In his insightful and provocative article on medical error, Leape1 raises a topic that has been distinctly unpopular among physicians. Concerning medical error and its prevention, the profession has, with rare exceptions, adopted an ostrichlike attitude. Mistakes have been treated as uncommon and atypical, requiring no remedy beyond the traditional incident reports and morbidity and mortality conferences.
The manner in which physicians manage medical errors must and will change in the future. It will change because a large and growing collection of literature demonstrates that physicians' approaches to the management of medical error do not work well enough, and the various parties to which physicians are accountable—purchasers, payers, government, and the public—have discovered this fact. The only question now is whether new systems for preventing medical error will be designed with the full cooperation and participation of the profession or under less desirable circumstances. The
See also p 1851.