Paths to Reducing Medical Injury: Professional Liability and Discipline vs. Patient Safety — And the Need for a Third Way

Abstract

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine (IOM) for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care.