To change something, build a new model that makes the existing model obsolete.
-R. Buckminster Fuller
If you think the answer is getting information to people in medicine so they can fix the problems, you don’t know what the problem is. I once was asked to make a list of the ten biggest myths in medicine. I stopped at seventy. But the first one is the idea that healthcare professionals, alone among humans on earth, do not make decisions that are influenced by self-interest, and are objective and lucid.
The way health care is set up would require them to be that pure. To be that they would have to be saints descended from heaven. The point of showing that they are not is not to vilify them. It is to save patients.
For instance, one of the nonsensical beliefs that patients have been force fed is the idea that medicine is too complicated for patients to understand and make sound decisions. Even people in medicine swallow such nonsense as though it is incontrovertible. But you do not have to be an engineer who knows what a torsion bar is in order to understand not to buy a car that has a history of blowing up more frequently than any other car in history. What you need is objective information on outcomes, something that never can be gotten from non-saints about themselves.
For instance, it is a requirement of law that when you are getting a hip replacement, they must to educate you so that you can make an informed decision about which one to get. As though they are complying, they teach the two different ways that they know to do the operation – information that would be useful for passing a course in medical school but of no value for the decision patients need to make.
Comparative Shopping
The result was twenty years of millions of patients around the world getting metal on metal his replacements that put toxic levels of cobalt into their blood streams without anyone in medicine collecting information on the outcomes to see what the outcomes were. Perhaps a third of those patients came down with dementia, blindness and/or heart failure as a result. That is what patients need to know – what has been the outcome for other patients 6 months ago, a year ago, five years ago, ten years ago. They need to know what has been the cost and outcome for patients with this operator in this facility compared to other operators in this facility and other operators in other facilities, information that no one in medicine ever will be selfless and objective enough to collect accurately because they are humans with self-interests like all other humans.
No one in medicine tries to track anything like that, not even for their own understanding. They do not want to know it themselves. It is not in their records. It especially is not in their minds. Only 2% of what goes wrong in medicine gets in the record accurately. 93% never get in the record at all no matter how overt and damaging the injuries were (see medical reporting). Violent crimes committed against patients in front of witnesses get no mention in any record. It can end the career of a health care worker to put it in the record . A year later none of the witnesses even will remember it, such is the nature of human memory. It is only the traumatic memories of victims that are immutable. War veterans who experienced traumatic events forty years later repeat the exact same story they told minutes after it happened. All other memories humans automatically rewrite to suit their own purposes over and over again as time goes on. Injured patients are the ones with the traumatic memories.
Here is how that plays out
The physicians who refuse to diagnose the injuries of patients who were injured in medicine do not believe that patients cannot get diagnoses of injuries incurred in medicine.
That is all you really need to know to understand how people in medicine think and make records. They don’t. They do not even make an accurate record of why injured patients came asking for help (and do not believe they don’t). Injured patients can find nothing in any record about what happened to them. That is normal (but try to find anyone in medicine who is aware of that).
This disables the ability of patients to make informed decisions. That suits the purposes of people working in medicine. It does not mean people in medicine are evil (well, okay, sometimes it does). But it definitely means they are not saints. They are humans. Humans perceptions and memories are self-interested. In medicine they believe they are above this. Stupidly the patient community believes whatever those authorities believe. But what else do patients have to go on? There is almost no information available to them except that which medical professionals choose to gather and record. Patients cannot make safe decisions with only 2% of the most important information necessary for doing that.
If you wanted to hold a contest to find the most subjective person on earth, the first requirement to gain entry into the contest would be to believe that you are objective. People who imagine that they are objective are among the most subjective people on earth. If people in medicine were not, if they truly held the interests of patients above their own, they would have explained to patients that metal on metal hip implants were toxic. Instead, they stayed in line with one of the mantras of medicine that says “Don’t go looking for problems” and did not put two and two together when their patients came back with problems caused by cobalt poisoning.
Medicine unnecessarily kills as many people per week as firearms kill per year (see Preventable Deaths). Medicine is the most dangerous place most people in the USA ever go. It is outrageous that patients have no ability to see what and where the dangers are so that they can avoid them. It is possible to collect the information that will enable them to do that. It is not “big data.” It is small counting. If we tracked just 3% of patients, we could learn an enormous amount of what is necessary for patients, for the first time in history, to be able to make the very first judgement any patient must make, and that is whether the risks of seeking care are greater than the risks of not seeking it for a particular set of symptoms. How could we get 3% to sign up for tracking? Have you ever spoken to a patient injured in medicine? They get so that they wish they could get all the information about their own cases on the front page of any site or newspaper that would show it, just to try to prevent what happened to them from happening to anyone else. But they cannot even get their own primary care physicians to make an honest record of it.
Small counting
There are cases like the physician who groped adolescent girls year after year. The girls were screaming mad. The parents were screaming mad. The state medical board did nothing. The police would not do anything. The press would not listen. What is typically the hope of last resort for patients, lawyers, would not take the case. The physician got away with it for fifteen years, by which time enough of the girls had become adults to bump into each other socially and form a group. A group of adults with the same memory still cannot get help from state medical boards or the police, but they can get a lawyer (even though not a medical malpractice one). It should not take fifteen years and hundreds of victims to be able to do something about such a problem. With a little data collection, this could have been addressed back near the beginning.
There is low hanging fruit. Tracking all the data of a small percentage of patients will uncover some of it, which will result in those injured patients asking to be tracked, which will uncover more. And it will grow.
That it is what this site is about.
Solutions ……….|………. Problems
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……………………. | ………… Myth #1
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Patient Agency… | …………………….
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Nequamitis ……. | ……………………
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……………………. | Conflict/Interest
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……………………. | ………… Loyalty
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……………………. | ..Wall of Silence
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……………… …… | …….Blacklisting
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…………………… | ….Psych of Care
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…………………… | … Transparency
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…………………… | .. Charles Cullen
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…………………… | Orville L Majors
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…………………… | ……… Kayshyap
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…………………… | ………….. OSMB
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…………………… | ….. Semmelweis
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…………………… | . Benjamin Rush
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…………………… | …. Government
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Patients Boards. | ……………………
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Campaign … | ………………
“If we can get just 10% of people to be smart patients, it will change the system.” – Mehmet Oz, surgery professor.