way to explain

In the news:
The John D. and Catherine T. MacArthur Foundation has given a $500,000 “genius award” to Peter J. Pronovost, 43, a critical-care physician who is trying to reduce the risk of fatal medical errors and infections in hospitals.
“The work I do is often the poor stepchild of biomedical research,” Mr. Pronovost said. “We spend a penny on patient-safety research for every dollar we spend on basic and clinical research.” But without patient safety “all the other science doesn’t do much good to protect health,” he said.

 

Home | Table of Contents | It's a Path
Silence versus Patient Safety
Loyalty versus Patient Safety
The White Wall of Silence versus Patient Safety
Blacklisting Patients
Freedom of Speech for Patients
Medical Complaints - How to

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It's a path

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Revised September 23, 2008