What Hospitals Won’t Tell You...Medical NegligenceMedical errors are one of the leading causes of death in the United States, and what’s even more shocking is that the harm often is preventable.
Hospitals often make egregious errors ranging from minor mistakes to treating the wrong patient, leaving behind surgical tools in a person after surgery, or operating on the wrong body part.
According to the 2011 Health Grades report,1 the incidence rate of medical harm occurring in the United States is estimated to be over 40,000 harmful and/or lethal errors DAILY!
Dr. Martin Makary is the author of The New York Times bestselling book Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare, which is a story about the dangerous practices and mistakes of modern medicine. He’s a practicing surgeon at Johns Hopkins Hospital and an associate professor of public health policy at the Johns Hopkins School of Public Health.
As a busy surgeon, he’s worked in many of the best hospitals in the country, and can testify to the amazing power of modern medicine to cure. But he’s also been a witness to the medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting.
Healthy eating, exercise, and stress management can help keep you OUT of the hospital, but if you do have to go there, knowing your rights and responsibilities can help ensure your hospital stay is a safe and healing one.
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Variations in Quality Medical and Safety of Health Care Driven by 'Perverse Incentives'
One in four patients in a hospital is harmed in some way from a medical mistake, according to the New England Journal of Medicine. Many doctors have been concerned about the quality and mistakes in healthcare, but the culture has been such that it dissuaded open discussion and transparency.
“We’re really at a very exciting time in medicine,” Dr. Makary says. “For the first time, we’re speaking up openly and honestly about this problem. We’ve got research now that supports it.
...[W]hen I was at a major medical conference once, I heard a surgeon at the podium ask the audience of thousands of doctors, 'Do you know of somebody out there in practice who should not be practicing because they are too dangerous?' And every single hand went up. Everybody seems to know about this problem. Everybody even knows of somebody who’s too dangerous to be in practice. Yet for a long time, we haven’t been honest about the problem.”
Dr. Makary goes on to tell a story from his days as a medical student. A young man came to the emergency room with a fractured humerus, and the doctor told him he needed an MRI, an X-ray, and a CAT scan. The young man replied he didn’t have health insurance, at which point the doctor suddenly changed his tune, telling him to just stay off his arm, wear a sling, and all would be fine.
“I thought about it,” Dr. Makary says, “The doctor was right; all those tests don’t really change what we do, because the treatment for that type of fracture was just a sling and to rest it. So, we see these wide variations on what we do. And when you ask the doctors, 'Look, what’s going on? Why do we have so much variation in quality and safety in America?' they point out things like 'Look at our perverse incentives that promote bad care among as subgroup of doctors out there.'”
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Is Your Surgery to Satisfy Your Doctor’s Quota?
Doctors are under tremendous pressure these days. Not only are they asked to see more patients per hour, many surgeons even have surgery quotas to meet.
“They’re told they need to do so many operations in a month,” Dr. Makary says. “Sometimes doctors tell me they get text messages and emails, saying, 'You need to do so many operations by the end of the month.' They’re expected to do more, often with less resources.”
Quotas aren’t the only symptom of a major disconnect between healing a patient’s problem and running a for-profit disease management scheme. As discussed by Dr. Makary, sometimes a computer software program will order tests and studies automatically, and the doctor just has to sign off on them.
“Doctors don’t like blind triggers that result in overtreatment. They want to practice medicine the way it was intended to be practiced – individualized in care,” he says.
While computers can help with some standardization in medicine increasing dependence on computerized diagnosis and even treatment is an issue that needs to be seriously considered and discussed. We’ve had a continually evolving improvement in artificial intelligence, so much so that in the next 20 to 30 years computers will be able to interview a patient and then spit out an entire battery of recommendations. However, the recommendations will only be as good as the information it’s based on. What good will it do if all RoboDoc can do is spit out tests and treatment protocols based on biased, inaccurate or fraudulent data at a more efficient rate than human M.D.'s?
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