Should CEOs Be Liable for Medical Errors Caused by Staff Shortages?

Two emergency room physicians believe the CEOs of hospitals and health systems should be held responsible for medical errors caused by staff shortages because they aren’t putting enough providers on the floor. According to a recent survey in Medical Economics, 34% of responding physicians reported an increase in medical errors due to staff shortages.

Dr. Robert Derlet and Dr. Mark Borden outlined their argument in a recent op-ed for Emergency Room Medicine. Both men wrote that CEOs and hospital administrators routinely jeopardize patients and staff for the sake of increasing profits. They claimed that most executives do not understand or want to understand how the emergency room works.

When the physicians asked an administrator how often they visit the ER, they responded, “I avoid that place at all costs. I might get some terrible disease or be spit on by one of your psycho patients.”

The men accused some administrators of intentionally understaffing the ER and other hospital departments out of greed and negligence rather than ignorance.

Borden explained that at the hospital where he recently worked, the board hired a CEO who didn’t have a background in medicine, so they often deferred to the data without heeding his concerns. The CEO didn’t have a college degree and had zero management experience. They told Borden and the other emergency room physicians to work 40 hours a week like other professionals, but Borden said the combination of 12-hour night shifts and day shifts would lead to poor patient outcomes, so the CEO tried to eliminate their call room.

“I did my best to correct his errors as the ED medical director, but it was a difficult battle,” Borden wrote. “The CEO’s background was in computer programming. He replaced our ED-dedicated electronic medical record with a hospital EMR that had a free module for the emergency department.”

The new software made entering data a nightmare for providers.

“We are still forced to enter a last menstrual period for all patients whether male, female, or pediatric,” he explained. “That may sound trivial, but it was actually difficult because the computer would refuse many dates that we tried to enter, and it refused to allow any orders to be placed until it was satisfied.”

So, what’s the solution?

Berlet and Borden go on to argue that CEOs and administrators should be made to take the Hippocratic Oath just like other healthcare professionals.

“The advent of physician servants has made the CEO the ultimate decision-maker about patient care, and therefore that is who should be held responsible for decisions that affect its quality,” the authors wrote. If CEOs refuse to take the oath, they shouldn’t be hired, the authors argued.

“A hospital administrator and the board are still responsible even if they don’t take the Hippocratic Oath,” they added. “Our attitude as physicians must be that anyone who chooses to work in a hospital has tacitly assumed the responsibility to prioritize patient welfare.”

They also believe hospitals and physicians should voice their complaints to the public, including to the press or on social media, if the board or CEO refuses to take action.

“Changes motivated by profit rather than quality of care must be examined critically, and we must not be afraid to denounce those decisions. Our professional societies must ensure that a physician can speak out on behalf of patients without suffering,” the authors concluded. “We advise [emergency physicians] named in a lawsuit as a result of their hospital’s gross negligence in providing the ED with resources to sue the CEO.”