Justinian Lane

Will tort “reform” get doctors to wash their hands?

I haven’t seen evidence that it will, but I have seen ample evidence that doctors are failing to do that and other basic measures:

About a week after my father’s death, The New Yorker ran an article by Atul Gawande profiling the efforts of Dr. Peter Pronovost to reduce the incidence of fatal hospital-borne infections. Pronovost’s solution? A simple checklist of ICU protocols governing physician hand-washing and other basic sterilization procedures. Hospitals implementing Pronovost’s checklist had enjoyed almost instantaneous success, reducing hospital-infection rates by two-thirds within the first three months of its adoption. But many physicians rejected the checklist as an unnecessary and belittling bureaucratic intrusion, and many hospital executives were reluctant to push it on them. The story chronicled Pronovost’s travels around the country as he struggled to persuade hospitals to embrace his reform.

Source: How American Health Care Killed My Father - Magazine - The Atlantic

And this is another reason I don’t buy into the “defensive medicine” argument.  How can the fear of lawsuits drive doctors to spend billions on unnecessary tests, but not drive them to wash their hands?  If a doctor doesn’t order an MRI, the odds are he or she can find a doctor to say it wasn’t malpractice to fail to do so.  But no doctor will testify that it’s OK not to wash your hands before you operate on a patient.  As long as doctors keep making basic and preventable errors, you have ample evidence that doctors are not paralyzed by the fear of malpractice suits.

P.S. – This article was brought to my attention by a soon-to-be new contributor to the site.  If you’ve got something you think I should see, or if you’d like to contribute to the site, drop me a line at justinian at justinian dot us.

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Posted at 7:59 PM, Mar 03, 2010 in Medical Errors | Medical Malpractice
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