A resource to encourage MEC discussions

Dear Medical Staff Leader:

In the October 16, 2003 issue of this newsletter, I quoted a physician who wrote in "The New Yorker" about physicians' difficulty confronting colleagues about alcohol or drug abuse, clinical complications, or behavior issues.

I have received numerous requests for the full citation for this passage over the past couple months. The article was written by Atul Gawande, MD, and is included on p. 95 of his best-selling book, "Complications: A Surgeon's Notes on an Imperfect Science." When reading this remarkable book, I found many passages that can be directly applied to hospital medical staff leaders' various activities. For example, Gawande presents a compelling case for the link between volume and outcome in his description of the Sholdice Clinic in Toronto. In addition, the physician discusses the benefits of surgical site-marking and contemplates the benefits and limitations of good old "M&M" conferences. His discussions of medical errors and the "demonizing" of such errors explain why so many physicians have difficulty acknowledging and publicly discussing them.

Gawande's book is a worthwhile and controversial read, which would benefit all medical executive committee (MEC) members. Consider highlighting your copy of the book as you read along and then distribute the book to department chairs and other MEC members. Make time during a scheduled MEC meeting to discuss the issues Gawande addresses.

I'm confident that the lessons your departments chairs take away after reading Gawande's "gripping accounts" will make fascinating conversation.

That's all for this week.

All the best,

Hugh Greeley