VCU's Woolf urges moderation in pursuit of patient safety in article published in Annals of Internal Medicine

By Michael Ford
University News Services

In the current issue of Annals of Internal Medicine, a Virginia Commonwealth University professor and physician warns that preoccupation with patient safety could inadvertently harm patient outcomes if it distracts attention from other defects in health care delivery.

Steven H. Woolf, M.D., M.P.H., VCU professor of family practice with a joint appointment in the Department of Preventive Medicine and Community Health, asserts that concentrating on a single disease or health theme, like patient safety, can ultimately compromise the overall health of the population if that focus comes at the expense of other problems that pose a greater threat to health.

"For every patient harmed by lapses in patient safety, more will suffer or die from deficient health care and flawed delivery systems, problems that a perfect safety record will not take away," Woolf wrote. "If failure to provide preventive care claims 100 times as many lives as lapses in safety, then a system preoccupied with safety and doing little about preventive care will see more of its patients die."

Woolf's article defines patient safety as a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that costs lives but do not affect safety. Woolf, director of research in the VCU Department of Family Practice, advocates a big picture approach to healthcare that examines the broader organizational causes of inadequate care including faulty information systems, systemic quality defects introduced by insurance and management policies, racial and ethnic disparities and flawed system designs that adversely affect health care delivery.

"Improving safety is vital, but it should not distract from the larger mission of helping people maintain their health and cope with illness, of which safety is but one component," Woolf wrote. "The medical profession should stay centered on this larger purpose, and not on fragments. Patients deserve far more than to not be harmed by their physicians."

Woolf earned his medical degree from Emory University in Atlanta and his master's in public health from Johns Hopkins University in Baltimore. A frequent consultant to government agencies and professional organizations on matters of preventive medicine, Woolf has authored two books and more than 60 articles.

To promote excellence in the clinical practice of internal medicine, the Annals of Internal Medicine was established in 1927 by the American College of Physicians. Publishing original articles, reviews, clinical conferences and editorials twice a month, it is considered a leading journal for studies in internal medicine.