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Anyone born in the United States at a hospital has encountered the nation’s healthcare system from birth. According to the Department of Health and Human Services, Centers for Disease Control and Prevention and National Center for Health Statistics data (HHS, 2015), if not at birth, at least once in ten years, 97% of people living in the US would have an encounter with the healthcare system. Healthcare facilities are a place that you expect to be safe as you entrust your health in the hands of trained health care professionals who work in a system that is meant to look after you. However, a report on improving patient safety published by the World Health Organization in 2002 states “patient safety” is one guarantee that our healthcare system cannot give patients (Emslie, Knox & Pickstone, 2002).

The Institute of Medicine’s Landmark Report “To Err is Human: Building a Safer Health System” published in 1999, shed light on deaths due to preventable medical errors (Institute of Medicine (1999)). According to researchers from the Johns Hopkins University, death due to medical errors is whooping 250000 (Makary & Daniel, 2016). The 1999 IOM report concluded: “ faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them.” This left individual clinicians not accountable for medical mistakes (IOM, 1999).  In an interview with the British Medical Journal, Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, states, “in healthcare, many mistakes happen again and again, and many mistakes are not investigated.”

We are now in the second decade of patient safety movement, and things have gone awry, to say the least. While most healthcare facilities try to maintain a culture that promotes patient safety, there are some that face extraordinary difficulty in promoting patient safety. Women and young girls are particularly vulnerable. For example, several news organizations reported (see below for PDFs) that an OB/GYN doctor at a healthcare facility in Maryland, was filming and taking photographs of his female patients without their consent. The CBS, Baltimore Sun, and Washington Post news reports state that this OB/GYN victimized thousands of women and girls (Shulte & Herman, 2013. George & Dance 2013., Fenton, 2014., & CBS News, 2013). This was a system failure at different levels. According to WBAL (Lettis, 2014) reports, women were photographed using a pen camera, there were hidden cameras in the toilet seat covers, and the co-workers were filmed while they used the restroom.

 

“We need solid legal protections for a reporting system that enjoys that enjoys the same legal protections that already exist when we discuss patient safety quality information within an institution.” – Makary

 

News media reports that, for decades, the organization’s security and maintenance staff did not know of cameras hidden in toilet papers and exam rooms leave alone a pen camera hanging on a lanyard around the OB/GYN’s neck.

On April 28, 2008, a lady doctor filed a lawsuit in the US district court of Maryland, case no: 1:08-cv-1073 reveals a culture of misogynistic conduct by doctors at this same institution. In this complaint it states in pertinent part, “ the working environment in the division was hostile to women because it featured sexually inappropriate and unprofessional conduct.” Additionally, “Dr. Stewart, the senior fellow in training in the division for the 2004-05 academic years, had offensive, sexually-suggestive photographs displayed as a screensaver on his office computer,” the screen saver was referred to as his (Dylan’s) “T&A display.” The complaint goes on, “the photographs on Dr. DeMaio’s was, and …computer screen saver was symbolic of the work environment in the division. It was an environment that regularly featured sexually inappropriate and unprofessional conduct by male employees. For example, on one occasion, the female physician came into the work and found several inflated condoms lying on her chair and around her office.” The complaint further alleges that a male attending physician gave his female medical graduate fellow a statue of a carved penis as a graduation present. According to the complaint filed by this lady doctor, after she reported the misconduct to higher authorities at Hopkins it only led to retaliation against her. According to the Hopkins website, Dr. Dylan Stewart is the Director of Pediatric Trauma and Burn Program, Division of Pediatric Surgery. According to Dr. Demaio’s Bio posted on Johns Hopkins Website, he is the “Director of Research, Division of Pediatric Surgery.” Despite the complaint filed in federal court by the lady doctor, nothing stopped this OB/GYN from his behavior because, despite the lawsuit, the institution did not put patient safety measures, particularly for women. Thousands of women now live in shame caused by an OB/GYN and his hospital they trusted that breached its duty in protecting their dignity.  Maryland is not alone; according to the Washington Post, recently, a Michigan doctor who pleaded guilty to sexually assaulting young athletes was sentenced and in issuing his sentence, Judge Aquilina told the doctor, “I just signed your death warrant.”. US News and World report somehow tend to rate these hospitals with staggering patient safety violations as the best place to receive care, and we have no idea where they are getting their statistics. The lack of transparency by the healthcare entities and the US News and World Report does not give much credence to these ratings.

 

Tips for your next visit to a healthcare facility:

Healthcare entities must promote a culture of safety and patients who visit these hospitals can help them accomplish that goal for everyone. Every patient has a right to ask questions and they should. Most healthcare facilities have patient safety measures in place. Nevertheless, it does not hurt to ask the right questions. For example, the next time you visit your local OB/GYN or the OB/GYN at any hospital in Maryland or rest of the world, you should ask if there are cameras in the exam room. In many states across the US filming a patient without his/her consent is a violation of patient privacy and confidentiality.

 
Mitra Rangarajan is an expert in the healthcare field and strives to empower patients to take charge of their health and safety. Read more on her patient safety research here!


References:

Makary & Daniel (2016). Medical error-the third leading cause of death in the US. BMJ 353:i2139

U.S. Department of Health and Human Services, Centers for Disease Control & National Center for Health Statistics (2015).  Summary Health Statistics: National Health Interview Survey.

Emslie, S., Knox, K., & Pickstone, M (2002).  Improving Patient Safety: Insights from American, Autralian and British healthcare. Based on the Proceedings of a joint ECRI and Department of Health conference to introduce the National Patient Safety Agency.

Institute of Medicine (1999). To err is human: building a safer health system. National academy of press.


News Media Links and PDFs:

All PDFs can be found on Mitra Rangarajan’s Behance Profile

CBS News Link

Baltimore CBS Link

WBAL Link

Washington Post Link 1, Link 2

Baltimore Sun Link 1, Link 2