In response to recently introduced Wisconsin legislation, we penned a column this past summer about the use of cameras in the operating room or so-called “surgical black boxes.” We got a lot of feedback from healthcare, insurance, and legal professionals, and almost all of it good and supportive. One veteran risk manager wrote, “How do we fix problems if we don’t know what they are?” And several lawyers wrote the evidence is powerful, and usually FOR the doctors and nurses. Unfortunately, these folks don’t work for the hospital and medical lobbying groups. The Wisconsin hospital and medical associations — the state where this legislative proposal has first been proposed — think it’s a terrible idea that will “get in the way of the patient/doctor relationship.”
How does me the patient or the family knowing what is happening in the operating room get in the way of a relationship with my doctor? Anyone who understands or has experienced marriage counseling knows that secrets in a relationship are a ticket to trouble. Being open is the best policy with those you want to trust. Why do medical and hospital lobbyists think they are different? Nope, just more knee jerk reactions and fears that this idea will benefit the evil trial lawyers. This crowd said the same things about disclosure 10 years ago…..
Moreover, when you think about it, operating rooms are full of technology, computers, and other gadgets which if coaxed by a qualified technician can spill all of their secrets. Also, today’s patients and families come armed with smart phones that record every utterance and image— remember the surgical case from the summer? Indeed, we already have many “mini” black boxes in operating rooms as well as waiting rooms and everywhere else in the hospital or doctor’s office, so why not the full Monty?
Lastly, most hospitals claim they are supportive of disclosure (although the truth is the “support” comes in various shades and colors). So, if we all like disclosure, then let’s really be transparent! Videotape the operations, and, as many defense lawyers say, the tapes will usually show the complainant there really is no case. When, however, the tape shows a mistake, no worries, we were going to disclose anyway! Now we can show you the screw up in color on our I-PAD.
With this last point in mind, I think true disclosure hospitals will have to lead the way on this idea. It may too big a push legislatively, but a disclosure hospital can say (without legislative approval) to their surgeons, “Look, you know our disclosure policy, if you make a mistake we want to know about it, together we will go to the family, and together we will get everyone right, including you. So, the camera is just another tool to help us that do that.” When these disclosure hospitals start reporting their experiences using cameras and can show the roof didn’t fall in, well, then, the idea will get a lot less scary, including for the medical lobbyists.
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