@Reba055 wrote:
Well this is no suprise to me. The move to more "socialized" medicine has led to the decline in medical care. Doctors are too busy jumping through hoops and filling out paperwork, pushing patients through their office at break neck speed, and being told what meds they can prescribe to have time to properly diagnose and treat patients.
When I worked in the medical field years ago (hospital and private practice) many times I left the office and the doctor was still there with medical journals piled sky high on their desk, when they had a patient where the diagnosis was not obvious. Often three or four other physicians would drop by and they would consult over the patient. Do you think they do that today? Nope. Any after hour time is spent dealing with red tape.
It also seems like critical thinking has been replaced with a formula. Order X test, if this, do that, etc. If tests are negative, they ship you off to another specialist. After all, they aren't paid to spend time trying to think outside the box. They'll be penalized if they spend too much time with you.
Add to that the crappy generic drugs being crammed down our throats, and it's no wonder.
There are exceptions at some teaching hospitals, but by and large, in my opinion, there is not much gathering around the patient to get to the bottom of what's truly going on.
Be careful what you wish for!
If that is the case, what was responsible when this first was recognized and the landmark publication by the Institute of Medicine published its "To Err Is Human" report way back in 1999? That landmark report, which can be googled and readily obtained by anyone, brought to light the enormous number of patients that were dying due to medical errors.
And by far in large, one of the greatest factors involved in the number of deaths that occur in this area are Adverse Drug Events due to the wrong medication or wrong dosage of medication being administered. Nurses work under-staffed and are required to work mandated overtime to the point they are many times exhausted. Therefore, more prone to make mistakes. Yet, nurses in many states have not been able to get legislation for mandated staffing ratios passed in their state.
Pharmaceutical companies make medications in vials or ampules that look quite similar, further making it much easier for a tired, rushed nurse to make a mistake.
And the next highest contributing factor is the archaic, complex system that is our health care system. Mistakes are made with communication between handoffs of physicians, nurses, and other health care providers. That may occur as a patient is transferred from the Post Anesthesia Care Unit to the Intensive Care Unit or even between 2 doctors.
Some research does suggest that those "formulas" or guidelines that have been developed, have improved patient quality outcomes. The serious errors occur due to misinformation during handoff between physicians as patients are being referred or transferred. Not that there aren't docs just making plain ole mistakes, but that didn't account for the biggest part of the overall problem.
Unfortunately, this problem is not new and has been around in the healthcare system for decades. There are initiatives that have been around for quite some time to deal with these issues: Save 5 million lives campaign, Quality Safety, and Education in Nursing (QSEN) to name just a few.
Problem is we didn't have a system that requires hospitals to participate in any of these initiatives and therefore, many hospitals didn't participate, or they decided to do their own thing leading to multiple hospitals being on all different pages as to if and how they were monitoring adverse events. So over the years, the problem exacerbated and the number of deaths due to medical error continued to climb. The Affordable Health Care Act addressed this in changing reimbursement. Authors of the 1999 Institute of Medicine Report requested this change to be included in healthcare reform to address their findings. It changed federal reimbursement to hospitals and made reimbursement dependent upon quality patient outcomes & plans to address their deficits. That is a major change in reimbursement and is an audacious goal. However, it has made hospitals have to work on developing quality initiatives to address their problems if they want to be reimbursed.
And there is no doubt that the numbers of deaths due to medical error are under-reported. We have miles to go to improve, but the greatest work that needs to be done is in the sytem itself, as well as addressing safety factors related to nurses having to take too many patients during their shift and work long arduous hours to cover low staffing.
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