Home - Patient Safety

Eat, Think & Be Wary

It is time to focus on protecting patients rather than fixing medicine. If patients know where the problems are they can avoid them and let medicine respond by fixing itself so we will come back.

We can do this by gathering the information necessary to know what treatments are worthless, where the infectious death traps are, what bankrupts the most patients, which physicians cannot be trusted, etc.

This information that cannot be collected by anyone working in medicine. They do not have the perspective to do it. It cannot be collected by people who have as one of their mantras that there are no bad people in medicine and so they do not look for them and do not protect us from them. They do not even protect us from bad treatments.

They have vested interests and no skin in the game. They do better when we do worse. They never will be objective and selfless enough to collect the information necessary for patients to protect themselves from them.

If we collect the information that they will not, we can change the game. It is a waste of time to focus on making medicine safer. That is a wack-a-mole game that cannot be won. What we can do is determine where they are playing such games and not go there.

Watching Patients

Imagine monitoring a community of 50,000 patients. You have access to their electronic medical records. You know what prescriptions they buy and what over-the-counter drugs they get. You know where they work. You have information about what symptoms motivated them to seek treatment. You hear from them when they have a complaint about their health care. Etc.

In addition, you monitor internet information similar to that monitored by the firm that listens to chat online to determine which chatters talk about cars, which have certain kinds of cars, and which have similar complaints about those cars. That firm says it is able to predict which cars will have recalls in the future. That can enable manufacturers to fix the problems now, while only a relatively few have been effected, without waiting until there are recalls or class action suits.

That's a win win.

If they can do that for cars we can do it for patients

4.8% of physicians are responsible for more than half of the med mal suits. Wouldn't you like to know which physicians those are without having to get injured to find out?

Where are most infections caught? Where are most patients bankrupted? Where healed? Where killed?

Currently we have nothing to go on but hope and ignorant faith in treatment providers to protect us. No one collects the data that would be needed for it to be otherwise. That is the biggest problem in medicine. Ignorant faith, both on the part of treatment providers and patients. We need for both parties to be less ignorant. Medicine is dedicated to making sure patients remain so with regard to the most important things patients could know about medicine. Like success rates.

It is a Data Problem

Solving this does not require passing laws, getting press, reaching the masses, or changing the medical industry. It needs only one person who is the right person to be the first one to recruit the expertise for deep data mining, fund raising, and such and then select the locality in which to set up the first entity that works on developing the means for gathering and making use of this information.

Low Hanging Fruit

Twenty years ago similar information coupled with all the rest of what could be gathered could have revealed that there were patients developing blindness, dementia and heart failure, and what they had in common was having gotten metal on metal hip replacements. But no one in medicine noticed that connection. So they were put in patients for 20 years without anyone checking the long term outcomes.

We still would not know about the problems if a surgeon hadn't gotten one for himself. Even now that we do know there are surgeons still earning their livings by putting them in patients, patients who have not been informed that metal on metal hip replacements frequently produce toxis levels of cobalt in the bloodstreams of patients that lead to severe health problems and even death. If one of the patients in your group of 50,000 were scheduled to get one, wouldn't you want that patient to be informed?

One way the institution of medicine crushed patients for 20 years was by keeping them ignorant - millions of patients all around the world, kept ignorant. Do you think one single doctor in 20 years, while educating patients to enable them to make informed decisions, ever told a single patient about the toxicity and the heart failures associated with metal on metal hip replacements?

Have you ever had a doctor tell you about the association between anesthesia and dementia? If you cannot get a procedure under a local anaesthetic, you should be calculating the risk of fixing one problem only to increase the odds of getting the other. Sometimes it is better to live with the orignal problem. Especially if the "fix" is one of the many things that don't really fix the original problem well or for long - something else patients are unlikely to learn from treatment providers.

Better Sources of Information

One group of data miners listened to the online chat of pregnant women and predicted which ones were going to have post partum depression. Think what they could learn about patients post treatment in order to enable future patients to make better decisions.

The data must be collected outside of medicine

Getting 50,000 patients in one locale to sign on for this, although not a snap of the fingers, is doable. Two large companies provides two thirds of them. An arrangement with an insurance company could bring in the next third. Insurance companies already have the sales force and an interest in patients making choices that result in less care.

When this is seen to work in one place, others will want to try it. Humans who are resistant to new ideas often are enthusiastic about copying something that they have seen work.

When there are ten such groups functioning they will learn from each other and it won't take as long to get sample sizes large enough to mean something. But just in one locality, is there one specific nurse who was on the scene for every fatal infection caught in a specific hospital in the last five years? Or is there a facility that, without knowing it, is dispensing a pharmaceutical that is fake? Medicine is unlikely to figure that out because they don't monitor outcomes and would be the wrong people for that even if they did.

Hippocrates would have figured it out. He believed in learning everything he could about his patients, even which way their houses faced and which way the prevailing winds blew. I think he would have wanted to know everyone who had been present for every fatal infection caught in the last years.

Wouldn't you want to know if the drug that was supposed to save your life was fake? Don't you have a right to know? If we arrange for patients to be able to find out, don't you imagine ways could be found to get paid for doing that? I could list a few.

A more verbose attempt at explaining it can be seen at Patient Agency link.

 

Solutions ..........|.......... Problems
|
......................... | ............ Myth #1
|
Patient Agency... | .........................
|
Nequamitis ....... | ........................
|
......................... | Conflict/Interest
|
........................ | ............. Loyalty
|
......................... | ..Wall of Silence
|
.................. ...... | .......Blacklisting
|
........................ | ....Psych of Care
|
........................ | ... Transparency
|
........................ | .. Charles Cullen
|
........................ | Orville L Majors
|
........................ | ......... Kayshyap
|
........................ | .............. OSMB
|
........................ | ..... Semmelweis
|
........................ | . Benjamin Rush
|
........................ | .... Government
|
Patients Boards. | ........................
|
Campaign ... | ..................

"If we can get just 10% of people to be smart patients, it will change the system." - Mehmet Oz, surgery professor.

 

--------

 

 

With regard to the institution of the medical industry, I suggest that we do what was done by Hippocrates, the founding father of medicine. It can be done only from an objective position outside of medicine. Otherwise we have done nothing but allow medicine to coopt the effort until it is only another pretense.

What Hippocrates did was get to know everything about his patients - the water supply at the patient's residence, which direction the patient's residence faced, which way the prevailing winds blew, the patient's diet, family, blood, tears, sweat, etc. With data science we can do that again and look for what patients with similar conditions have in common. Like if in the last year, within the group of, say, 50,000 patients that you are monitoring, 6 are declining with symptoms that include dementia, blindness and heart failure and the one thing they have in common is metal on metal hip replacements.

Eat, think and be wary

How can patients be wary, or give informed consent, when they cannot even learn that the treatment being recommended has a history of poisoning patients?

For 20 years millions of patients around the world received metal on metal hip replacements that poisoned them with levels of cobalt that were toxic beyond what would be tolerated in industry. There were treatment providers who knew about the toxic levels in the blood, but who decided it would be all right. Decisions and policies in medicine frequently are based on nothing more that kind of than self-interest.

That is why no one monitors outcomes - self-interest. So no one checked to see if it actually was all right. It wasn't. But for 20 years no one in medicine gave any of their patients information about that to help them make their "informed" decisions.

It is time that we began monitoring outcomes from outside of medicine so that they are not monitored by people who think that toxic levels of cobalt probably will be all right for patients.