By MARTIN JOHNSTON health reporter
Our "eye-for-an-eye" system of disciplining dodgy doctors has been dismissed as useless in reducing the rate of medical errors.
But that does not mean it should be scrapped, says Professor Jim Reason, a British expert on errors in healthcare, aviation and engineering.
The Manchester University psychologist was brought to New Zealand by anaesthetist professional groups to speak at their Auckland conference. He also met hospital chiefs and Health Minister Annette King.
He told the Herald that shaming and punishing doctors for errors was of some emotional value for affected patients and their families.
But it did not help to rectify the faulty systems, like long hours and badly designed equipment, which contributed to many errors.
Doctors can be censured, suspended or struck off, fined up to $20,000, and ordered to pay costs if the Medical Practitioners Disciplinary Tribunal finds them guilty of serious charges which can relate to such things as failure to diagnose a condition or sexual offences against patients.
But Professor Reason said disciplinary systems were needed to deal with the small number of "rogue" doctors who committed the worst offences.
A big difference between pilots and doctors, he said, was that the aviation industry assumed "people will screw up." By contrast, many doctors spent 13 years or more "training to get it right."
Too little time was devoted to how to deal with their human fallibility. The operating-table virtuosos were those with the greatest ability to detect and remedy their errors.
Anaesthetists were the most advanced group of doctors at developing systems to avert errors, said Professor Reason.
One in Adelaide had built up a database of 8000 mishaps by anaesthetists as a way of identifying error patterns so hospitals could avoid repeat mistakes.
That had led to counter measures like colour-coding of syringes to avoid drug mix-ups.
Public hospitals struggle to find money to spend on developing safety systems.
Hospital chiefs are pressing the Government, unsuccessfully so far, for money tagged to improving safety systems.
Mrs King said Government money was integrated into health budgets for safety systems.
"It is simplistic to suggest it [clinical safety] is about money ...
"Preventing errors and increasing safety is about attitudes, the way health professionals work, and teamwork."
Room for upgrade in health discipline
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