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PHOTOS: Healers Who Harm
For more than 20 years, trial lawyer Rick Boothman defended doctors and hospitals in malpractice lawsuits. The job taught him plenty about the disconnect between the defensive behavior practiced by the medical establishment and the humane treatment patients want. So when the University of Michigan Health System needed a new in-house attorney in 2001, Boothman made an offer: hire me and revolutionize your approach. We’ll be up front with patients when medical errors happen, and we’ll pay quickly when a case warrants it, rather than dragging everybody into court. “It’s the decent thing to do,” says Boothman. A new study published in August found that since Michigan adopted Boothman’s program of disclosure and compensation, lawsuits have declined and legal-defense costs have dropped by 61 percent. There’s no proof that acknowledging mistakes led directly to savings, but it didn’t cause a malpractice frenzy either. “The sky doesn’t fall in when you are open and honest,” he says.
Boothman’s approach is part of an expanding push nationwide to tackle one of medicine’s most complicated and agonizing blights. In 1999 the Institute of Medicine’s landmark report “To Err Is Human” found that as many as 98,000 Americans die every year from preventable medical errors—a number many experts now believe is conservative. Since then, incorrect diagnoses, needless infections, drug mix-ups, and surgical mishaps have piled up as doctors face an onslaught of patients, an abundance of imperfect information, and an ill-served tradition of shaming and blaming individual practitioners when things go wrong. Health care, says Dr. Lucian Leape, a pioneer in patient safety and chair of the Lucian Leape Institute at the National Patient Safety Foundation in Boston, “remains fundamentally unsafe.”
The debate over health-care reform (the first significant provisions of the new law kicked in last week) spotlighted major weaknesses in the U.S. medical system, including errors. Even before the law’s passage, the Centers for Medicare and Medicaid Services—now headed by Dr. Donald Berwick, a stalwart in the patient-safety movement—announced it would no longer reimburse hospitals for the cost of preventable complications, such as bedsores and wrong-type blood transfusions. Twenty-eight states now require hospitals to report infection rates to the public. And the reform law mandates that hospitals with high infection rates will see their Medicare payments reduced by 1 percent starting in 2015.
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