Medical Incompetence

Marta Russell ap888 at lafn.org
Sat Mar 3 09:06:11 PST 2001


It is about time that the whistle gets blown on the medical industry. I would not agree that it is common practice for doctors to treat diabetes appropriately either. marta

March 1,2001 Updated 11:13 AM ET

Report: Nation's health care woefully lacking. More on health care

WASHINGTON (AP) - The nation's health care system is a

tangled maze that too often leaves Americans with inadequate, outdated, even unsafe therapy, according to a scathing report Thursday that recommends an

urgent overhaul to bring 21st century care to more patients.

U.S. specialists know sophisticated and effective ways to

fight killers like diabetes, heart disease and breast cancer. But too many

patients slog from doctor to doctor in search of one who can even fit a

basic physical examination into their crowded schedules, much less one who

understands and uses the best treatments, says the report by the Institute

of Medicine.

"The frustration levels of both patients and clinicians

have probably never been higher," the report says. "Health care today harms

too frequently and routinely fails to deliver its potential benefits."

The report is a follow-up to the institute's

groundbreaking 1999 announcement that medical mistakes kill from 44,000 to

98,000 hospitalized Americans a year. While some scientists quibble with the

toll, that report has sparked major changes as hospitals nationwide adopted

new programs and technology to cut mistakes.

The new report looks at overall health systems, from

private doctors' offices to insurance. The institute, a private organization

that advises Congress on scientific matters, recommends an overhaul toward

patient-focused health care that gives Americans more information about

their health and makes more doctors follow the latest scientific evidence

instead of outdated treatments.

It urged Congress to set aside $1 billion over the next

three to five years to boost programs that would spur such change.

Another big recommendation: If someone gets sick late at

night or on a Saturday, and it's not an emergency, they still should be able

to get care, even if all they need is a doctor's e-mail recommending

self-treatment.

That represents "a fundamental shift in the culture of

medicine," Dr. Kenneth Kizer of the National Quality Forum, a nonprofit

health improvement research group, said after reviewing the recommendations.

Round-the-clock care access in particular has been ignored by doctors simply

because "it was not a priority. We need to make it a priority."

"The medical establishment will have trouble with this,"

predicted Dr. Lucian Leape of Harvard University, a co-author of the report.

But "patients fall through the cracks," he said, and "it doesn't have to be

that way. There are ways to make it possible for patients to be taken care

of promptly and efficiently and not break the bank."

One of the report's most alarming findings: It can take 17

years for important research discoveries to become accepted and used by the

average doctor. Heart medicines called beta blockers, for example, were

proved more than 10 years ago to increase significantly a person's chances

of survival after a heart attack. But nearly half of heart attack victims

still don't receive them, Leape said.

Other problems: Women forced to wait nine weeks for a

biopsy after a suspicious mammogram; patients denied access to their own

medical records, so that they can't weigh treatment options; paper medical

records that emergency rooms can't get during a crisis and that are easily

lost when patients switch doctors; sufferers of complicated chronic

illnesses bounced from specialist to specialist who don't coordinate their

care.

The health payment system can discourage doctors from

doing the right thing, the report said. It cited physicians who give

high-quality care that controls diabetics' blood sugar only to see their

incomes plummet as those patients' need for more expensive care declines.

Insurance companies pocket the savings.

Patients should receive care whenever they need it, 24

hours a day, and not have to wait months for a nonurgent doctor visit or

head for the emergency room, the institute said. That doesn't always mean

face-to-face visits, it said, urging more doctors to e-mail patients or set

up telephone consultations. It also recommended that insurers cover such

care.

Nor should treatment vary illogically from doctor to

doctor, the report says. It suggested that the government identify 15 of the nation's most problematic diseases and establish care standards for them

within five years.

Copyright 2001 Associated Press. © Copyright 2001 USA TODAY -- Marta Russell



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