Re: Laura's code of silence

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Posted by PREVENTING PATIENT INJURY IS URGENT from IP 65.209.120.239 on August 21, 2010 at 02:56:58:

In Reply to: Laura didn't read it well!!! posted by It makes sense on August 21, 2010 at 01:06:45:

Doctors' Code of Silence:
Many Keep Mum on Colleagues' Incompetence


HEY DOCTOR! Would you tell if you knew another doctor
was incompetent, drunk or mentally ill?

Would you report a physician whom you felt would end up
hurting a patient?

Dear reader, do you believe that your doctor would
answer "Yes" to those questions? Think again. About
one-third of you are wrong.

OVER ONE-THIRD WON'T REPORT A BAD DOC

More than one in three American physicians don't think
they're responsible for reporting colleagues who aren't
fit to practice. This is one of the findings from a new
study by researchers at the Mongan Institute for Health
Policy at Massachusetts General Hospital, reported in
the July 14 issue of JAMA (Journal of American Medical
Association.)


The study was based on survey responses of 1,900
physicians throughout the U.S. specializing in internal
medicine, pediatrics, cardiology, general surgery,
family medicine, psychiatry and anesthesia. About 36
percent of those who responded said it was not their
professional obligation to report any colleagues who
were significantly impaired, due to substance abuse or
mental illness, or incompetent.

"I'M NOT RESPONSIBLE"

Compared with other doctors, the anesthesiologists were
most responsible, followed by psychiatrists.
Pediatricians were the least responsible.

The researchers warned that self-regulation in the
medical field may not be enough to ensure that ill-
equipped physicians aren't potentially harming
patients.

WHY? THE REASONS DOCTORS GAVE

Why did doctors keep quiet? Some said they believed
that someone else would report on failing physicians.
Others reported a lack of confidence that anything
would actually result from a report or feared that they
would suffer some retribution once the transgressing
doctor discovered who reported them.

Lead author Catherine DesRoches was asked by NPR
(National Public Radio) why doctors don't speak up more
often when they see something wrong. Her response:

"In smaller practices, doctors are very dependent on
referrals, so they may worry that if they report a
colleague they'll face some kind of retribution. Their
number of referrals or professional reputation might
suffer."

To improve the situation DesRoches offered that doctors
need to know exactly how to report: the specifics of
who to call and where to go. Physicians also need to
know that reporting systems are confidential, that
they'll have anonymity.

STATES VARY WIDELY ON MANDATED REPORTING

Interestingly, states very widely on how they handle
incompetent doctors. Only some states mandate
reporting.

The reports findings were that a large number of
practicing physicians do not support the current
process of self-regulation -- peer monitoring and
reporting. This system is underused and has major
shortcomings.

PREVENTING PATIENT INJURY IS URGENT

"The report concludes: "All health care professionals,
from administrative leaders to those providing clinical
care, must understand the urgency of preventing
impaired or incompetent colleagues from injuring
patients and the need to help these physicians confront
and resolve their problems. The system of reporting
must facilitate, rather than impede, this process."

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