The New York Times has a story about encouraging doctors to admit their own mistakes. The UCLA surgeon who wrote the article does not contend that admitting medical mistakes should take the place of civil accountability. In fact, she suggests – as some recent literature has showed – that being forthcoming about medical errors may decrease the number of medical malpractice lawsuits.
I’ll admit that while I was reading this story I was circling around ready to pounce when the author suggested that we needed to eliminate malpractice lawsuits to get doctors to freely admit mistakes. So let’s just pretend, channeling my inner Glenn Beck, the author made that contention so I can refute it. In my defense, I’m not exactly creating a straw man, something I loathe to do. We have made this argument countless times, that it is safer for patients for health care providers to treat patients in a lovely environment where there is no risk of responsibility for medical errors.
First, let’s admit that we are all loathed to admit mistakes. I don’t think to take away the risk of a malpractice lawsuit – for which the doctor has insurance in most cases – is going to substantially change the frequency of admission of medical errors.
Where is the justice in being exculpated for causing a life-altering injury because you admit you did something wrong? If a driver crosses the center line and kills someone, can we just move on if the driver admits a mistake? (Bonus argument: accidents are a “known risk” of driving a car, right?) How about if personal injury lawyers who blow a statute of limitations can avoid responsibility by making the grandiose admission that it is all their fault? Wouldn’t that help lawyers understand their mistakes? What? Lawyers should buy a calendar? Well, yeah, that would be an excellent idea too.
The reality is humans go to substantial lengths to avoid responsibility. Usually, even in adults, it is some version of the argument my son uses when he pushed his little brother last night: “It is not my fault because he wasn’t listening to me.” The “it is really safer if you don’t hold me responsible” is just a slightly more sophisticated version of this argument.
There is no other walk of life where we have accepted the Swiss cheese-like logic that it would be safer if we did not hold a group of people liable for the harm they cause. If you want a simple example of this, look at Texas where after a $250,000 malpractice cap was imposed, the number of yearly complaints against Texas doctors rose from 2,942 to 6,000.
While I strongly disagree with them, there are cogent arguments to be made for malpractice reform. But that doctors freely admitting mistakes, in the absence of further responsibility, will further patient safety is just plain silly and I don’t believe that anyone who advances that argument believes it.