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See Something, Say Something!

From Roni Caryn Rabin writing in the NY Times Vital Signs column;
"One in three physicians say they do not believe they should always report an incompetent or significantly impaired colleague, a new study reports."
I wonder, do physicians upset over their malpractice premiums ever examine their own attitudes toward reporting incompetent or impaired colleagues?  Do they connect their silence with the hidden costs of higher malpractice premiums for everybody?

It's suggested that medical schools re-emphasize the importance of reporting.   And here I thought physicians were supposed to acquire a certain amount of common sense BEFORE arriving at medical school, not after.

I know, I know, why rock the boat when good physicians get sued right along with the bozos?  And of course the main problem is really the cabal of rapacious insurers and venal trial lawyers, right?  Why do anything substantive when solutions are difficult and complaining makes for such great headlines?

Don't believe me?  Well, Ms. Physician, let me ask you a question: If a family member landed in your hospital's ER this evening, critically ill, can you name the few physicians to whom you would unhesitatingly entrust your loved one's life?  Of course you can.

And can you name several that you wouldn't let within 50 feet of the patient without a bodyguard and handcuffs?  Of course you can.

So what have you said or done about it?  Silence is golden. Sometimes it's also expensive and dangerous.


Rebecca S. said…
I'm an RN with 20+ years of diverse healthcare experience. For a time, I worked as an organizational development specialist. In this role I was tasked with developing and implementing strategies to improve patient safety and quality. At the heart of almost all sentinel events and near misses is broken communication. Through the needs assessment process and a series of coaching and education, I was not surprised to find that the underlying culture throughout the clinical areas of this faith-based, non-profit organization supported silence when it came to reporting inappropriate behavior. Drilling deeper, I found the cause of that silence to be rooted in fear of intimidation, humiliation and isolation often associated with speaking up. In not all, but most cases, specific physicians coming from a wide variety of well-respected medical schools were named as those most feared. It wasn't long after this (July 2008) that the Joint Commission released a sentinel event alert related to intimidating and disruptive behaviors and their link to increased medical errors.
A few months later, I accepted a position as the Director of Education for a web-based continuing healthcare education program at an institution of higher learning which includes a renowned medical school. I was shocked, to say the least, when I discovered that no one in my division seemed to be aware of the sentinel event alert and subsequent JC standards, or the extensive amount of research that had been devoted to the subject. It told me we have a long way to go!

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