Following a lecture I gave at George Washington University two years ago, I was asked by an audience member to name the outstanding healthcare figure of the 20th century.

I said then, and still believe, that the one person I would single out would be Mother Teresa.

She embodied all of the characteristics of greatness. She had mission, vision, values, service and leadership. She wasn’t a high-powered executive. She didn’t care about any bottom line other than service to the poor. She didn’t covet healthcare awards and I don’t think she was ever viewed as being particularly powerful. What she did was to courageously and unstintingly provide care to the maimed and diseased children she found in the slums of Calcutta, India. Her example, set decades ago, survives her, and today there are some 360 religious orders all over the world that continue her work.

This may seem to be a roundabout way of getting to my point, which is a consideration of the current state of the U.S. healthcare system, but bear with me.

For cutting-edge procedures, the latest and most expensive equipment and large-scale medical research into diseases such as cancer, the United States is far ahead of other nations. We also have preserved a strong element of personal choice. For most people, insurance coverage generally allows us wide latitude to select the doctors and hospitals we want. We have far too many uninsured people, but the health reform law promises to change that.

What I worry about is not the best of the best, but the day-to-day quality of care most patients receive, even at some of our most storied institutions.

This concern has been one I have had for many years, even before the 1999 Institute of Medicine report raised national concern over medical errors. Over the past five years, however, my generalized concern has become more specific. I have had both knees and both hips replaced in four separate surgeries as well as recent surgery to repair a tear in my aortic valve, all in a couple of our most prestigious hospitals. That’s a lot of surgery and a lot of contact with physicians, nurses and other allied healthcare professionals.

In general I have received decent care. That is, the end result was in line with what I hoped for. I’m alive, and the replacement joints and aortic value are working. And yet, along the way I experienced carelessness, incompetence and waste. Like hundreds of thousands of other people, I almost died as a result of medical mistakes. The details are worth a story in itself, one I will tell another day.

There’s been a lot of controversy around the appointment of Donald Berwick to head up the Centers for Medicare and Medicaid Services for at least the next two years. Right after he was given a recess appointment, I went back and read one of his books, Escape Fire: Designs for the Future of Health Care, which was published in 2004. It gives you great insight into Berwick’s philosophy and his concerns about the quality of healthcare delivered in this nation. I don’t know or care if he is a Democrat or Republican; I do care that he believes his work can ensure that someday, every patient entering a hospital will not be harmed and will receive the very best care that this nation can provide.

A couple of years ago when Dennis O’Leary was stepping down as head of the Joint Commission, he warned everyone who becomes a hospital inpatient to make sure to have an advocate who can stay with them. He said that unless he had someone with him to act as his advocate, he wouldn’t set foot in a hospital because he would not be safe.

A decade after the Institute of Medicine’s To Err is Human report found that as many as 98,000 people died from preventable medical mistakes, it appears that not nearly enough has changed. A recent study by the Leapfrog Group stated that one out of every four patients entering a hospital is harmed one way or another. Another analysis, by the Department of Health and Human Services’ inspector general’s office, found that of a random sample of 780 Medicare beneficiaries hospitalized in October 2008, one in seven were harmed by medical care. That finding, extrapolated to the U.S. as a whole, means that 134,000 patients would be harmed per month and 1.6 million would suffer an adverse event every year. The results indicate that adverse events “contributed” to about 180,000 deaths that year.

The HHS study led Leah Binder, the CEO of the Leapfrog Group, to tell Modern Healthcare: “This report suggests you'd have to be a daredevil to allow yourself to be admitted to a hospital. “What other industry in human history has a rate of injury like that? Maybe tightrope walkers or people who get shot out of cannons.”

We still have a long way to go and all of us – providers and suppliers and nurses and physicians and anyone connected to healthcare, have to bear responsibility for any harm that befalls patients. We all should re-read the Hippocratic Oath. I worry that there is still no sense of alarm or even urgency among the healthcare establishment to fix the problems that lead to such tragically poor outcomes.

More Mother Teresas may be too much to ask for, but can’t more people try to be like Don Berwick?