Author Affiliation: Columbia Law School, New York, NY.
The quintessential service business can be identified by a sign mounted
prominently behind the counter proclaiming that "The Customer Is Always Right."
Despite the lip service paid these days to consumer sovereignty and patient
autonomy, however, it is hard to imagine a similar placard in a hospital or
doctor's office reading "The Patient Is Always Right."
Consider medical error. For decades, error has been addressed primarily
through malpractice litigation, the availability of which often depends on
the lobbying muscle brought to bear by organized medicine, on one side, and
the trial bar, on the other. Whether in the courts or the legislatures, patients
rarely speak, but are spoken for. Following the publication in 1999 of the
Institute of Medicine's report, To Err Is Human,
it has become fashionable to think of error prevention as a cooperative, system-based
pursuit of improvement rather than the identification and discipline of individual
bad apples.1 This process, however, is typically
framed as an exclusively professional one. Again, the patient is often the
object of discussion and seldom the discussant.
Sage WM. Putting the Patient in Patient SafetyLinking Patient Complaints and Malpractice Risk. JAMA. 2002;287(22):3003-3005. doi:10.1001/jama.287.22.3003