Patient safety: Will doctors trust the Feds?

December 2, 2005

A new law establishes a voluntary system for reporting medical errors. Critics applaud the effort but raise doubts that doctors will participate.

For the better part of the past decade, lawmakers have come under increasing pressure to do something about medical errors. This year, they responded, passing, to great fanfare, The Patient Safety and Quality Improvement Act of 2005. PSQIA, as it's known among policy wonks, extends legal protections to doctors and other health professionals who voluntarily report their medical errors to specially certified patient safety organizations (PSOs).

President Bush has called the new legislation "a common-sense law." JCAHO has hailed it a "breakthrough." And the AMA has said it would prove "the catalyst we need to transform the current culture of blame and punishment into one of open communication and prevention."

Individual doctors have also been supportive. "Following the Institute of Medicine's 2000 report ('To Err is Human: Building a Safer Health System'), this is the minimum that should be expected of medicine," says Brian K. Bevacqua, chief of anesthesiology services at Middleton Memorial VA Medical Center, in Madison, WI. Joshua B. Grossman, an internist in Johnson City, TN, agrees, adding, "For sure, I'd participate, because I believe that the truth shall make us free."

Doctors' liability fears, despite what the new law promises, are "very understandable," says patient safety expert Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health. "They feel that far too many people sue, that most suits aren't justified, and they don't want to do anything to make a suit more likely." Still, Leape, a former surgeon who believes physicians have an ethical duty to be candid, hopes that the law "would make doctors feel more comfortable about sharing information with each other as well as with their patients."

Is that likely, despite physicians' fears of litigation and general distrust of government? Or is the new patient safety law doomed to failure before it even gets off the ground? We took a closer look to find out.

The law's intent is clear-but questions remain

Here, in a nutshell, is how the new system is designed to work: