Patient safety requires changing the culture of medicine

Patient safety has become more pronounced in hospitals today. But for the movement to have its full impact, doctors have to buy into it wholeheartedly.

And that’s where the progress is slower.

In her recent New York Times column, surgeon Pauline Chen discusses the “culture of fear” that pervades medical training. She cites a report from the Lucian Leape Institute of the National Patient Safety Foundation, which concluded that newly graduated residents go into the real world with little formal training in patient safety.

In fact, not much has changed over the years:

“Young doctors are being educated in a toxic culture,” said Dr. Lucian L. Leape, a leading patient safety expert at the Harvard School of Public Health who was chairman of the report’s committee. “The current environment is hierarchical, stressful for the individual, driven by the fee-for-service payment system and humiliating, all of which works against improving patient safety.”

Changing the medical culture begins early on in training. And that means that cash-strapped medical schools and residency programs need to find the funds and physician leadership to take charge — not easy to do when there are so many other competing interests.

It could be something as simple as teaching a resident to fill out an incident report; something, I admit, I was never taught during residency. If we want to create a “culture of safety” at our hospitals, physicians need to take the lead by instilling concrete methods to do so in their students and trainees who can then pass on those lessons when they become attending doctors.

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