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Nearly 1 In 3 Doctors Admit To Seeing Error

Dec 12, 2002 | The Boston Globe Four of every 10 Americans and one of every three doctors say that they or their family members have been the victims of a preventable medical error, and nearly 10 percent say a family member died as a consequence, according to a national survey being published today.

In addition, nearly 30 percent of doctors said they had seen a serious error in the past year in the course of their work.

But despite the prevalence of the problem, neither the public nor physicians called the mistakes a top priority in health care. Doctors said that malpractice lawsuits were more pressing, while the public said health-care costs were the biggest issue.

However, both groups rejected the no-fault approach to curb medical mistakes that policy makers are aggressively pursuing across the nation. Instead, both physicians and the public blame health professionals rather than the institutions where they work for the errors. And Americans strongly support punishing the wrongdoers.

''This is really a significant problem that warrants greater attention than we are giving it,'' said Drew Altman, president of the Kaiser Family Foundation, which conducted the survey along with the Harvard University School of Public Health.

''At the same time this is not going to be an easy problem to address.''

Researchers were surprised by how many people said their families were directly affected by errors and conceded some people may have mistakenly counted other problems as mistakes. However, the researchers said that earlier estimates, such as a 1999 Institute of Medicine report of up to 100,000 deaths a year from errors, was based solely on hospital records, while the new survey asked about errors in all medical settings over a lifetime.

''The truth probably lies somewhere in between,'' said Mollyann Brodie, director of public opinion research for Kaiser, which is based in Menlo Park, Calif.

The medical community began focussing on the consequences of mistakes in the 1990s. Massachusetts has led the way, spurred by research at Harvard and the 1994 death of Boston Globe reporter Betsy Lehman from a chemotherapy overdose at Dana-Farber Cancer Institute.

The state has one of the nation's toughest reporting requirements for medical errors, and most major hospitals, led by Dana-Farber, have hired top-level safety specialists, adopted computerized systems to catch medication mistakes, and implemented strategies to reduce wrong-site surgery.

Nationally, a group of major businesses formed the Leapfrog Group to push hospitals to improve patient safety by requiring specialty training for doctors and computerizing drug ordering.

But the survey results, which are being published in today's New England Journal of Medicine, suggest that most physicians are lukewarm about the changes. A majority of the 831 doctors surveyed said only two solutions would be most effective at reducing errors: computerized drug ordering and increasing the number of nurses.

Doctors and members of the public also disagreed about the best approaches.

Although three-quarters of 1,207 Americans surveyed said hospitals should be required to report serious medical errors to a state agency, only 23 percent of doctors thought that would be very effective. And although 62 percent of the public said those reports should be public, 86 percent of doctors said they should be confidential.

Half of Americans also advocated suspending the licenses of doctors who made errors, but only 3 percent of doctors said that approach would be fruitful. The public thought the most effective strategy would be to give doctors more time to spend with patients.

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