Doctors and nurses are a lot like the rest of us; if they goof up, they'd just as soon try to correct the mistake before announcing it. Yet medicine is far less forgiving than plumbing or bartending: The government estimates that medical errors kill from 44,000 to 98,000 patients a year.
Consumer advocates are skeptical of any effort to reform hospitals' routines for investigating and reporting mishaps. This month, for instance, the nation's largest health-care accreditation group announced that it would require hospitals to "tell a patient if he or she has been harmed by the care provided." But the Joint Commission on Accreditation of Healthcare Organizations, which certifies about 18,000 facilities nationwide, has little power to enforce its standards, advocates say.
As even the joint commission itself acknowledges, the culture of cover-up in medicine is deeply entrenched: "The incentives to report are all negative--potential job loss, humiliation, shunning. It is a small wonder that we know so little about this terrible problem."