Say what you will about Bill Clinton, but he sure knows how to exploit a populist issue when he sees one. If the healthcare community could develop a similar savvy, the industry might not suffer from a bad image, as it often does.
That image was reinforced by the recent report from the national Institute of Medicine. It estimated that medical errors kill as many as 98,000 hospital patients annually. That death toll is equivalent to what you would get if a large jetliner crashed every day for a year.
The report made a splash in the press and, presumably, resonated in the public mind. Any sentient person who has spent time in hospitals knows that lots of serious mistakes are made, even in the best facilities.
That's why it's understandable that Clinton would race to get ahead of the quality-improvement parade. The president last week announced, with much fanfare, several steps the administration will take to reduce medical errors.
What's less understandable is why the healthcare industry didn't seize the initiative a long time ago. Hospitals and doctors might have pre-empted some of the bad publicity from the IOM report if they had undertaken dramatic efforts. The problem has been studied for years. This magazine reported more than a year ago that quality experts had concluded that providers could learn a few things about accident prevention from other industries-most notably airlines (March 2, 1998, p. 60).
Now the government has taken the lead, embarrassing the healthcare industry by trumpeting a scathing report and starting to impose solutions that may be painful and possibly counterproductive. In addition, some members of Congress, including Sen. Edward Kennedy (D-Mass.), are preparing legislation to correct the situation.
It was commendable that American Hospital Association President Richard Davidson appeared with Clinton last week to vow action against medical mistakes and announce an initiative to reduce medication errors. But the industry should have taken this issue more seriously earlier. The AHA, the American Medical Association (whose motto often seems to be "Physicians accountable to no one for the health of America") and the Joint Commission on Accreditation of Healthcare Organizations, among others, might have devised an error-reduction system before the government felt compelled to act.
The moral: He who hesitates is regulated.