No one likes a snitch, even when a patients health or safety is on the line. Thats the take-away from the survey released earlier this month by researchers from Massachusetts General Hospital and several other health services research organizations. As Modern Physician reporter Jennifer Lubell reports in this issues Top Story, almost half of the nearly 1,700 physicians surveyed said that they didnt report cases of impaired or incompetent colleagues or medical errors by colleagues.
Let the experts and our Modern Physician readers (by taking this issues reader poll) speculate on the reasons. Fear of lawsuits. Fear of permanently damaging a peers reputation or career. Fear of losing the revenue generated by a turned-in physician.
The real reason is no one likes a rat no matter what profession youre in. And no one likes a rat for two reasons. If youre a snitch, no one likes you. And if youre a snitch, someone else is more likely to snitch on you. Its a lesson most people learn in grade school, if not medical school.
Thats human nature, and thats the failing of most professional self-policing efforts. To be successful, self-policing efforts must encourage individuals, organizations, institutions or corporations to report themselves rather than relying on a second party to turn them in. And thats a tough sell to physicians and physician-owned healthcare operations when the downside is potentially ending a career or going out of business.
That, of course, opens the door wider to greater state and federal regulatory oversight. Helping make the case for stronger state and federal intervention is the fact that disciplinary actions against physicians by state medical boards dropped 10% in 2006 to 5,575 actions, down from 6,213 in 2005.
Unless the nations medical associations and societies are more effective in getting impaired or incompetent or error-making physicians to seek help or report their own behavior, its only a matter of time before the government takes control of the situation. And thats bad for the business of medicine.