December 4, 2007 
There was an article out yesterday summarizing a survey of physicians. The key point it made was that “up to 96 percent of those surveyed said they should report all instances of significant incompetence or medical errors to the hospital clinic or to authorities.” [It was only 45% among cardiologists and surgeons??] BUT, 46% of those surveyed knew of a serious medical error that had been made and did not report it.
Given all the focus on quality and error rates over the past few years, this seems concerning. Although I am equally as concerned that the surgeons didn’t feel it was necessary to report issues.
At the same time, I believe we can’t expect different standards from others that we wouldn’t be willing to be held to. So, if you knew a collegue did something wrong, would you report them? If they acted inappropriately at a client social event. If they presented poorly and lost a sale. If they made a mistake in their financial model. If they had a spelling error in a marketing piece.
Of course, not all of these are life and death, but I could certainly argue that rejecting a claim that pushed undue financial stress to a patient would be a serious issue. Or, simply telling them a service wouldn’t be covered might discourage them from getting needed work performed.
“There is a measurable disconnect between what physicians say they think is the right thing to do and what they actually do,” said Eric Campbell of Massachusetts General Hospital and Harvard Medical School in Boston, who led the survey.
Some of the other findings included:
-
Doctors are willing to order unnecessary — and often expensive — tests. [How many of us don’t always take the least expensive path?]
-
Only 25% consciously tried to avoid gender or racial bias in how they treat people. [How many of us consciously do this in our job?]
-
93% of doctors said they should provide care regardless of a patient’s ability to pay but only 69% actually accepted uninsured patients who cannot pay. [How many of us would be willing to provide our services for free to someone that needed them?]
URL:
Enabling Healthy Decisions 
I still see the MD as a critical part of the care team. I am not sure the system is designed to maximize their contribution with some of the administrative issues and lack of aligned incentives, but I hope that will change.
I am not sure I would work for free, BUT I wouldn’t kid anyone to say that I would either. I think if physicians feel so strongly about caring for the uninsured they should be (and maybe they are) lobbying for a better process to get reimbursement for providing the key safety net of services. It’s a systemic issue of care for those in need not an individual problem.
Look at how many non-profit hospitals have struggled over the years when they are located in a location where the majority of their revenues are from people who cannot pay the bills.
Beware of your assumptions. Bottom bullet, above, % of Doctors who accept uninsured, and you said:
[How many of us would be willing to provide our services for free to someone that needed them?]
The other way to look at this one is the realization that doctors have that alot of the services they provide aren’t really needed.
Read “Overtreated”, S.Brownlee