This post was originally published on 10/18/2012
Are doctors and hospitals killing us? Headlines are generated when a plane crashes, yet medical mistakes kill enough people to fill four jumbo jets each week.
How many times have you read these provocative lines? They cropped up again recently in a Wall Street Journal article.
Maybe we “can’t handle the truth.” The public and the media, like Tom Cruise’s character (Lt. Kaffee) in “A Few Good Men,” say they want the truth about medical errors and “bad doctors.” But as in the movie, Col. Jessep (Jack Nicholson) enlightens Kaffee about the special, unwritten rules that exist for those who have been given the responsibility to guard our world.
Are there unwritten rules about physicians covering up the mistakes of their colleagues? Or is the truth far more complicated? Can the general public handle the truth? Do physicians need to do more to clean up their ranks?
The truth is that the answers are yes, yes, yes, and yes of course, but (and this is one of my favorite phrases these days) the devil is in the details.
Understanding the details is the key to solving the problem. The solution is not easy or simple. And all the parties (yes, even you patients or consumers of health care) carry some of the blame for the problem. That’s the truth. Can you handle it?
First, identifying the problem and confronting it requires data. In medicine, there is no worth in anecdotal evidence. That’s the stuff whispered in halls, the rumors and innuendo that physicians keep to themselves, while muttering, “I wouldn’t send my dog to that doctor/hospital.”
Critics ask why we don’t scream this to the world. Because it’s opinion, based on personal observation or second- or third-hand stories. Are rumors and stories backed up by data? Other than what physicians have heard or seen, does anyone understand the whole picture? It’s hard to accuse on hearsay, and hard to correct on hearsay. So we need data.
Data is available. You can look up your local hospital on several websites, including Hospital Compare or the Pennsylvania Health Care Quality Alliance website. This limited number of measures putatively reports quality. Physicians and hospitals work hard to have a high score on these measures, so having a lower score is not a happy situation.
Do these scores provide “the truth?”Even though they’re considered “facts,” those with low scores question their validity with arguments like “my patients are sicker.”
And patients often don’t base their health care decisions on “the truth.” My elderly parents don’t read these reports to choose a hospital. No, they pick a hospital because, “The parking is easier there…” That’s part of their decision tree. That’s part of their “truth.”
The WSJ article refers to Dr. Hodad (Dr. Hands of Death and Destruction). Does he or she exist? I don’t believe any physician deliberately practices bad medicine, but I do believe a lot of us do not practice at the top of our skills.
How do we know if we’re not practicing at the top of our skills? (Do we even want to know?) Data is the key yet again, but it requires some method of gathering it. Right now the easiest (LOL) way of gathering data is with good electronic health records.
If you want to start finding out “the truth” about hospitals and physicians, there are a few places you can start.
- Consumer Reports has a report for primary care physicians in Massachusetts and, for members, offers a listing of websites where information can be found.
- Check the PA Department of State website for disciplinary actions and licensing.
- Look at the PHC4 website for a limited set of surgical reports.
But these sites only give a portion of what’s really going on.
Here’s another important aspect of the truth (if you can handle it). Every day, physicians and hospitals are trying to improve quality. We have a long, long way to go. But Pennsylvania is a leader.For example, the PA Patient Safety Authority is working hard with the Pennsylvania Medical Society and other experts to educate providers and improve care.
The Foundation of the Pennsylvania Medical Society offers the highly successful, long-running Physicians’ Health Program, which helps physicians overcome substance abuse problems and other impairments and, if possible, get back into practicing medicine. Our new LifeGuard program is helping physicians improve skills and get back into practice after a time away from their profession.
That’s the truth. Progress is being made. I think we can all handle that.