The Dec. 27 editorial "Fixing Medical Mistakes" encouraged action to improve health care and, appropriately, gave the veterans' health system credit for its avant-garde position of encouraging the reporting of errors.

Two points should be added. One is that this has been Veterans Administration policy ever since I first joined the VA as a resident physician in 1952. Self-reporting of errors was, and is, encouraged, expected and effective at the VA.

Generally, 85 percent of the errors were "system faults," and 15 percent individual mistakes. A reported error was, and is, looked upon as an opportunity to correct a system fault, educate the person who made the error and augment training programs. Punitive action is, and must be, minimized or eliminated if possible.

My second point would expand on The Post's acknowledgment that the legal responsibility of an errant physician, nurse or other health-care provider is eliminated in the VA. This is of infinite value in encouraging self-reporting, as well as third-party reporting, of errors. Could this not be replicated in the private sector? The financial obligation could be transferred to "the system," as it is in the VA. That system could be a hospital, an HMO or a medical or nursing society--some corporate body.


Gainesville, Fla.