A medical doctor published an article in the Newsweek recently that reminds all patients that hospitals are not quite as safe as we suspect. The article is an excerpt from the doctor’s book: Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.
The author notes that he had a wake-up call about the dangers of care when he was in medical school. He watched with dismay as an elderly patient of his died after a procedure that she did not need or want. The author explained that the drive for doctors to perform certain medical actions (in this case, surgery for ovarian cancer) was “like a train no one could stop.” This lead the medical team to understate the risks and overstate the benefits. During the biopsy before the procedure a needle accidentally punctured a blood vessel causing many different problems–including a six week hospital stay. She died not long after–spending most of her final weeks in the hospital undergoing blood transfusions, CAT scans, facing malnutrition, and more.
Keeping Med Mal Secret
The doctor was angry and confused about this case–wondering how this could have happened and what could be done to prevent it from happening again. Amazingly, he found that the hospital was under no obligation to do anything about disclosing the problem. That is true even when the occurrence of those problems are greater than the national average.
Most patients never learn about the scope of the patients safety problem until they are affected. For that reason it probably should not be surprising that much care is dangerous, mistake-ridden, and often unnecessary.
“Unnecessary” care–like that affecting the elderly woman in this case–is perhaps the least understood. The president of the Institute of Medicine noted that between 30% and 40% of medical care is actually unnecessary or fraudulent. At times it is blamed on”defensive” medicine or is said to be the fault of the civil justice system. But in reality, the legal system has little to do with unnecessary care. As our lawyers have often explained, the legal system is based on comparison on actions taken with reasonable conduct and the applicable standard of care–not some arbitrary tally of the total number of tests taken or treatments provided.
Besides hidden information, a big problem is that dangerous doctors continue to practice day in and day out. Tens of thousands of patients are hurt as a result. For example, the article explains that even if only 2% of doctors provide dangerous care (and he suggests this is a low estimate), than 10 million patients are seeing impaired doctors each and every year. But, so few patients consider the risk that their medical provider–even ones performing high risk surgeries–might pose higher risk of causing serious damage.
Changing the Game: More Information
The doctor notes that the best cure is more comprehensive information which provides real information to patients about the care they are likely to receive at different medical institutions. Right now, that does not exist. Even considering the “hospital safety” ranking systems available, the doctor summarizes that “a hospital’s outcomes are hidden from the public, neither consumers nor payers have any way of measuring whether the medicine they provide is good, adequate, or even safe.”
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