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Secrecy in health organizations is a disservice to patients

About Luis Fábregas
Picture Luis Fábregas 412-320-7998
Medical Editor
Pittsburgh Tribune-Review

Luis Fábregas is an award-winning reporter who specializes in medical and healthcare issues as a member of the Tribune-Review’s investigations team.

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By Luis Fábregas

Published: Saturday, April 13, 2013, 12:01 a.m.

Some health organizations love to keep secrets. They've mastered the art of withholding information about incidents that take place on their premises by trumpeting the notion they're protecting patients' right to privacy.

The mindset that people ought to be left in the dark became more clear over the past few weeks with two prominent stories in the Tribune-Review.

The first is the perplexing outbreak of Legionnaires' disease at the VA Pittsburgh Healthcare System. VA administrators have said so little about the outbreak — linked to 21 infections and five deaths — that veterans and their families can only wonder if someone isn't telling the truth.

What's perplexing is that the VA isn't the only one keeping silent. Even The Joint Commission, the agency known in health care circles as the top hospital watchdog, is staying mum. The agency paid an unannounced visit to the Pittsburgh VA in December after receiving a complaint. That's just about all they'll tell you.

For years, the Joint Commission has said that revealing details of its inspections would stop hospitals from being open and honest. If hospitals are forced to talk about errors and mistakes, the thinking goes, then it would be very difficult for them to improve their quality. In other words, the more you know about what happens in your hospital, the more your care will suffer. Makes absolutely no sense to me.

In Pennsylvania, the state Department of Health makes public its hospital inspection reports. It's a pain to look through them but it's better than nothing. There's also a new website,, cleverly designed by the Association of Health Care Journalists (disclosure: I am a member). The website compiles thousands of federal hospital inspection reports since January 2011.

Last month, administrators at Western Psychiatric Institute and Clinic would not dare speak about a disturbing incident in which police said an 8-year-old patient was sexually assaulted by a fellow patient. The victim was never identified, yet admitting that this incident even happened would have violated the unnamed patient's privacy.

You tell me how someone's privacy can be violated when we don't even know her name? The privacy laws exist to make sure doctors, other health care workers and health insurance plans don't share medical information by imposing significant fines. They don't exist to prevent hospitals and health plans from using common sense or being transparent.

Transparency is possible. At Brigham and Women's Hospital in Boston, administrators produce an online newsletter for employees that details medical errors, according to a story this week in The Boston Globe. One issue of the newsletter included the story of a woman who received the wrong medications. Yet another featured the case of a woman who waited in the emergency room for hours with abdominal pain. She left and went to another hospital, where she got an appendectomy.

The hospital doesn't reveal the patient's identity or the workers who were in the wrong. They do, however, explain how the problem was fixed. That's a tremendous step forward in the quest toward transparency. The culture of secrecy that we've allowed to fester in our hospitals makes it impossible to find a way to prevent problems.

Informed patients can be part of the solution.

Luis Fábregas is a staff writer for Trib Total Media. He can be reached at 412 -320-7998 or




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