[forrester]

Originally Posted by bobweiss

I should note I speak from the perspective of some naivete as an outsider (patient) looking in (upon the system). Regardless of country one thing I always felt would be constructive (if not already in place) is what I describe as an AnonymousPeerReview, which would be step one at the first hint of a formal complaint precursor to litigation by a patient or family member. The "anonymity" would be only that the case would be assigned a number from a registry and the physicians name would never be known to those reviewing. As pertains to the USA, I'd be interested to know if such a formality exists now.

2 main problems with this.
1st, many of the "mistakes" are not readily apparent without intricate knowledge of the specialty, or at least much more than just superficial medical knowledge in a case. Here again, nursing could be assisting with this process, but medicine simply refuses to let "others" play an oversight role. They have no choice in the courts.
2nd, the "deep pocket" perception of health care organizations and providers coupled with the fact that medical errors often result in permanent or disfiguring conditions make them emotional not just legal cases.

Peer review was supposed to work, but it has basically been a joke for many years.
Now, make the medical staff employees of the facilities and tie in their group malpractice rate to performance, and you just might reinvigorate a true peer review system.

[bobweiss]

Understood forrester! It would appear that as is true in many instances of needed reform one must step back and get a perspective of the "overall" system and it's influences to properly address any reformation. I specifically acknowledge your comments regarding litigation which are all too true in this country.

It's not unlike the bumper sticker that opines..."We have met the enemy and he is us." Any establishment tends to have those entrenched in power and control close ranks upon criticism/evaluation. It is a near genetic corporate predisposition. Acknowledging such doesn't bode well for addressing health management and dispensation of care issues. It is further complicated by politicians who'll say anything as they whore for the vote.

In a manner of speaking..., the patient must cooperate when his well-being is the stated goal.