Medical Secrecy Harms Patients – Part Two

I have written in the past about the harm caused by the medical profession keeping secret the identities of incompetent physicians and allowing them to continue to malpractice on patients.  While this is a significant problem, there are many other ways in which healthcare secrecy harms all of us.

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Hospitals and doctors hide what they charge for procedures.  If you thought airline companies made airfares difficult to compare, they have nothing on the medical profession.  Hospitals and doctors negotiate different charges for different payors.  A big insurer may negotiate very favorable rates for its customers.  A small insurer may not be able to get the same deal.  If you end up at a hospital that is out of your plan because you are traveling or because the ambulance took you to the closest hospital, you may end up paying a different and higher number than is charged anyone else.  It is very difficult to compare prices between two comparable hospitals or two equally qualified physicians.  Without the ability to compare prices, there is little or no competition.  Little or no competition means that prices stay high.

Except in cases involving Medicare, hospitals refuse to provide information about quality or outcomes.  How many people in a particular hospital get infections?  How many die?  Even if they live, how many have a bad outcome?  How many complain about their care?  How many make claims for bad care?  How many claims for bad care has the hospital settled and for how much money?  How many incidents of bad care did the hospital itself recognize and investigate?  How many doctors lost privileges at the hospital and why?  These are only a few of the areas in which hospitals, with the approval of state and federal government, keep critically important information from the public.  I don’t believe I am alone in saying I would like answers to all of these questions and more when I am deciding whether to have my operation at hospital A or hospital B.

How about my doctor?  How many times has she had a patient die during the same operation she is going to perform on me?  How often has she had an emergency during the surgery she is going to perform on me?  How often has she been disciplined by the medical board or by a hospital?  Has she ever had her privileges limited by a hospital and why?  How much experience does she have with the operation she is doing on me?  When was the last time she performed the same surgery?  How often has she done this surgery in the last month.  If ever there was a place where “practice makes perfect,” it is the operating room.  The statistical evidence is overwhelming that the more often a surgeon performs a procedure, the better he or she does it.  For doctors with only an office practice, how often do their patients complain?  How often do they have claims made against them.  Most importantly, how do their patients fare under their care?  How many end up in the hospital?  This kind of information should be readily available and used by patients to decide to whom they want to entrust their health.

All the recent uproar about sexual harassment suits has drawn attention to the problems arising from the use of confidential settlements.  Bad practices and bad actors which should be brought to the attention of the public are hidden from view and the victims are effectively muzzled.  Following every payment made on behalf of a physician arising out of a claim of medical malpractice, a report is made to the National Practitioners Data Bank.  Those reports are available to medical boards, to malpractice insurance companies, to the government, and to hospitals making credentialing decisions.  Pretty much the only people to whom this information is not available is the public.  All malpractice settlements ought to be matters of public record.

Transparency won’t come to the healthcare industry on its own.  There is too much money to be made under the current secrecy rules.  Only if the public demands an end to secrecy will we see the transparency we deserve.

Posted in disclosure of medical mistakes, Doctors, Health Care Costs, Health Insurers, Hospital Negligence, Hospitals, Infection, Lawsuits, Medical Costs, medical errors, medical ethics, Medical Malpractice, medical malpractice claims, medical mistakes, Medicare, Secrecy, Surgical Errors |