YOU SAY YOU GOT SICK IN THE HOSPITAL?
by William A. Collins
September 17, 2008
Love my doctor,
What a brick;
Just too bad,
He made me sick.
It’s a lot of work becoming a doctor. Or nurse for that matter. That’s good because it means that the folks in charge of our health are well trained. But all that training also has unintended consequences. A familiar one is arrogance. No, not arrogance of personal demeanor, but rather a sense that the doc and his buddies know what they’re doing and everyone else ought to butt out. That’s risky.
Another consequence is all those buddies. In any clubby profession, be it medicine, law, police, aviation, military, or banking, practitioners hate to rat on one another. They never know when their own turn will come to need their colleagues to keep mum.
These frailties are a problem in any line of work, but health care has the biggest direct impact on our lives. A TV program the other day estimated that 100,000 Americans die prematurely each year from botched medical treatment, often improper medication. One of our friends lately dodged that bullet, so we’re somewhat sensitive.
Of course, medicine is a very complex business so lots of patients are going to be lost in the confusion. But 100,000? The trouble is that we rarely get to read about any of them. How many obits have you scanned that say, “succumbed to a MRSA infection acquired in the hospital,” or “bled to death when accidentally administered the wrong dosage of blood thinner?” Or maybe, “Died because the doctor was too busy to wash her hands.”
No, what we read is “died from complications related to diabetes.” Or congestive heart failure, or pneumonia. Or take my wife’s near miss. The doctor punctured her colon during a routine hospital colonoscopy and didn’t figure it out right away. Dangerous stuff. Luckily, she’s a tough cookie, the hospital pulled out all the stops, and she wasn’t allergic to the small cask of antibiotics they poured into her. But suppose there had been a less-happy ending. Would the obit have read, “Doctor punctured colon”? Well, sure, if I wrote it. More commonly though, “died of an overwhelming internal infection.”
Lawsuits and medical examining boards don’t help much either. Doctors hate to testify against or discipline one another, especially publicly, so medicine settles for more slaps on the wrist than a hyperactive kids’ birthday party.
Insurance companies reinforce this syndrome. Let’s say a doctor really screwed you up and the insurer is ready to settle. OK, but first you have to sign an agreement that you’ll never divulge anything about the case.
Consequently, most of us laymen have no idea what’s going on. The scope of the problem is kept tightly under wraps. If the press would put as much zeal into medical error as it puts into West Nile virus there would be a massive hue and cry for reform. But mosquitoes don’t advertise in the paper while hospitals do.
Sensible reform would call for MRSA screening for all new admissions, computerizing all patient records, more routine medication review, press coverage of disciplinary board proceedings, penalties for skipping hand washing, and a dozen other improvements for which advocacy groups have long lobbied. Fortunately, some hospitals are already doing these things, profitably.
Most institutions though, while working hard to cure us, succumb to comfortable routines, avoid embarrassment at all costs, and keep a tight grip on the bottom line. It’s an old boys’ game where the most diligent institutional effort of all goes into enhancing management staff salaries. Thus excessive medical error remains just one more symptom of America’s broken health care system.
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Columnist William A. Collins is a former state representative and a former mayor of Norwalk, Connecticut.
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