ASHRM responds to TV autopsy segment

A recent episode of 60 Minutes on CBS has prompted the American Society for Healthcare Risk Management (ASHRM) to issue a public protest of comments that accused the risk management profession of widespread deception of patients and participation in a coverup of medical errors.

The segment aired Oct. 11 and focused on the nationwide decline in autopsies. Reporter Mike Wallace claimed that hospitals were intentionally discouraging autopsies due to fears of malpractice claims. George Lundberg, MD, the editor of the Journal of the American Medical Association, was interviewed and made comments critical of risk managers, including an anecdote about a risk manager masquerading as a grief counselor in order to deceptively urge a family against a "truth-finding" autopsy.

ASHRM president at the time the program aired, Leilani Kicklighter, RN, ARM, MBA, DFASHRM, responded with a letter to 60 Minutes. In particular, she criticized the allegation that risk managers suppress autopsies to avoid malpractice claims, and a statement from JAMA’s Lundberg that, "Risk management, in many institutions in this country, is designed to suppress truth."

Both statements reflect a severe lack of knowledge about the risk management profession, Kicklighter wrote. Any effort to discourage autopsies would be unethical, and risk managers usually are not involved in that decision, she says.

"To blame health care risk managers for the declining autopsy rate, or worse yet, to accuse them of being part of a broad conspiracy to suppress information about causes of death, is inaccurate and irresponsible," she says.

The American Medical Association released a statement distancing itself from Lundberg’s comments. In that statement, Randolph Smoak Jr, MD, chair of the AMA’s board of trustees, says that Lundberg spoke as an individual and his comments do not represent the AMA’s position. "It’s irresponsible and unsupported to assert that malpractice is the reason the rate of autopsies is declining," Smoak says.

It should be noted, however, that Smoak’s near-apology addressed only Lundberg’s disparagement of physicians, not risk managers. The AMA did not respond to requests from Healthcare Risk Management for further comment concerning the allegations about risk managers.