A more promising solution to the malpractice "crisis"

In March, I wrote:

We need to turn the debate toward how to prevent patients from being injured by the medical profession in the first place. The answer is to learn from the quality systems in place in other high-risk industries, such as commercial aviation.

Today's Wall Street Journal leads with a story about how the anesthesia profession has been doing just that, directly focusing on patient safety rather than caps on damages and other attempts to change the legal system. Deaths from anesthesia have dropped from 1 in 5000 cases to 1 in 200,000 to 300,000 over the past twenty years.

Over the past two decades, anesthesiologists have advocated the use of devices that alert doctors to potentially fatal problems in the operating room. They have helped develop computerized mannequins that simulate real-life surgical crises. And they have pressed for procedures that protect unconscious patients from potential carbon-monoxide poisoning

So far, there are no widespread examples of other specialties following the anesthesiologists' lead. It's time for that to change and there are some signs of hope:

• MedPharma Partners' client, Advanced Practice Strategies, which got its start in providing courtroom illustrations to defend physicians accused of malpractice, has turned what it learned in the courtroom into a series of online courses that train physicians and nurses to avoid mistakes in the first place
• Women's Health USA, which manages a group of 150 OB/Gyn's, has created a set of risk management and patient safety tools to improve quality. The group has its own captive insurance carrier, so the physicians are very involved in day-to-day risk management issues