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There are many issues affecting patient safety, including medical malpractice suits and disclosure of physician reviews.
Everyone wants to promote patient safety, but what isn't known is that some legislation intended to promote patient safety actually harms good physicians directly and harms patients indirectly. This is through the National Practitioners Data Bank, established through the Health Care Quality Improvement Act of 1986, in response to the Patrick v. Burgett case in Oregon.
Check out our site, and see how bias peer review boards are destroying physician's careers and hurting patients. We provide in depth analysis regarding the effects of the NPDB on physicians, written by practicing physicians. Furthermore, we provide contract advice regarding due process and hospital administration issues involving physician groups. We also provide a list of hospitals known to take part in bias peer reviews.
Semmelweis Society International
http://208.56.184.71/
Andrew Holley
Everyone wants to promote patient safety, but what isn't known is that some legislation intended to promote patient safety actually harms good physicians directly and harms patients indirectly. This is through the National Practitioners Data Bank, established through the Health Care Quality Improvement Act of 1986, in response to the Patrick v. Burgett case in Oregon.
Check out our site, and see how bias peer review boards are destroying physician's careers and hurting patients. We provide in depth analysis regarding the effects of the NPDB on physicians, written by practicing physicians. Furthermore, we provide contract advice regarding due process and hospital administration issues involving physician groups. We also provide a list of hospitals known to take part in bias peer reviews.
Semmelweis Society International
http://208.56.184.71/
Andrew Holley
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Re: Patient Safety and Bias Peer Review
Sat, September 11, 2004 - 9:01 AMAre you saying that disclosure of physician reviews is a good thing or a bad thing? -
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Re: Patient Safety and Bias Peer Review
Sat, September 11, 2004 - 3:51 PMDisclosure of physician reviews are a good thing, but we have to set a standard for review and disclosure that does justice to a) physicians and b) patients.
If national disclosure of physicians who are involved medical malpractice suits were required, we would not have a single physician left standing, and involvement in a malpractice suit is not a sign of guilt.
If disclosure of error in a medical malpractice suit were required, again, we would have very few physicians left standing. Even notable physicians who handle thousands of patients a year with an extremely low error rate would be avoided like the plague.
It relates back to the policing issues, and the layman's interpretation of data. If you heard a physician accidentally hurt a patient, you would likely avoid them. However, with further information you would discover that every physician has hurt a patient. This is not a mark of incompetence, malice or greed, instead it is a sign of the human element.
The Health Care Quality Improvement Act of 1986 requires that any review involving the suspension or dismissal of a physician's priveleges be reported to the National Practitioners Data Bank. When a bias peer review or corporate executive targets a physician, and the findings are reported to the Data Bank, that physician's career is over.
Dr. Poliner in Texas just won $366 million from 3 "peer" physicians and the hospital administration after proving they acted in bad faith with malice.
I hope I'm beginning to paint a picture that can be comprehended. I know it gets a bit bland and abstract, especially for those not familiar with medical/legal lingo, but let me know what you think...
Andrew Holley
Semmelweis Society -
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Re: Patient Safety and Bias Peer Review
Tue, September 14, 2004 - 5:31 PMThe philosophy that patients are too stupid to be allowed access to information is the same philosophy that said that democracy never could work because citizens were too stupid.
Your argument regards the careers of physicians as being more immportant than the lives of patients, even though I'm sure you will believe that what is good for physicians is good for patients.
But you talk about the dangers for physicians if patients learn about physicians who "accidentally" hurt a patient when, in fact, patients cannot even learn about physicians who intentionally hurt patients. Victims of violence and rape in medicine not only cannot get criminal justice, they cannot even get treatment because the physicians they go to do not want to diagnose something that could harm the career of another physician.
The knee-jerk response to this issue from people in medicine is to say that it is so rare that it is not important. It is rare on the street too. So that makes it OK?
Besides, it is not as rare as physicians pretend it is. They are in denial about it.
Patients who have had their lives ruined by lechery or jealousy or greed or just plain cruelty on the part of their physicians need more than disclosure of the accidental hurts caused by physicians. When medicine becomes a place where crimes are reported, then maybe it will be time to begin worrying about whether or not to reveal the small percentage of errors that become known.
When even crimes do not become known, how many errors do you think become known? Not many. -
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Re: Patient Safety and Bias Peer Review
Wed, September 15, 2004 - 11:35 AMWe just elected a Hollywood star as governor of California. I don't think people are stupid, I think people individually and as a whole make bad decisions and many times these decisions should be left to experienced and involved individuals and groups.
If you want to take it the political level, it sounds like you want direct democracy, but direct democracy is not what we have in this country. Instead we have something closer to a Republic, which insulates the most powerful individual from the whiplash will of the people. Senators have 6 year terms, insulating them from temporary trends and fads.
And no, the careers of physicians are not more important than the lives of physicians, you misinterpret the argument and my statements, so any tangent you go on from that point is meaningless.
Physicians who intentionally hurt patients have been brought to court and sentenced, rightfully. Your statements of "victims of violence and rape in medicine" is blatantly false, so I'm guessing you're operating on false assumptions. Perhaps you could do some research.
You say "rare" and "street," but you're not giving me any numbers from research, instead you are again making broad observations without any backing or foundation.
You say you want more disclosure about the "lechery or jealousy or greed or just plain cruelty" on the part of physicians. It sounds like you think this behavior is more common than accidents, and I'm sure you probably have some research data to back this up...
Here's something for you. The current neurosurgeon in Florida has an average of 3 medical malpractice cases pending against them. Many other states have this very same trend, yet the cases are coming before all physicians, those just out of residency, veterans, distinguished, notable, recognized, all of them. This is a similar number for orthopedic surgeons, internal specialists and others. I'm not making a judgement on this trend, but it is contradictory to what you are saying.
After reading your 2 pages of opinion, I'm going to venture out a guess of my own. I'm guessing someone close to you was treated by a physician in a way they felt was improper, and I'm guessing you're very angry about this. Angry not only at that doctor, but at doctors in general, and due to your personal experience you feel this is systemic of doctors in general, and you feel all or most doctors are greedy, jealous criminals operating without any accountability.
Andrew -
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Re: Patient Safety and Bias Peer Review
Thu, September 16, 2004 - 8:29 AMI've done more research than you.
The point is not whether intentional injury is more common. The point is that even the victims of intentional injury cannot get justice. Until the system can account for crimes against patients, there is no hope for keeping track of and learning from errors.
This isn't even on the radar of the medical profession as you amply demonstrate by your refusal even to consider it. The medical community lives in a state of denial that prevents it from learning. The practices and routines that deflect liability for well meaning mistakes also cover up crimes.
Everyone has a bad day. In normal life there are inhibitors to prevent people from acting out when they do. In medicine there are not in too many instances and they act out.
Claiming mental illness on the part of those who do it is silly.
If you were trying to understand conditions in prisons but spoke only to guards and wardens, you'd be missing what might be the most important voice. You really need to get your feet on the ground and speak to some patients who have become victims of crimes in medicine. When you hear the commonalities of how things were done to them and how easily the perpetrators get away with it, you'll understand what I'm talking about.
Yeah, I know you can find examples of justice in medicine, but it's so rare. The opposite is the rule. Criminal justice in medicine is practically nonexistant. Speaking about accountability and errors, in an environment when even assault and rape can be gotten away with, is silly. What kind of accountability can there be for the small stuff when the really big life-ruining stuff slips through?
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Re: Patient Safety and Bias Peer Review
Fri, September 17, 2004 - 12:24 PM"I've done more research than you."
Obviously.
"even the victims of intentional injury cannot get justice."
There are courts in this country that have been established to take criminals off the streets, including physicians, and it is a necessary tool for society to continue in a healthy manner. But I'm guessing you're going to attack the court system and lawyers next.
"The medical community lives in a state of denial that prevents it from learning. The practices and routines that deflect liability for well meaning mistakes also cover up crimes."
That's a pretty bold statement. Any data to back this up? Any long term analysis of this trend you perceive?
"You really need to get your feet on the ground and speak to some patients who have become victims of crimes in medicine."
You're assuming my expertise, and for what reason I'm not sure.
"Yeah, I know you can find examples of justice in medicine, but it's so rare. The opposite is the rule."
Any evidence to that claim? Research data? Or are we relying on our perception and personal experience once again?
"What kind of accountability can there be for the small stuff when the really big life-ruining stuff slips through? "
Wow, that's very abstract and deep, but I'm not sure if it means anything.
I'm guessing your whole motive here stems from your interpretation of my organization's purpose. You hear "defend physicians" and you think "the physicians are the bad guys, they shouldn't be defended!" Well, that's not what we're all about. If you were to read my site (and I'll send you the link once again in the off chance you actually visit the site), you might learn that the situation we're addressing is completely different than the one you think EXISTS, let alone the one we're addressing.
So, until you show some interest and knowledge in my group's undertaking, I cannot respond to you.
Andrew Holley
Semmelweis Society
http://208.56.184.71/
Good luck.
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Re: Patient Safety and Bias Peer Review
Sun, September 19, 2004 - 9:51 AMWent to your site the first time you gave me the link.
My responses are no more bold and unfounded than yours. Why don't we narrow our focus so we can be less unfounded and see if we cannot get somewhere? And why don't we keep our responses in one tribe? I suggest the Patient Safety tribe. See my last response there for a beginning.
"Until you show some interest and knowledge in my group's undertaking, I cannot respond to you." Come on. -
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Re: Patient Safety and Bias Peer Review
Tue, September 21, 2004 - 5:43 AMOk, here's a link for you. Read the percentages of sentinel events in medicine that are assault/rape/homicide. Further insulating health care professionals will increase the rate at which they commit crimes against patients. Imagining that they have no motive to do so flies in the face of common sense and statistics and the experience of patients.
www.jcaho.org/accredited+..._setting.htm
Unfortunately this link my take some manual work on your part because when a link is longer than the line, the automatic break that is inserted can corrupt it.
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