Allowing patients to define a medical adverse event

Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there.  That being said, the other way for patients to get some retribution is to stop seeing that doctor.   Word of mouth will spread, like any other business, and that doctor’s business goes under.

Right now, state boards allow patients to complain about anything and they have to investigate that complaint.  Many are a waste of time.  I was a victim of this recently when a patient complained that I didn’t give her an antibiotic for a virus.  Her strep test was negative and so was her culture.  Long story short, her complaint was dropped but not after a tremendous amount of angst, stress, evidence gathering and time on my part.  The state boards represent patients and not doctors.  Unfortunately, this has become an antagonistic situation with all the power going to the patients.   Val Jones, MD just tipped me off to another system being set up that can easily be abused.

The Obama administration is creating a pilot program that will launch this fall, which is prototype patient reporting system through a contract with RAND Corporation and the Agency for Healthcare Research and Quality.  It is called the Consumer Reporting System for Patient Safety and the project is designed to collect information from patients “about medical errors that resulted or nearly resulted in harm or injury” and can also secure reports from family members with the data supposedly being available for use by providers and health systems that wish to create or enhance their own local reporting systems.  Create?  Enhance?

This is right from the Kentucky Health News article:

Here’s how the system will work: When a patient recognizes a medical error, an intake form will ask what happened, including questions about the details of the event and the health care provider(s). Providers and patient safety officers are expected to follow up with the patient, which AHRQ estimates would add 28 hours to the provider’s annual work load. The collected data will be analyzed to produce estimates about the patient safety events, which will be shared with health institutions.

Anyone else see a problem with this?  Only 28 more hours to the provider’s workload.  Is that per complaint?  And define a medical adverse event?  That is the key.  Just because you didn’t like the doctor because he didn’t give you antibiotics doesn’t mean it is an adverse medical event.  Just because a bad outcome happen doesn’t mean it is a medical adverse event.  Bad things in life do happen. People do die.  Trust me, this will be problematic because you are banking on patients to discern the definition when that definition is already confusing.

Doug Farrago is a family physician who blogs at Authentic Medicine.

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