New Medicare Policy Mandates Disclosure of Medical Errors
Federal officials will soon reverse a policy preventing Medicare recipients from obtaining information about doctors under investigation for medical mistakes, ending a two-decade rule that has "medical errors secret," the New York Times reports. Under the new policy, doctors will no longer have the power to veto disclosure of the investigations' findings. Investigators also will have to tell patients whether they received "professionally recognized standards of health care" and inform them about actions against doctors or hospitals -- information that patients could use in lawsuits. The policy shift comes after Alan Levine, the son of a Medicare patient who died in the hospital after an asthma attack, filed suit against the government. According to Levine's attorney, Amanda Frost of the Public Citizen Litigation Group, the current Medicare policy regarding medical errors "violate[s] federal law." HHS officials have since promised to change the policy to allow patients to receive information about medical mistakes. "The revision of our policy is definitely an outgrowth of this particular case. We want to fix the problem and make sure no one has the same problem in the future," one senior HHS official said. While consumer advocates "welcome" the new rules, doctors and peer review organizations -- "powerful watchdog" groups that investigate Medicare patients' complaints -- worry that physicians, fearing potential patient lawsuits, will no longer "cooperate" with investigators. "If doctors know that anything they provide can potentially be revealed, they will be more worried about lawsuits, penalties and a punitive reaction," Dr. Ferdinand Richards, medical director of a Florida peer review group, said, adding, "They will be less apt to come forward with information about mistakes and errors. That will retard the effort to improve the quality of care." Tens of thousands of Medicare patients file quality of care complaints against doctors and hospitals annually (Pear, New York Times, 1/2).
In other medical error news, the Joint Commission on Accreditation of Healthcare Organizations, the group that oversees most U.S. hospitals, announced last month a new requirement forcing hospitals to provide an "honest explanation" of medical errors to patients and their families. The group hopes to "identify and acknowledge" medical mistakes, investigate them and help curb them. By failing to comply with the rules, which will take effect July 1, hospitals could endanger their accreditation. "What patients want is an honest explanation, and apology and a description of what you are doing to change so it won't happen to someone else," Colorado anesthesiologist Dr. Michael Leonard, an advocate of medical error disclosure, said. While many doctors, fearing lawsuits and disciplinary action, "remain silent" about medical mistakes, Leonard said that "honest communication" often proves "crucial" to patient safety. He said, "There is a dramatic potential for error reduction if we could be open and honest about the errors we make." Still, the new policy will likely "stir considerable controversy," raising the "specter of malpractice lawsuits." Dr. Richard Frankenstein, a JCAHO and California Medical Association board member, said, "We have got to separate concerns about lawsuits and liability from carefully evaluating (a medical error) and honestly talking with the patient," adding, "The thing that infuriates a patient the most is that they aren't told what's going on with their own body. Leveling with the patient is best" (Wells, San Francisco Chronicle, 12/24).