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Why I Voted “No”

I am a member of Pennsylvania’s Patient Safety Authority. In fact, I was the first member, having been appointed by the Pennsylvania Senate when the Bill became law creating the Authority. The Patient Safety Authority is an independent governmental authority which imposes assessments on hospitals, which started out at $5 million per year statewide and, thanks to the Consumer Price Index, is now approximately $7.5 million. These assessments are the maximum that can be imposed, and there have been years when the Patient Safety Authority has assessed less.

The purpose of the Patient Safety Authority is to make hospitals safer places. At the beginning of the decade, the Institute of Medicine came out with a blockbuster study that the number of patients who die in American hospitals as a result of preventable medical errors is about the equivalent of two 747’s crashing every month with the loss of all life aboard. Many reputable medical organizations which have studied the crisis of care in American hospitals have indicated that the number of preventable medical deaths in American hospitals is higher and is one of the leading causes of death in America.

Reducing medical errors in hospitals and in the medical community generally not only will save many lives and save patients from suffering, but would also drastically reduce the cost of health care.

The right of patients to recover for medical errors in a court of law has been reduced, and in many places eliminated. The Pennsylvania Supreme Court keeps records on the number of medical malpractice cases filed. For the last full year, the number of cases filed was 1,528, which represents a continued reduction in the number of claims filed. Considering that the Patient Safety Authority receives several hundred thousand reports of incidents and serious events, the number of people who sue and recover for preventable medical errors is miniscule.

The reason why so few people sue and so few people collect money in connection with preventable medical errors is because of the significant burdens and hurdles created by the medical community for those who seek legitimate recovery in a court of law.

Every year that I have sat on the Patient Safety Authority, it has increased its budget and spending.

This is a great organization, which I fully support. We do not always agree on everything, but the goals and purposes are terrific. The people who sit on the Board are principled. The employees and contractors we use are dedicated.

What I have learned sitting on a government entity is the ease of increasing budgets, taxing others, and permitting spending creep to occur unabated. I recall the first time I demanded to see a budget, noticing very high expenditures for lawyers. “What,” I asked, “do we need to spend so much money on lawyers for?” We have nothing to do with the law. We do not get sued. We do not sue others. Perhaps, every once in awhile, we have a question about confidentiality or a Right-to-Know request from a newspaper, but “why do we need to spend so much money on lawyers?” I was treated as though I had just come from Mars. Here I am, one of the few non-doctor representatives on the Patient Safety Authority, and a trial lawyer myself, and I am questioning the use of money for legal expenditures. The fact is that we did not need the money, that we did not use it, and we certainly did not need expensive outside counsel. Today, we use much less expensive legal counsel that work for the Commonwealth.

At the last meeting, there was an 8% increase in the budget, and the organization is undertaking some wonderful new strategic programs to help effectuate patient safety. I simply could not vote for it. I explained my position. “We are living in the age of sequester. Every government is being asked to cut. Workers are being asked to sacrifice. It is true that corporations are making record amounts of money, but they are not hiring and they are not paying their employees any more.” I explained that I simply could not ethically vote for an increase in our budget and an increase in the assessment that would ultimately be passed on to taxpayers, even though we are a relatively small organization which does important work.

One of the strategic initiatives which I strongly support is to come up with a way of measuring how our work enhances patient safety and therefore decreases health bills. We need to be able to justify our work to the public. I believe that everyone on the Board agrees with this, and it obviously is a daunting and difficult task.

After the vote, the Acting Chair of the Patient Safety Authority came over and sat down next to me. “Are you a Republican now?,” he asked me. I was the only “no” vote. I explained to my friend, for whom I have the very highest respect, why I could not vote to increase our budget, given the current national situation.

Public safety is an issue that will never go away. We need to have organizations like the Patient Safety Authority which drive a safer environment, thus reducing costs. On the other hand, we need to make sure that there is a remedy for those who have a right to go to court.

I will continue to advocate the rights of those who seek their remedies under the American Constitution, while at the same time supporting the work of economical good government. The two do not have to be mutually exclusive.

Patient Safety Awareness Week 2013 is celebrated in March. The slogan this year is “I am Patient Safety,” and I was given a pin to prove it. The message for this year is as follows:

I encourage patients to take part in decisions about their healthcare by urging them to ask questions about anything they may not understand.
I recognize that rules, regulations and procedures in my facility are there to help me promote a safe environment for my patients and co-workers.
I practice with a questioning attitude and clearly communicate and document information for my co-workers to safely care for my patients.
When I see something happen that can lead to patient harm, I voice my concerns.
When handing off a patient or receiving a patient from a handoff, I listen and communicate effectively with my co-workers.
I promote the highest standards of practice and behavior to reduce the risks of patient injury.
I keep up to date with patient safety literature including the Patient Safety Authority’s Patient Safety Advisories.

Slogans are great, and the idea of Patient Safety Week is even better, but how many patients or medical health care providers know anything about it? Unfortunately, not many.

The latest project of the Patient Safety Authority are distractions in the health care setting. There are suggestions for patients and their families to avoid distractions that occur in the health care setting which cause medical errors.

Clifford A. Rieders, Esquire
Rieders, Travis, Humphrey,
Waters
161 West Third Street
Williamsport , PA 17701
(570) 323-8711 (telephone)
(570) 323-4192 (facsimile)

Cliff Rieders, who practices law in Williamsport, is Past President of the Pennsylvania Trial Lawyers Association and a member of the Pennsylvania Patient Safety Authority. None of the opinions expressed necessarily represent the views of these organizations.

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