Allison Wall

Can We Survive Healthcare in an Accountability-Free Zone?

Columbus bricklayer and artist David Brown rushed to his local emergency room after he cut his right hand on a broken glass table. He told the intake representative that he had no feeling in his hand and pain in his arm, and was taken to see the emergency room physician, who stitched up his hand and ordered him to return in seven days to have the stitches removed. The doctor never examined the depth of the cut, and never checked the wound for broken glass.

When he returned one week later, a different doctor told Brown that he had extensive and permanent nerve damage in his right hand and arm. He told Brown he should have been admitted for surgery on the day he was injured – not given stitches – which would have prevented the permanent nerve damage. Brown has since seen a surgeon and a neurosurgeon, but he cannot afford the surgery that would replace the nerve in his arm and potentially restore feeling in his right hand.

Because Brown is right-handed, he can no longer work for his family masonry business, nor can he create his art. Moreover, since Georgia passed it’s tort “reform” bill, Senate Bill 3, Brown and his family have been unable to secure legal representation. The “Emergency Room immunity” provision of the law makes it nearly impossible to hold providers accountable for actions in the emergency room – even the most careless actions that are clearly avoidable, and that result in lifelong disability or death.

Unfortunately, Brown’s story is not uncommon. Since Georgia lawmakers capped the compensation for patients injured or killed by medical mistakes, many attorneys here have stopped taking new medical cases. The result is that it has gotten almost impossible for medical malpractice victims to pursue justice in a courtroom.

But tort reform has another, equally serious consequence. It also threatens to further erode the quality of care that Georgia patients receive.

Simply put, if medical providers and caregivers don’t feel that there will be serious consequences for their deadly errors, they will likely be more prone to make those mistakes.

The Journal of the American Medical Association has ranked the quality of Georgia’s health care system 47th in the nation. To be fair, that does represent an improvement in recent years (up from 48th), yet Georgia remains at the bottom of the health care barrel.

A 2004 survey of all licensed practitioners in the state found that 3.5 percent of Georgia doctors were responsible for 40 percent of the malpractice claims. In fact, between 1991 and 2003, 18 doctors each had between four and eight insurance payouts for malpractice claims. Yet, not a single one of these doctors were disciplined by the Composite State Board of Medical Examiners, which is charged with doctor licensing and discipline.

If the state’s own discipline board consistently fails to suspend or retrain repeat offenders, who will? Who is watching over the proverbial hen house? If failures and dangers in our health care system are no longer even aired before the state’s justice system, what quality-of-care future can we envision for our families?

Currently, there is a lack of quality care in our hospitals, created by aggressive competition for patients and hospital administrators who prioritize cost-saving shortcuts over life-saving measures. According to data from a 1999 Institute of Medicine report, there are as many as 2,800 preventable deaths in Georgia hospitals every year. The human cost to our families is devastating. The economic cost, estimated at $493 to $841 million annually, is enormous.

Meanwhile, one in 20 patients, or about two million each year, contract an infection while in the hospital. Every year, at least 90,000 Americans – or 250 people daily – die from hospital-acquired infections, according the U.S. Centers for Disease Control. The price tag of these hospital infections to the U.S. health system is approximately $5 billion.

Many states around the nation have passed laws to require hospitals to publicly report infection rates. But the Georgia House refused to take action on a resolution to simply study the issue in 2006.

Instead, Georgia created a system where hospital doctors are held accountable for only the most egregious errors. For example, patients injured in an emergency room now must prove “gross negligence” in a court of law, which means proving that their medical provider willfully and knowingly mistreated them. Of course, it is virtually impossible to prove this in an emergency setting, after the fact. Thus, today, if a patient loses a leg, or a life, due to negligence in the ER, the hospital doesn’t even have to pay for a pair of crutches.

Apparently, the assumption of our policymakers – and of so-called tort “reform” – is that we should expect and accept negligence in our health care.

At a time when the health care system in Georgia and across the nation is in desperate need of improvement, we should be demanding more accountability, not less.

Posted at 9:00 AM, Nov 29, 2006 in Permalink | Comments (1) | TrackBack (0)