doctor disease

Marta Russell ap888 at lafn.org
Thu May 10 21:35:55 PDT 2001


Thanks, Ian The story you posted "Misprescribed medicines" is the one reported about today on KPFK but there is another study too recently released by Rand (below). I don't think Rand has hit a major problem, however, which is that doctors are poorly trained in diagnosis. In my many years of being involved with disability, I know of too many instances where the doctor could not locate the source of a problem, even something as obvious as a blood clot in a leg, and the consequences were impairments for the person who was unfortunate enough to not find a good doctor. These were not managed care cases so I can't blame them on the tendency to undertreat or not enough time with a patient to detect the problem. marta

Health care in critical condition

Kim Laviere says a surgeon mistakenly cut a key artery during an operation to repair a varicose vein, which led to the amputation of one foot.

By Robert Bazell

NBC NEWS BOSTON, May 7 Ñ A new report from the prestigious RAND Corporation says the quality of health care for most Americans is surprisingly poor: The group ranked the U. S. medical establishment 37th in overall performance worldwide. But some hospitals, like BostonÕs MassachusettsGeneral, are taking much-needed steps to fix this broken system.

Study finds many nurses dissatisfied

Hospitals go overseas for nurses

KIM LAVIERE says she understands bad health care. She says a surgeon mistakenly cut a key artery during an operation to repair a varicose vein. Now she is severely disabled, with one foot amputated. ÒBefore it happened I was a very independent woman,Ó Laviere said. ÒI came and went as I pleased.Ó She sued the surgeon and hospital; both deny the charges. Experts say such frightening stories are far too common. ÒWe get undressed, we disclose our innermost thoughts,Ó said Dr. Robert Brook, vice president of RAND Health, a think-tank organization. ÒItÕs hard to believe that we do this in front of a system that is providing mediocre results at best, and is disorganized and using ancient technology.Ó The report points out that half of Americans do not get needed preventive care: 40

percent of those with chronic conditions like diabetes and high blood pressure do not get proper treatment and 98,000 die a year from medical mistakes. Yet few seem to care. ÒThere is no public constituency,Ó Brook said. ÒThereÕs no walk for quality of care. ThereÕs no march to improve quality of care.Ó

What should be done? The biggest problem is that while we have amazing new medical machines and drugs, much of health care relies on ancient technology Ñ often illegible notes in medical records that get lost.

ÒWhat needs to happen is that there needs to be the kinds of checklists and systems that are built into every other industry to make sure that the work gets done and people donÕt forget what theyÕre doing,Ó Brook said.

REDUCING HUMAN ERROR

Some hospitals like Massachusetts General are bringing in large-scale computerization. Every doctor and nurse sees the entire patient history at once Ñ and bad handwriting and poor memory do not lead to mistakes with orders for drugs and tests.

ÒIn a place like the Massachusetts General Hospital, there are 3,000 medications you can prescribe, 1,100 lab tests, 300 radiology procedures,Ó said Dr. Joseph Glaser of Partners HealthCare System. ÒAnd they have to master that. And itÕs inconceivable that any human being masters that.Ó

[Image] Study finds many nurses dissatisfied

[Image]

The computer asks questions to ensure the dose of a drug is correct and it does not interact with other medications.

ÒYou cannot even write the order before you answer these questions,Ó said Dr. Charles Boucher, a cardiologist. Every day in response to questions from the computer, doctors or nurses change 4 percent of the order Ñ avoiding potential mistakes.

But even at this Harvard teaching hospital, officials say, many doctors and nurses initially resisted the new computer system.

And across the country, most hospitals say they are so strapped for cash that they canÕt even consider computerizing medical records Ñ no matter how many lives might be saved.

The new report says changes arenecessary throughout AmericaÕs health-care

system, to prevent problems that create potentially deadly consequences for millions every year.

Avoiding medical mistakes

¥ Become an expert on what ails you. Ask

your doctor all about it and do your

own research.

¥ Know all about your medications.

Thousands die each year from medication

errors. Know what you're taking, what

the name is, what the strength is and

what it's for.

¥ After taking new medications, watch for

new symptoms that could be side

effects.

¥ Bring all of your medicines to the

doctor with you -- even

over-the-counter drugs and herbal

remedies -- so your doctor can see

everything you are taking.

¥ Know your lab results. Call your doctor

if you don't receive notification after

lab tests.

¥ Be on guard, even in the hospital.

Every time a drug is about to be

administered, even intravenously, ask

what it is.

Source: NBC News

Robert Bazell is chief science

correspondent for NBC News.



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