Confidentiality of Medical Mistakes Kills

98,000 people are killed every year by medical mistakes, yet sometimes the circumstances of the deaths are, by law, closely guarded secrets. While some health care providers argue there is not enough confidentiality, in reality, there is too much. Consumers can learn more information about the refrigerator they want to buy than they can about the doctor who is going to cut them open. Buried mistakes do nothing to improve patient care—changing the current system will.

Current Reporting Systems Are Not Working

The Institute of Medicine reports that underreporting "is believed to plague all [existing] programs." Even mandatory reporting can be avoided by practitioners. Unless reporting is made truly mandatory and available to patients and their families, confidence cannot be restored and the system cannot be strengthened. The system today is inadequate:

Peer Review: (confidential)

• Allows doctors to share medical error information with each other, but 49 states have peer review confidentiality laws that block this information from the public.

• Bars patients and families who are considering medical treatment from making informed health care decisions. It even blocks information from families of patients who are injured or killed.

Mandatory Reporting: (confidential)

• Mandatory systems are run by state regulatory programs that can investigate cases and issue fines and penalties.

• Many states will not release error data unless they are subpoenaed or issued a Freedom of Information Act request. Some state agencies ask courts to overrule subpoenas, so the information is never released.

National Practitioners Data Bank (NPDB): (confidential)

• Contains reports of malpractice claims paid by insurers on behalf of named practitioners, but the public never sees this list. Only authorized users—like hospitals—are granted access.

• The Institute of Medicine (IOM) reports that some physicians have learned to avoid being reported to the data bank. Practitioners settle their lawsuits in the name of corporate defendants and their names are dropped from lawsuits.

• In fact, the American Medical Association at one point had a website subheading that begins, "How to evade a report to the NPDB...."