Michael J. Stabile, M.D., an anesthesiologist with Anesthesia Medical Group, and a recent graduate of the MBA program at the Jack C. Massey Graduate School of Business, has written an op-ed on medical malpractice and why the healthcare system itself is to blame, published today in the Nashville City Paper. The piece draws on Stabile’s background as an anesthesiologist and his Massey MBA management education.
Here’s an excerpt:
I would pose the question, have larger punitive damages and increasing malpractice litigation made your hospital stay safer over the past 20 years? Why not? Malpractice focuses on the person and ignores the organizational flaws responsible in the background. Unfortunately, everything suggests things will only get worse.
An internist who saw 20 patients a day in 1980 must now see 30 patients a day to keep a practice afloat. More insurance forms, decreasing re-imbursement and higher malpractice premiums mean smaller margins. The emphasis on throughput in a system already at capacity inevitably leads to more errors and lapses.
Hospitals have been pressured to cut overhead also. This has led to recruitment of transient staff that often are undertrained. Experienced people are viewed as too expensive or simply not available. Hence, LPNs replace RNs. Everybody now has a white jacket but maybe not the expertise that went with it.
The critical shortage of nurses and specialists will only worsen with the aging demographics of the United Sates. Just as patient care has become more complex, staffing becomes less qualified. Moreover, hospitals don’t have the capital surplus to maintain and upgrade equipment.
If this doesn’t seem enough of an uphill battle, throw in a whole layer of bureaucracy and regulations under the guise of patient confidentiality (HIPPA). Doesn’t it seem in your best interest that everyone involved in your care (from OR transport to discharge nurse) know you and the type of surgery being performed.
Safety in medicine is no different than safety in other high-risk activities. It will require upgrades in technology, an open reporting system for critical events, and the implementation of fail-safes and redundancies. Don’t kid yourself. It will be very expensive. However, increasing litigation costs and punitive damages won’t fix this problem. If they had, patients would be flocking to Mississippi for their care.
