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Communication Errors Result in Deaths,
Costly Malpractice Suits — 6 Insights
By Megan Wood
M
edical providers may have saved $1.7
billion in malpractice costs if they
had communicated more effectively,
based on a CRICO Strategies malpractice study,
according to STAT.
e report analyzed 23,658 malpractice cases
from 2009 to 2013, which account for about
one-third of all paid malpractice claims in the
nation.
Here are six insights:
1. e malpractice report found 30 percent of
the malpractice cases had communication er-
rors.
2. One instance involved a nurse not informing
a surgeon that a patient had abdominal pain and
a drop in red blood cell level. e patient died of
a hemorrhage.
3. e reported noted busy workloads, hierar-
chical workplace cultures, electronic health re-
cord challenges and interruptions contribute to
communication errors.
4. Electronic medical records have hurt commu-
nications somewhat, as providers sometimes as-
sume other providers will see results even when
not flagged.
5. Medical staff miscommunication when trans-
ferring patients accounted for 80 percent of
medical errors, based on a Joint Commission
study.
6. e report suggests improvement through
I-PASS, a program Boston Children's Hospital
established in 2008. e program offers a way
for providers to relay information when chang-
ing shis. n
T
he United States is facing physician shortage in the not-
so-distant-future. The Association of American Medical
Colleges found physician demand will surpass supply
by approximately 46,000 to 90,000 physicians due to an ag-
ing population and increasing number of insured individuals.
Despite this deficiency, medical students are fighting for a
limited number of residency slots. Currently, there are 175
medical schools across the United States, and the number
is growing to combat the looming physician shortage. How-
ever, medical school enrollment has increased 25 percent
since 2002 with an all time-high of 20,630 enrollees in 2015,
according to AAMC.
In 2007, The Association of American Medical Colleges im-
plored states to increase the number of medical graduates
by 30 percent by 2015, according to PEW Charitable Trusts.
Residency slots have not increased at nearly the same rates,
leaving medical students without a residency position stuck
in limbo. In March 2015, The National Resident Matching
Program had a rather successful year matching graduates
with residency slots. NRMP measures a successful match
based on two criterion — volume and how well it matches
the applicants and program directors' preferences. NRMP
found an overall position fill rate of 95.7 percent. While
2015 marked the most successful match on record, what
about the remaining 4.3 percent?
Increasing the number of residency slots is not a simple feat.
The Balanced Budget Act of 1997 limits the number of resi-
dencies Medicare is able to fund. Medicare helps cover the
financial costs associated with training each resident, which
the AAMC estimates is approximately $150,000 each year.
Therefore, states and healthcare facilities have to pay for
residency slot creation, and a large portion of hospitals do
not have residency programs or necessary Medicare fund-
ing. Many states are implementing measures to encourage
hospitals to create residency programs. For example, Texas
offered hospitals $150,000 planning grants and an addi-
tional $250,000 to develop the programs. Those hospitals
already equipped with residency programs could apply for
$65,000 to add slots. Additionally, Texas designated $56
million to help expand residency programs through 2018.
Some members of the medical community claim the United
States is granting too many residency slots to non-U.S. citi-
zens. According to the Educational Commission for Foreign
Medical Graduate, of the 12,482 students who participated
in the 2014 Match, 7,334 IMG participants were not U.S.
citizens. Of this cohort, 49.5 percent of 3,633 participants
received first-year residency positions.
In July 2014, the American Osteopathic Association passed
a resolution imploring the medial profession to push forth
federal legislation granting U.S. medical school graduates
priority of U.S. residency positions. Robert Goldberg, DO,
dean of the Touro College of Osteopathic Medicine in New
York, said, "There's a collision between the numbers of
graduates of U.S. medical schools and the limited number
of residency positions currently in the United States."
In 2015, Rep. Joseph Crowley (D-NY) and Charles Boustany
Jr. (R-La.) proposed The Residency Physician Shortage
Reduction Act of 2015. The legislation would increase the
number of Medicare direct medical education and indirect
medical education slots. The bill mandates National Health
Care Workforce Commission to submit a report to Congress
by Jan. 1, 2018, listing physician shortage specialties. The
bill also increases by the number of residency slots nation-
ally by 3,000 each year between 2017 through 2021 for a
total of 15,000 slots. Under the legislation, one-third of the
new residency slots are allotted to teaching hospitals train-
ing over their cap, and at least 50 percent of the remaining
available slots each year must be allocated for shortage
specialty residency slots the National Health Care Workforce
Commission identified in their report. n
A Call for Expanding Residency Slots: Medical School Graduates May
Face a Bleak Future
By Mary Rechtoris
