Patient Safety America
CA Medical Board Petition: Require that Physicians on Probation Inform their Patients of the Physicians’ Probation
Petition to the California Medical Board requesting doctors on probation notify patients of their status.
Medical harm is the third leading cause of death in the US. These Safe Patient Project activists are doing amazing things to change that. Check out our new video!
Categories: C. diff, Doctor Accountability, Hospital Infections/ Superbugs, Medical Errors, MRSA
Tags: Consumers Union, John James, medical harm, patient safety, patient safety advocacy, Patient Safety America, Safe Patient Project
Summary from John James: For many around the country spring cannot come too soon. Sadly, spring will not come again for too many Americans who sought only to be healed of their illness, and instead experienced a preventable adverse event that harmed them to death. I am sad for those who lost loved ones in the Oso mudslide and in the Malaysian jet disappearance, but far, far more human lives were cut short by suboptimal medical care. I offer this month’s newsletter as a tribute to all who have been lost in the last month to medical errors. They are nameless like the Unknown Soldier; however, few pay any attention to their passing.
Newsletter contents this month are as follows:
• Harm to nursing home patients
• C diff infections – kids and adults
• Do you really need a transfusion?
• White-coat infections
• Beware high-dose acetaminophen
• Surgical site infections in out-patients
• Hospital-dependent patients
• Infections from endoscopes
Summary from John James: “Spring’s renewal of life has arrived in my neighborhood with robins hopping around and trees budding. I saw a spectacular red-bud tree yesterday near a bayou. One must hope that our country will renew its efforts to intelligently manage the way healthcare is delivered in America. As far as I can tell the non-system is not working well for anyone but a few medical specialists. This month’s newsletter addresses the following topics:
• Continuing efforts to identify and discontinue worthless tests and treatments
• The over use of Pap tests in older women
• The failure of renal artery stenting to add value to optimal medical treatment
• Welcome evidence that patient safety is improving in some instances
• Trust and mistrust of medical guidelines
• The case for less mammography screening
• Ways smoking can be further reduced
• Troubled peer review in VA hospitals
• The case for improving management of obesity in very young children
I might note that just as this issue was “going to press” the Houston Chronicle ran a front page story called “Preschooler Obesity Plunges.” It explained that there has been a 43% drop in obesity rate in 2-5 year old children during the past decade.”
Summary from John James: “The first article in this month’s newsletter describes the new guidelines for management of high blood pressure and the second speaks to new guidelines for healthy living. Both sets of guidelines seem to me to be more realistic than previous ones. In keeping with the guideline theme, the third article summarizes how “patient preferences” could be integrated into evidence-based medical guidelines. This is an important area because patient-centered care must be consistent with your preferences.
I was surprised to read the complications that result from tonsillectomies, so I wrote about that in the 4th article. Treating healthcare associated infections is expensive; find out how expensive in the 5th article. Informed consent, the subject of the 5th article, is often denied patients, despite the sham paperwork that often accompanies the pre-surgical process. The concluding article summarizes how the perverse incentive of money affects the care received by nursing home patients with advanced dementia and an acute illness. If you are looking after such a person, then you need to be aware of the incentives to over-treat.”
Summary by John James: As this traditional holiday season passes into history, I hope you have found peace and joy as you celebrated with family and friends. We face a new year that has many uncertainties, not the least of which is how to get quality, affordable healthcare. My January newsletter is probably not going to help you feel better about those uncertainties.
The lead feature this month is a book review of “How We Do Harm” by Otis Brawley, MD. The other articles are as follows:
• A new way to dramatically improve care in a children’s hospitals
• Medical care that refuses to bend to evidence-based guidelines
• The cost of lost lives from having no health insurance
• The possible health benefit of eating nuts
• Over-diagnosis of lung cancer
• A proposal to deal with Medicaid patients
• Dealing with seasonal weight gain
Summary from John James: “December’s newsletter is a little late due in part to a long and joyful visit of my daughter’s family. Her two little children remind me that there is a good reason why old folks are not new parents – insufficient energy! These little ones also remind me that each generation must pass along better ways to the next generation. Automobile safety, industrial safety, and aviation safety have improved greatly since the days when I was a young man with small children, yet the safety of medical care has lagged other industries. This month I emphasize some reasons for that situation: lack of patient access to information, perverse incentives that drive up costs and put patients in harm’s way, costs that cause harm to people who cannot afford care, insufficient evaluations of hospital quality, failure to help patients with addictive behaviors, barriers to transparency, and inadequate management of hospital patient loads. Yes, it’s all a mess.”
Summary from John James: “The devastation wrought by hurricane Sandy leaves us full of empathy for those who lost loved ones and homes. When disaster unfolds suddenly, we notice it as the news media graphically magnifies the events on our TVs. The disaster that comprises much our medical industry quietly unfolds as medical errors occur in hospitals spread across the nation, and no one is there to produce graphic images of the death and suffering. In an attempt to display some of the suffering, my November newsletter begins with a review of the book “Unaccountable” by Marty Makary, MD. I was not fully aware of the endemic nature of the dangers lurking in hospitals.
The first two articles deal with medical errors – the first on diagnostic errors and the second on errors of omission. On page 3 I take a look at recent misdeeds of big Pharma, and then deal with ethical issues associated post-marketing drug testing on patients. A business model suggests that providers should start giving us what we really want – health – not medical care. Finally, we have a look at why hospital prices continue to escalate. I hope you find these stories informative.”
Summary from John James: “These are frustrating days in our country because it seems that anyone left in the middle ground on major political issues is rare, or at least they dare not speak. As we chide Congress for its ineptness, we must acknowledge that we put those people there, and in most cases they reflect what we want.
This month I was honored to have my new estimate of harm to hospitalized patients, which was published in the September issue of the Journal of Patient Safety (http://journals.lww.com/journalpatientsafety/pages/articleviewer.aspx?year=2013&issue=09000&article=00002&type=abstract), picked up Marshall Allen of Pro Publica (http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals). He brought validity to my estimate by asking MDs in the patient safety community what they thought of my work. I have marked his and other sources that wrote about the new estimate with an asterisk in my “SitesLinks” collection this month. There are many examples of medical care gone bad.
October’s newsletter deals with 1) over-diagnosis of mental illness, 2) the secrets of the medical industry, 3) how unintended consequences can occur when physician performance is measured, 4) the death toll on women from painkillers, 5) the need to stop calling so many things cancer, and 6) the issues associated with high blood pressure and too much sodium.”
John James’ summary: “Young children often grow up in a world where everything is about their needs, both perceived and real. Wise parents work against this self-centered worldview so that by the time children become adults, they understand that they are not the center of the universe. There is one circumstance where this view must be discouraged – medical care. When receiving medical care you should be the center of all that can be reasonably done for your wellbeing – with you giving informed permission for anything invasive.
In reality, medical care, although headed in the direction of patient-centered care, has a long way to go. My newsletter’s first article demonstrates this reality. The second suggests that intense care is not usually patient-centered for critically ill patients; furthermore, the money we spend on medical care can be misspent, in part due to the fee-for-service scheme that doctors prefer. The third article describes how stress from medical bills can become pervasive, especially for the uninsured.
The fourth article slams the FDA for not enforcing a law that requires drug makers to do additional testing of their drugs, and a fifth criticizes Congress for not requiring stronger control of compounding companies. The newsletter ends with an article on regulating those who could misinterpret images, and with another article on cancer-drug makers who downplay the side effects of their potent products.”