What's missing from the Hippocratic oath


As FierceHealthcare reported yesterday, some teaching hospitals want the Hippocratic oath to require physicians to abstain from inflicting financial harm on patients and the overall healthcare system.

Medical bills are the biggest factor sending people into bankruptcy, as the article notes, which makes "do no financial harm" a great addition to the oath.

Whether you look at the classical or the modern version, the Hippocratic oath seems a little lacking in today's rapidly evolving healthcare environment.

What else should doctors and other healthcare professionals swear to before entering the profession? I can think of a few oaths I'd like my own physician to take:

"Provide informed consent"
With recent research finding that doctors don't disclose all the possible risks associated with certain treatments to their patients, pledging to give patients complete and accurate information will help them make informed choices about healthcare.

Such an oath also could motivate doctors to acknowledge that all risks warrant a discussion with patients, even if a specific risk is extremely rare.

Improving the way clinicians and patients communicate about treatment not only can improve care, but also can protect hospitals from lawsuits if something goes wrong. On top that, better informed patients are good for a hospital's bottom line, as providing patients with more information about their conditions and medication management can reduce readmissions.

"Wash my hands"
The industry is well aware that hand-washing compliance across hospitals is routinely dismal. But even with hand-washing stations and hand sanitizer dispensers, providers play a vital role in keeping hospitals clean.

While the Hippocratic oath already requires providers keep patients safe, it could benefit from an added emphasis on better hand hygiene. More doctors and nurses tapping on iPads and other mobile devices at work, for example, is just one of many reasons for a hand-hygiene pledge.

"Maintain my own health and wellness"
Physicians should be counseling patients on healthy diet and physical activity, but advice can be hard to follow when it comes from someone who's not exactly a model for healthy behaviors.

In fact, research indicates hospital employees have higher healthcare costs than the general population and are less healthy. And they're more likely to be diagnosed with chronic medical conditions like asthma and diabetes.

Moreover, a survey last month found that almost half of U.S. physicians suffer from burnout, which can lead to patient safety errors, poor staff morale and greater physician turnover.

It's not surprising, given providers usually work long hours in a high-stress setting--not to mention easy access to vending machines and greasy food in hospital cafeterias.

To honor a vow to promote their own health and well-being, providers need to make non-work a priority. A better work/life balance, whether through mindful living, engaging in fun and fulfilling activities, or setting clear, achievable goals, will keep providers healthy--something that could rub off on their patients.

"Speak up about medical errors and bad behavior"
To help ensure patient safety, providers need to be vigilant about reporting medical errors. Yet most health professionals remain reluctant to speak up, fearing their mistakes and event reports will be held against them.

Some hospitals may not have a blame-free culture, but providers should still be advocates of transparency and patient safety and vow to reduce rather than ignore medical errors.

Unfortunately, some healthcare workers are still hesitant to speak up when their colleagues make mistakes or take dangerous shortcuts. To prevent potential hazards to patients, they must share concerns with the person involved, go higher up the chain of command or report it to the hopsitals' incident reporting system  when appropriate. 

So what would you add to an updated Hippocratic oath? Share your thoughts by leaving a comment below. - Alicia (@FierceHealth)