Sacred cows make the best hamburger.
That journalistic creed comes to mind as hospitals and doctors have been jolted off their pedestals by a series of tragic and well-publicized clinical errors.
The incident that riveted attention was the amputation of the wrong leg of a 51-year-old diabetic patient, Willie King, at University Community Hospital in Tampa, Fla. That was followed by revelations of two other incidents at the same hospital, as well as cases elsewhere (See box).
The events should serve as a wake-up call to providers in terms of risk-management efforts and marketing policies.
Richard Wade, senior vice president for communication at the American Hospital Association, said these cases should be "a bucket of ice water over the heads of marketers" who make overzealous claims about quality while disparaging competitors.
"These things can happen at any hospital in America at any time any day of the year," he said. "We should do the job of communicating with the public in a measured and appropriate way."
The Tampa healthcare community was somber over the misfortunes at University Community, said Jay Wolfson, a professor at the University of South Florida's College of Public Health in Tampa. "All of the hospitals and all of the providers know it could happen to them-they really do," he said.
The nation's media made that point. The amputation touched off a series of news reports about medical injuries and sent reporters from Sacramento, Calif., to Allentown, Pa., checking local hospitals' safety procedures.
The cases fueled arguments against national tort reform and provided a forum for consumer advocates.
For University Community Hospital, the amputation incident was devastating. The hospital had been enjoying a financial comeback since suffering losses in the 1980s. Under the leadership of President Norman Stein, the hospital added an open-heart program and a women's center, bought Centurion Hospital of Carrollwood in Tampa in 1993 and developed a reputation as a strong community provider.
Staff pride apparently served as a hindrance and a help in the crisis.
University Community was faulted by the media for waiting several days to disclose its errors. The hospital cited confidentiality rules for the delay.
Then, in a clumsy attempt to explain the amputation, hospital officials reportedly said the good leg would have succumbed to circulatory problems and required removal anyway-a view King and his attorney denied.
University Community officials did not respond to requests for an interview.
Some of the public relations blunders were characterized as the acts of loyal employees who simply were unprepared to deal with the catastrophe.
"People instantly tried to be protective of the institution," said Michael Hoad, associate director of health sciences public affairs at the University of South Florida.
In an age of consumer awareness, dodging responsibility is the wrong approach. "There's one four-word rule that you absolutely have to follow: communicate, communicate, communicate and communicate," Wade said. "Hospitals that close the blinds and think they can weather the storm are deluding themselves."
But it is employee pride that University Community decided to use to restore its reputation. The hospital employed New York-based image-crafter Hill & Knowlton to advise it.
Employees openly told the St. Petersburg (Fla.) Times of their struggle to restore pride after the hospital was the butt of jokes on the "Tonight Show" and in their own communities. The interviews resulted in a moving article titled, "The healing has begun for UCH staff."
But word from competing hospitals and local physicians is that University Community's census decreased dramatically. Tampa General Hospital, where Wolfson is a board member, saw its census increase by about 100 patients-especially in orthopedics-
since the amputation incident, he said.
Wolfson predicts patients will be back at University Community within the year because it's conveniently located, has quality physicians and "is fundamentally a good place."
Cigna HealthCare of Florida, the hospital's prime managed-care contractor, said it is following state and local investigations "very closely, and we will review any findings."
A Cigna spokesman said no enrollee has asked not to be sent to University Community.