Addressing consumer grievances in medicine: policies and practices of newborn screening programs in the United States.
Newborn screening programs collectively administer the largest genetic testing initiative in the United States. The redress of grievances is an important mechanism for consumers to provide input into clinical and public health programs. In this study, we evaluated mechanisms for addressing consumer grievances in newborn screening programs. To do this, we surveyed all 50 state plus the District of Columbia newborn screening programs by questionnaire regarding protocols for receipt and redress of problems reported by parents of newborns and ascertained the existence and nature of complaints and how complaints were documented and addressed. Pertinent state and federal legislation and regulation were also reviewed. Six of 49 newborn screening programs reported having formal policies for handling consumer grievances. Four states reported having pertinent legislation or regulation. Thirty-eight of 49 states reported having received complaints from 1993 to 1995. Thirteen of 49 newborn screening programs reported that they actively seek feedback from consumers. Consumer grievances ranged from minor complaints to potentially life-threatening concerns. In general, complaints are managed on an ad hoc basis; formal policies are typically lacking. As newborn screening programs affect a vast number of Americans, a proactive and comprehensive approach, including solicitation of consumer feedback, could benefit both newborn screening programs and the public served by them.
Departments of Neurology and Pathology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. natowim@ccf.org
Marvin R
MR
Natowicz
Elaine H
EH
Hiller
D003256:Community Participation; D003258:Consumer Behavior; D005820:Genetic Testing; D006801:Humans; D007231:Infant, Newborn; D011639:Public Opinion; D011640:Public Policy; D011795:Surveys and Questionnaires; D014481:United States