Our top Chicago medical malpractice attorneys have long been concerned by the use of unsupervised residents to provide patient care at hospitals. Now, several recent studies and reports have confirmed that the stories of patient harm from these dangerous practices at teaching hospitals are not merely anecdotal, but represent a nationwide, industry-wide problem that must be met head-on and corrected.
For example, medical professionals and medical malpractice attorneys alike have long known about what is termed “the July effect.” Every July, across the United States, freshly-minted medical school graduates begin work as residents at teaching hospitals. Thus, it has long been held that medical errors and patient harm increase in the month of July.
Now, a study out of the University of California has looked at, and proven, this effect. In fact, the researchers found that over the course of the 28 years for which they had data, medication errors that lead to a fatality increased by a shocking 10 percent in July only. But this effect was present only in counties with teaching hospitals, confirming that the arrival of new residents was the source of the increase.
Likewise, we recently wrote about a study by the federal health department’s Office of Inspector General looked at adverse events – a polite term for harm to patients. This study represents one of the largest-ever looks at patient harm. The study found that around one in seven Medicare patients are harmed in hospitals, with nearly half of these problems the result of preventable error. To put it in perspective, this represents about 15,000 unnecessary deaths each month. Our Chicago medical malpractice lawyers are appalled that this situation is allowed to continue.
Think that these deaths and injuries may not have to do with resident supervision? Think again. Harvard University researchers, using federal funding, recently looked at two decades of data gathered from the malpractice claims of five major insurance companies. The researchers found that in fully a third of medical error cases, residents played a role. More qualitatively, the researchers noted in their published results that “supervision breakdowns and lack of experience emerged as important human factors.”
As Dr. Bertrand Bell, a professor of medicine at Albert Einstein College of Medicine who has been instrumental in efforts to improve resident supervision, puts it, the current standards for granting residents “autonomy” are merely “a smoke screen to obscure the fact that medical education, which is hierarchical and authoritarian, encourages (although this need not be the case) physicians to hide what they do not know.”
Moreover, it is common knowledge that medical residents are grossly overworked. Like any other worker, fatigue plays a role in a doctor’s effectiveness. And only recently have any improvements been made. That improvement? The industry has now self-regulated by setting an 80-hour “average” work week limit for medical residents, which some states have now made law. The Chicago-based Accreditation Council for Graduate Medical Education, a private nonprofit organization funded and directed by the medical profession Our medical malpractice attorneys would not want to be in a bus driven by a driver who was near the end of an 80-hour week: we likewise would not want to be in surgery or an emergency room under the care of a doctor in the same situation.
And the problem is pervasive: it effects every teaching hospital in the country. Hospitals need residents to provide cheap care: paying more experienced, supervising attending physicians is far more costly. Thus, a pattern has emerged where residents are overworked, undersupervised, and often fatal. And not one University or hospital – not one – has emerged to lead the way to better practices. As Chicago’s own Dr. Jeanne Farnan, who teaches at the University of Chicago, has noted about her own efforts to improve medical education for young doctors-in-training: “This is the biggest problem: There’s no model for best practices, and there’s no faculty development or education on how to be an effective supervisor.”
This problem has persisted for long enough. Our Chicago medical malpractice lawyers urge our lawmakers to stand up to the medical lobby and mandate that the medical profession, like any other, be required to supervise its trainees to ensure the safety of its customers. Unfortunately, such legislative efforts have thus far been stymied by the powerful industry lobbyists. Federal legislative efforts have been completely stymied. And no state but New York yet requires supervision of residents – and New York only requires that an accredited attending physician be present on site at all times, not that he or she be actively supervising residents.
This cannot continue. We urge our federal and state representatives to take action. In the meantime, the victims of medical error at teaching hospitals must come forward, tell their stories publicly, and take legal action to hold these hospitals accountable for shoddy or nonexistent supervision of medical residents. Lobbyists can stop a bill from becoming law, but they cannot stop a grieving mother from filing suit. Perhaps through the courage of victims and their families, lives can be saved.
For a free consultation with an experienced Chicago medical malpractice attorney at Passen & Powell, call us at (312) 527-4500.