MEDICAL ERRORS: AMA Not in Favor of Mandatory Reporting
Sen. Arlen Specter (R-PA) and Nancy Dickey, former president of the AMA, "clashed over whether the government should require health care workers to report and publicly disclose serious errors" during a three-hour hearing of the Senate Appropriations subcommittee on labor, health and human services and education, the Philadelphia Inquirer reports. Subcommittee Chair Specter asked Dickey if the AMA would favor the Institute of Medicine recommendation of a federal reporting system for serious errors. Dickey responded, "We don't believe at this point that we need a federal mandate," adding that "mandatory reporting would not improve patient care" (Gerlin, 12/14). She said, "Past federal efforts to collect data on physicians and other health care providers in the name of quality improvement have had a negative effect on efforts to create an environment that fosters trust and open communication" (Rovner, CongressDaily, 12/13). Specter shot back, "I would respectfully disagree with you about the need for a federal mandatory reporting system. I think the evidence is on the table for it. ... You're talking about a problem here which is pretty well recognized nationally" (Philadelphia Inquirer, 12/14).
Others testifying before the subcommittee included industry insiders, patients harmed by medical errors and family members of those who had been harmed. Stanton Smullens, who testified on behalf of the American Hospital Association, agreed with Dickey's sentiments, saying, "We have to create an environment in which we learn from failure. This cannot be achieved in an environment of punishment or fear of legal prosecution for doctors, nurses and other care givers who step forward after an unfortunate mistake is made" (CongressDaily, 12/13). Dr. John Eisenberg, director of the U.S. Agency for Healthcare Research and Quality, said that the IOM report's finding that mistakes result in between 44,000 and 98,000 deaths each year might be an underestimate. He said that "since the report principally examined errors in hospitals -- because very little data is available on other health care settings -- we believe the magnitude of the problem is understated" (Reuters/Washington Times, 12/14). Eisenberg added that if the problem of medical errors "were a disease, we'd call it an epidemic. If it were a disease, we'd attack it with the best resources we could." Mary Wakefield, an IOM committee member and director of the Center for Health Policy, Research and Ethics at George Mason University, pointed out that almost one-third of states currently have reporting requirements, information that "is critical to learning why errors occur." She added, "We also believe that the public has a right to know about errors resulting in serious harm, and that this information should be made available to the public with appropriate safeguards for protecting patient and provider confidentiality." Florida resident Patricia McEachern testified about her partial paralysis as a result of a stroke she suffered when a catheter became entangled in an artery during surgery performed by a resident. After winning a lawsuit, McEachern formed the Association for Responsible Medicine with her husband, Ray McEachern, who testified, "A cover-up is a crime. The concern should not be to protect the health care providers, or, more precisely, their insurance companies. The concern must be to find ways to prevent injuries from being covered up" (Philadelphia Inquirer, 12/14). The debate appears to have the potential to rage on as Sen. Edward Kennedy (D-MA) said he would introduce legislation during the next congressional session. Specter said he will make a similar move (CongressDaily, 12/13).