Doctors not always to blame

Published: Friday, January 31, 2003 at 6:01 a.m.
Last Modified: Thursday, January 30, 2003 at 10:44 p.m.

The editorial (Jan. 22) "Medical Errors" referred to the Institute of Medicine's 1999 report on preventable medical mistakes and some of the efforts underway in health care to avoid errors. You then shift your focus to the Florida Board of Medicine and its responsibility to "weed out bad doctors."

Medical errors and "bad doctors" are separate issues, although the legal resolution of specific cases may look similar.

Medical errors are generally viewed as mistakes, which are systemic and not associated with being a "bad doctor," nurse, therapist, etc.

Revisions to the way drugs are labeled, use of computers to write orders, as you have cited, are examples of system changes which help avoid errors.

One of the largest deterrents to eliminating medical errors is, as the IOM report shows, a "culture of blame," which says: "Let's identify the person responsible for the error and get rid of him!"

Out of fear of being blamed or harming colleagues, health care professionals are reluctant to report instances. As a result, the real problem, which is almost always systemic, is not identified and proactively eliminated.

Unintentionally perhaps, your editorial contributes to this misunderstanding about effective approaches to eliminating medical errors by encouraging blame.

The Board of Medicine does have an appropriate role in setting and enforcing professional standards for physicians. But this is a distinctly different issue than addressing the problem of medical errors.

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