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Fri Mar 2 17:45:57 GMT 2007

Dear Ryan,

you are absolutely correct and Ron provides no evidence to support his contrary minded view.
Recently a well known Surgeon  from new York has published an account of how poorly the current accountability situation plays out in a hospital. "Behind the Green Door" professor Z worth the read.

Tom

> ----------
> From: 	trauma-list-bounces at trauma.org[SMTP:trauma-list-bounces at trauma.org] on behalf of Ronald Gross[SMTP:Rgross at harthosp.org]
> Reply To: 	Trauma &amp; Critical Care mailing list
> Sent: 	sexta-feira, 2 de março de 2007 10:07
> To: 	Trauma &amp; Critical Care mailing list
> Subject: 	Re: Never 27 Law Watch
> 
> Ryan,
> 
> It is quite clear that you have never been involved with an investigation of a reportable "adverse event".  And I am sorry to say that it is just as clear that you fail to give the average "consumer" (formerly known as a patient) the credit that he/she is due when you assume that these folks are accepting their PMD's golf partner as their physician.
> 
> I hope you return to this list with your revised comments 2 or 3 years after you have entered the real world as a practicing physician.  Even better, as a solo practitioner who hangs out a shingle in a town where there are 16 other surgeons, you don't have time to play golf, and your practice grows solely on your ability to practice medicine or surgery and care for your patients the way they want to be cared for - as if each and every one of them were the most important person in your world getting the best results possible.
> 
> Good luck,
> Ron
> 
> >>> Ryan Shanahan <rs339 at georgetown.edu> 3/1/2007 6:10 PM >>>
> With considerable respect to Drs. Mattox and Gross I would question whether anyone on this list or the hospitals they work for create enough report-able events to make this law an administrative hassle.  If it is the case than the reporting requirements should be the least worry.  (granted the last report-able event "any adverse event ... that causes death or serious disability" is uncomfortably vague)
> 
> For all the problems that the consumerization of medicine has and will continue to create it should allow people to compare and choose a doctor based on some objective criteria.  At least something more objective than a list in a phone book or their primary care providers golf partner.  Yet there has been considerable reluctance to provide practice quality data like this to the public.  Usually adverse events like the ones mentioned in this law are buried in an internal QC review with admonitions to do better in the future and very little tangible change.  Every so often when an error occurs a patient sues but that is the exception rather than the rule. (Keepnews D, Mitchell P. (2003, September 30). Health systems' accountability for patient safety. Online Journal of Issues in Nursing 8(3):2).  More often patients sue when no error has been committed.
> 
> Legislation like this is the least efficient way to make the required changes in openness and accountability for mistakes but if the profession is unwilling to make the changes internally then external prodding is the only way left.
> 
> Ryan Shanahan M'09
> 
> 
> 
> ----- Original Message -----
> From: KMATTOX at aol.com 
> Date: Thursday, March 1, 2007 11:35 am
> Subject: Re: Never 27 Law Watch
> 
> > Ron:   I think that the majority of the persons on this list  
> > (including 
> > international members) are in total agreement with  you.   There 
> > are a few on this 
> > list that are supportive of the  Regulatory Industrial Complex and 
> > the clip 
> > board carrying job assurance  programs. 
> > 
> > k
> > <BR><BR><BR>**************************************<BR> AOL now 
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