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Wolfgang Zöller: “Patients Have a Lot of Rights“
Wolfgang Zöller; © BMG
In the past, doctors were unchallenged authorities, but times are changing. These days, if patients are in doubt about the right treatment, they voice their concern. If they have become the victim of a medical malpractice, they also don’t shy away from going to court. A new law soon intends to inform them about their patient rights even more.
Wolfgang Zöller is the Commissioner of the German Federal Government for the interests of patients. It’s his goal to pass a Patient Rights law as soon as 2011. MEDICA.de spoke with him about ethics, voluntary participation and a new error management culture.
MEDICA.de: Mr. Zöller, some talk about a Patient Safety Law, others about a Patient Rights law. What is the difference?
Wolfgang Zöller: When you talk about a Patient Safety Law, it might give the impression that immature patients need to be protected from people who work in the health care system. A Patient Rights law however considers the patient an equal partner in the health care system.
MEDICA.de: You want to develop a draft for a Patient Rights law. Why is this so important to you?
Zöller: Patients have a lot of rights and they need to be clearly and precisely educated about them. At the moment, different laws regulate rights that patients have in different cases. And this often leads to confusion. You can tell by the many daily inquiries and complaints at helpdesks. For me it’s important to finally create some legal clarity with this new law.
MEDICA.de: One controversial issue probably is the Medical Malpractice Registry you are proposing and which you want to define in this law. In it, physician errors are supposed to be documented and published. What are you hoping to gain from this?
Zöller: More patient safety. For me it’s important that this registry doesn’t just list errors, but also in particular near-errors. If you know at what point errors accumulate, you can communicate among colleagues and establish recommendations to reduce errors.
MEDICA.de: Could you give an example?
Zöller: There are two drugs, which are used for different treatments, but only differ by one letter in their name. That is why they are often mixed up. If doctors are made aware of this problem, they will probably watch out even more that their patient is administered the correct drug.
MEDICA.de: Are doctors asked to report their own errors?
Zöller: Yes and anonymously. They don’t have to state who made the error, only that it happened.
A new law should bundle the rights of patients; © Thorben Wengert/ Pixelio.de
MEDICA.de: And who monitors that doctors are actually doing this?
Zöller: We rely on voluntary participation. There are no controls, because I don’t want a mandatory registry and I don’t want to put any doctors on the spot. Initially, there were some misunderstandings about this particular subject at the German Medical Association, which have been cleared up since then. A voluntary error management system is also supported by the German Medical Association.
MEDICA.de: And you think this is going to work?
Zöller: Yes. There are already hospitals that maintain such a registry successfully. If users have a positive experience, systems like these have a good chance to establish themselves. If nothing else, we hope that doctors register their mistakes for ethical reasons and for the safety of the patient. The prerequisite is that doctors don’t have to fear any sanctions, if they publish their mistakes.
MEDICA.de: Patients also have the opportunity to report medical malpractices with the review and arbitration boards of their regional Medical Association. So the frequency of errors is already known at this point and can be discussed at training seminars and used to ensure quality. Where is the additional benefit of a new registry like the one you are proposing?
Zöller: Compared to other systems, I would like to introduce a nationwide registry, covering all of Germany. Another important point is that I am primarily concerned about reports of near- errors. Arbitration boards only account for errors which were reported there and which have already happened. If you can also draw on near- errors, mistakes can be better prevented.
MEDICA.de: How do you feel about the recommendation of the German Medical Association to create better working conditions for doctors in order to avoid errors?
Zöller: One does not exclude the other. By registering errors and near-errors we will also get a picture about working conditions. If we find out that most errors happen after an 18-hour shift, we need to discuss working hours and improve them.
MEDICA.de: What other main issues does this law intend to regulate?
Zöller: We want to setup a central independent helpdesk for patient inquiries, which will be able to give the caller advice and connect them with the proper places. In addition, I would like to ensure by law that the patient’s burden of proof is made easier. Right now, the entire burden of proof for an appeal lies with the patient. What’s more, those procedures are taking much too long – and most of the time it’s at the expense of the patients. Another aspect: At the moment, I am conducting talks with all concerned parties – also including self-help groups. For people with rare diseases for example, it typically takes a very long time until therapies are officially approved. Maybe we can soon change this.
MEDICA.de: When is this law coming into effect?
Zöller: By the end of this year, I would like to develop a discussion outline and hope that the law can be adopted during the course of next year.
The interview was conducted by Simone Heimann and translated by Elena O’Meara