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Transparency Key To Health Care Quality Improvements

According to the Institute of Medicine, medical mistakes cost the U.S. health care system between $17 and $29 billion a year. It estimates that medical errors kill nearly 2,000 people per week. New technology and, potentially, new attitudes among rising doctors could greatly reduce medical malpractice and make the health care system safer for everyone, according to surgeon Marty Makary. According to Dr. Makary, secrecy among medical professionals and hospitals must be overcome before the industry can improve its dismal record of safety.

The call for transparency is supported by the improvements made by New York hospitals in the late 1980s and early 1990s. In 1989, New York enacted laws that required hospitals in the state to report their heart-surgery death rates. The rates for the same procedures varied widely by facility. The lowest death rates were around 1 percent while the highest was 18 percent. The public was made aware that a person was 18 times more likely to die of a particular type of surgery at one facility than at another. With that knowledge, consumers who were aware of the numbers were unlikely to choose a hospital with a poor record. The hospitals scrambled to improve their mortality rates and the state saw an 83 percent decline in total death rate for heart surgeries by 1995.

Most patients assume their doctors will follow the accepted best practices when performing any procedure. That assumption is often faulty. The New England Journal of Medicine conducted a study that found that roughly 50 percent of all medical care follows the guidelines of the day. Dr. Makary suggests that cameras and peer review of techniques and procedures could help more doctors keep pace with the safest and most up to date practices.

In general, Dr. Markary suggests that the health industry needs to be more transparent. Mistakes that are exposed to the bright light of public scrutiny are more likely to be corrected than those that are hidden from view.

Source: The Wall Street Journal, "How to Stop Hospitals From Killing Us," by Marty Makary, 21 September 2012

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