Analysis: Open discussion is norm in medicine globally

Patient safety relies on consistent action on best practice and disclosure of issues, writes Dr Muiris Houston

Prof Freddie Wood: “One of the key issues emerging from our research and discussions was the need for leadership in putting agreed values for good professional practice consistently into action.” Photograph: Alan Betson / The Irish Times

Prof Freddie Wood: “One of the key issues emerging from our research and discussions was the need for leadership in putting agreed values for good professional practice consistently into action.” Photograph: Alan Betson / The Irish Times

Wed, Mar 5, 2014, 01:01

It is entirely appropriate that the main thrust of the Medical Council’s five-year strategy is centred on patient safety.

With the indefensible perinatal deaths at Portlaoise hospital fresh in public memory and the shock of the Savita Halappanavar case still palpable, the safety of patients in Irish hospitals is a hot button issue.

Prof Freddie Wood, president of the Medical Council, said yesterday: “One of the key issues emerging from our research and discussions was the need for leadership in putting agreed values for good professional practice consistently into action.”

The use of the word ‘consistent’ is significant: while no health professional goes to work with the intention of causing patients harm, a system that does not put safety consistently at its core will make preventable errors in patient care.

The new research on the views of the public and of doctors on what it means to be a good doctor in Ireland is especially interesting.

While the report shows continuing high levels of trust in doctors from members of the public, with more than 90 per cent of patients satisfied with the level of care they received from their doctor, the research uncovered areas where the public and doctors have differing expectations.

Reporting concerns
Some 70 per cent of patients polled felt confident their doctor would report concerns about another doctors’ professional performance

However, just half of doctors said they would always report concerns they had about an impaired or incompetent medical colleague.

And while three-quarters of patients were confident their doctor would tell them when an error had been made, only two-thirds of doctors said they would always say when a significant medical error had occurred.

Notwithstanding that most adverse outcomes in medical practice are not the result of an error but are caused by known side effects of treatment, the results suggest that the internationally accepted norm of open disclosure in medicine needs wider acceptance here.

And of course doctors need safe and fully resourced workplaces if they are to maximise patient safety.

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