When Rahul Shah, MD, then a pediatric otolaryngologist at Children’s Hospital in Boston, and several colleagues first undertook a survey of otolaryngologists’ reactions to adverse events in 2004, they provided a blank form for respondents to write about what had happened. In the more than 200 responses they received, Dr. Shah and his colleagues read an outpouring of emotion.
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July 2010“It was cathartic for everyone who responded, like they had wanted to tell someone before but couldn’t,” said Dr. Shah, now on the pediatric otolaryngology faculty at Children’s National Medical Center in Washington, D.C. “They’d write things like, ‘This has been bugging me for years.’ They wanted to discuss the aftermath of adverse events in a peer fashion with colleagues but felt uncomfortable talking about these things with someone who knew them. We were nobody to them, so they could tell us.”
For years, adverse events in medicine resulted in a response similar to the one applied to gays in the military: “Don’t ask, don’t tell.” “The old attitude was that you couldn’t tell the patient anything, or they’d sue you,” said Brian Nussenbaum, MD, professor of otolaryngology and patient safety officer for the otolaryngology department at Washington University in St. Louis. “It placed an element of distrust between physicians and the public.”