It's not that doctors are evil or nurses incompetent. The system itself works against the delivery of quality. Time to modernize Several key areas need to be fixed, the report said, including the way doctors themselves do their jobs. In an era of high-tech medicine marked by dazzling advances in treatments, diagnostics and surgical techniques, doctors are still clinging to practices rooted in the 19th century. They rely on often illegible, messy, handwritten notes to track patients' progress and are expected to remember appropriate approaches to treating a wide variety of disease, rather than referring to formal guidelines.
Airline pilots have checklists.
Studies have consistently shown that implementing standard procedures yields a higher quality of care and better survival rates. Yet the Rand researchers found no national tracking system for ensuring that the best practices are used, or any method for pinpointing defects and correcting them before someone dies. And because there is no way to identify who is doing a good job, and who isn't, there are no financial incentives to drive poor-quality hospitals, medical groups and doctors out of business. Part of the problem is that the health-care system is so fragmented. Getting different HMOs, insurance carriers, hospitals and medical groups to adopt uniform systems, especially when they're competing with one another, is more difficult than herding cats.