re: #816 quickjustice

I think the answer lies, not in “tort” reform, but in a renewed emphasis on “patient safety”.

According to an authoritative IOM study (Crossing the Quality Chasm: A New Health System for the 21st Century 2001 at 4): “Safety flaws are unacceptably common, but the effective remedy is not to browbeat the health care workforce by asking them to try harder to give safe care. Members of the health care workforce are already trying hard to do their jobs well. In fact, the courage, hard work, and commitment of doctors, nurses, and others in health care are today the only real means we have of stemming the flood of errors that are latent in our health care systems.”

The IOM report continues: “Health care has safety and quality problems because it relies on outmoded systems of work. Poor designs set the workforce up to fail, regardless of how hard they try. If we want safer, higher-quality care, we will need to have redesigned systems of care, including the use of information technology to support clinical and administrative processes.”

And an earlier Institute of Medicine report (To Err is Human: Building a Safer Health Care System, November, 1999 at page 49) concurs: “People working in health care are among the most educated and dedicated workforce in any industry. The problem is not bad people; the problem is that the system needs to be made safer.” (emphasis added).

Most important, because they focus on individual responsibility for medical errors, rather than upon improvements in the health care safety systems of which individuals are only a part, lawsuits and the current legal system erroneously target “bad people”. By perpetuating its own obsolete myth (that individuals are to blame for medical errors), the current legal system diverts energy, attention, and huge amounts of human and financial capital away from efforts to improve patient safety into its own systemic “blame game”. In this respect, the current legal system actually injures patient safety, and prevents the health care system from improving its safety record.

The IOM report adds that to make patients safer, “[H]ealth care organizations must develop a systems orientation to patient safety, rather than an orientation that finds and attaches blame to individuals.”

The legal system’s sole purpose is to find and attach blame to individuals. It is quite clear that its goals are completely out of sync with those of the patient safety movement. Worse, the legal system’s systemic orientation towards finding and attaching blame to individuals is itself a serious barrier to real improvements in patient safety.

Why not look at alternative compensation systems that “spread the wealth” fairly and equally among all persons injured by medical errors, instead of making jackpot awards to the “lucky” few who suffer catastrophic injuries, as does the current legal system?

Workers compensation, which solved a similar problem with the tort system a century ago, could be a model for real reform.

My whole reply to you was just eaten. Suffice it to say, I do not think that resorting to a Work Comp scenario is the fix.