Hospital transparency is a tricky subject. 

It’s fantastic for keeping hospitals honest, providing them incentive to improve, and allowing patients a venue for considered decision making.

For many hospitals, however, transparency has the potential to destroy bottom-lines. Strengths and weaknesses vary between hospitals, but being able to attract patients, through marketing campaigns (that depict stellar physicians or the latest technology, for example) or simple geographical convenience, is what keeps hospitals profitable and afloat, among other things. 

For decades, hospitals have enjoyed a product shielded from scrutiny by an inherent trust between physicians and the public, and the knowledge that medicine is much too complex for a layman’s analysis. In the age of the internet and open communications, that shield, however, is eroding and data is prying it open. 

St. Mary’s, the hospital central to this article, predictably attempted to counter transparency on its failed pediatric cardiology surgery service. They calculated that the risk of creating a new program (and thus growing as an organization) was worth the cost of public trust and lives - an admittedly high stakes gamble. 

It didn’t pay off to heartbreaking effect.

And therein lies the rub. If we look at medicine in general as a product, it’s one of the only products in the world with little to no margin for error. Customers expect medicine to work every time. To advance and innovate medicine from an organizational perspective, however, it takes risks that uncomfortably widen the margin - experimental techniques, drug trials, new surgery suite configurations, new EHRs, the list goes on. In St. Mary’s case, they trusted a pediatric surgeon from Stanford, a world renown school, to carry that innovation through and it seems he failed to deliver. 

So what’s the solution?

Well, it sure isn’t lying to patients, disregarding failsafes, and ignoring peers, as St. Mary’s seemed to do. Let this be a case study of a triple threat of failure - corroded public trust, shoddy self-improvement, and failed innovation all, possibly, in the name of the bottom line.

• 06/01/15