Should hospitals punish docs for medical errors?

Punishing doctors for medical errors is ineffective and hospitals should only do so under clear cases of negligence, according to a former healthcare executive's letter to the editor published in the New York Times.

"People in the medical field are well intentioned and feel great distress when they harm patients," wrote Paul Levy, former chief executive of Beth Israel Deaconess Medical Center in Boston. "Let's reserve punishment for clear cases of negligence."

Levy related an anecdote in which an orthopedic surgeon accidentally operated on a patients' left ankle instead of her right. Upon realizing his mistake, the surgeon reported it to his superiors. When a trustee asked how the hospital planned to punish the surgeon, Levy said it would not punish him as punitive measures do nothing to decrease "inadvertent" errors not caused by negligence.

Instead of focusing on punishing the surgeon, Levy said, hospital leaders devoted their efforts to improving their care delivery system to prevent similar mistakes in the future.

Furthermore, Levy wrote, punishing mistakes works against a hospital's attempts to create an environment in which clinicians report errors and near-misses. This kind of mistake, Levy wrote, "should be used to reinforce a learning environment in which we are hard on the problems rather than hard on the people."

Levy is not the only person against overly punitive measures for physicians. Jonathan H. Burroughs, M.D., CEO of Burroughs Healthcare Consulting Network in Glen, N.H, argued against hospitals being quick to suspend physicians for problems with their performance in a February Hospital Impact  blog post. Suspension "should, with rare and egregious exception, be unnecessary the vast majority of the time," Burroughs wrote. Instead, he recommended improving physician performance by measuring it and providing feedback.

"Most reasonable individuals will improve so they are not perceived as a negative outlier by their peers, as professional respect is important to most," he wrote.

However, an August investigation by USA Today indicated treating physician errors too lightly can have deadly consequences. Between 2001 and 2011, 6,000 doctors had clinical privileges restricted or revoked, but less than half of them were fined or had their licenses threatened, FierceHealthcare previously reported.

To learn more:
- read Levy's letter