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Medical errors kill enough people to fill four jumbo jets a week. A recent survey of doctors, nurses, technicians and other employees at 60 U.S. hospital found that at one-third of them, most employees believed the teamwork was bad. At other hospitals, by contrast, an impressive 99% of the staff reported good teamwork. Of interest is the fact that these results correlated strongly with infection rates and patient outcomes. Good teamwork meant safer care. The public needs to have access to such information for every hospital in America.

Part of the problem is that doctors fail to comply with well-established best practices in their fields. One New England Journal of Medicine study found that only half of all care follows evidence-based guidelines when applicable. If cameras were routinely used to record care and treatment, the compliance rate might improve significantly. Cameras are already being used in health care, but usually no video is made. Reviewing tapes of cardiac catheterizations, arthroscopic surgery and other procedures could be used for peer-based quality improvement. Video would also serve as a more substantive record for future doctors. The notes in a patient's chart are often short, and they can't capture a procedure the way a video can.

Though health care is moving toward increased transparency, resistance to open information is still evident. Increasingly, patients checking in to see doctors are being asked to sign a gag order, promising never to say anything negative about their physician online or elsewhere. In addition, if you are the victim of a medical mistake, hospital lawyers will only settle if the victim agrees to never speak publicly about the injury.

We need more open dialogue about medical mistakes, not less. As one author of the study noted, when hospitals have to compete on measures of safety, all of them will improve how they serve their patients.

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