![]() ![]() Correct protocols were followed, but just when the patient seemed to have stabilized, she collapsed. Snyder that because several treating physicians were present at a “protected” case discussion and had not been consistently identified in the minutes, the entire discussion was open to legal discovery by the plaintiff’s attorneys.ĭuring residency, one of us (C.L.) cared for a young patient who had overdosed on a potent cardiac medication. In December 2021, a New York court ruled in Siegel v. Casualties include future patients and self-censored doctors who succumb to anxiety, depression, and - at twice the national average - suicide.Ī recent “Clinician of the Future” report by Elsevier Health revealed that 31% of health workers were going to “leave their current role within the next two to three years.” Yet the criminalization of medical error, which contributes to this diaspora, proceeds apace. Doctors do not learn from each other’s mistakes, or even their near misses, since it is hard to predict what might spark a lawsuit. This legal tripwire hurts everyone: people who may have been harmed by a medical error or their family members get no useful information. Physicians need to openly discuss medical mistakes and near misses To truthfully answer no, the defendant doctor must keep mum for years. Driving home this code of omertà, medical malpractice plaintiff attorneys in New York State invariably open depositions with this question: “Have you discussed this case with anyone in any setting ever?” The Catch-22 is obvious: doctors must prevent mistakes but they will be punished for honestly analyzing them. In other words, a hospital committee can discuss a possible error but no one involved in the case can speak - or even be present - because anything they say can be used against them at cross-examination in a future trial. The law protects those discussions from later legal discovery, but then goes on to explicitly carve out an exception: “The prohibition relating to discovery of testimony shall not apply to the statements made by any person in attendance at such a meeting who is a party to an action.” New York State Education Law 6527 requires hospitals and health care facilities to form peer and quality review committees to investigate possible errors and patient harm. In New York State, anything a doctor says or writes - to colleagues, friends, partners, or even relatives - can be used in court against them. But similar environments exist in Florida, California, and other states. Since we all practice in New York State, we are writing here about its culture of silence. ![]() Imagine a death in the family with no outlet for grieving. Coverys, a large malpractice insurance carrier, released its analysis of 11,907 medical malpractice cases from 2010 to 2019, and concluded that over the past 10 years, “we continue to see high numbers of claims in largely the same areas.” Which is a polite way of saying: health care providers keep making the same mistakes.ĭespite much recent advocacy for physician well-being and “just culture” (chalking up many errors to systems rather than to individual providers), what has not changed in New York State since 1999 is that the day a doctor commits an error that may have hurt a patient, when you are desperate to process, to understand, to make amends, you are immediately warned to stay silent. Twenty-three years later - after billions of dollars spent on quality improvement and mountains of analyses filed - we are not even close. The authors called for a 50% reduction within five years. In 1999, the Institute of Medicine published “To Err is Human.” This landmark report estimated that 100,000 Americans die of medical error every year. Exclusive analysis of biotech, pharma, and the life sciences Learn More
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