The nation's PPOs have been unwilling to collect or publish any quality information. At the same time, our research and others' confirms that safe medical care is a central concern of most Americans. Certainly each of us is deeply concerned about quality and wants to have information that would enable us to make good decisions for ourselves and our families. Yet the leading health care organizations often resist most such initiatives. The risk of public embarrassment, the difficulty of creating effective management systems in our highly fragmented health care world, and the cost and uncertainty of investing in computer technology prevent even the best intentions of so many health care professionals from achieving meaningful changes.
Sunlight is said to be the best of disinfectants.
Requests by providers for confidentiality and protection from liability seem inappropriate in this context. First, patients have an absolute right to know about the risks they face when receiving medical care. Our failure to honor these two principles contributes to the persistent alienation of the public from health policy and the continued difficulty the nation faces in improving the performance of its health system. Medical ethics dictates that doctors have a duty to disclose errors to patients and relatives, regardless of liability concerns. Similarly, we should view the advance disclosure of risks, including the risks of error, as an intrinsic part of informed consent.