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Josie King FoundationOn February 22, 2001, eighteen-month old Josie King died
from medical errors. You have to be grateful for the superhuman effort of people
trying to protect patients like the founders of this effort do. But they might not
be looking in the right place for the answers. The experts contributing to their site are learned and articulate, but they
are examples of why, year after year, improvements in patient safety are nominal
at best. How to Choose a Lawyer?Like their advice about how many lawyers to interview before choosing one. Only 3% of injured patients can get a lawyer. The question for 97% of them is not how to choose one. Most injured patients do not begin by seeking lawyers in the first place. They begin by seeking help. They are injured. Their first concern is getting diagnosis and treatment. When they cannot get that, they seek answers. When they cannot get that they seek justice. When they figure out that there is no agency or department to help patients with that and that the only avenue to justice possible is court, then they call lawyers. But the conundrum they face then is not how to choose which lawyer. It is how to get one at all. 97% of patients with legitimate grievances can call every lawyer in the phone book without getting one. For the expert lawyers on this foundation's site to articulate the problem as being one of how to choose one from among the many truly is telling starving people to eat cake. It is the same perspective held in medicine with regard to patient safety as a whole. Safety Advice from a NurseLike the nurse on the site who explains how to improve patient safety. Her points are not invalid. But they address only something like 3% of the problems in her own field. 97% of what patients need her to address is outside of what her blinders allow her to see. Her points would not make a noticeable reduction in the thousands of patients who die unnecessarily each year and the many more who have their lives ruined unnecessarily, sometimes intentionally because nurses don't see and don't address that which would prevent it. Indicative of their perspective is that not only do none of the people on the site acknowledge intentional harm, they issue an active denial of the possibility, “caregivers cannot be blamed when the system fails,” as though no caregivers sell unneeded products to make money, as though there is no lechery or jealousy in medicine, as though all people in medicine are saints without agendas that compete with the well-being of patients. Every page I turn to on the site leaves me with the same thing to say. Medicine watches out for itself first and has its own political correctness to aid that. In medicine it is politically incorrect to suggest that the fundamental problems and obstacles are anything other than innocent errors. Any suggestion that anyone in medicine might have a motivation other than pursuing the well-being of patients is not tolerated. Learned, experienced people assume objectivity and selflessness on their own parts and on the parts of everyone else in medicine as they have discussions that have too much in common with the old discussion about how many angels will fit on the head of a pin. They are not quite that fanciful, but in terms of solving safety problems for 97% of patients, they are just as far removed. If It Were Doctors DyingHow differently would doctors would throw themselves at the
problems if it were two hundred doctors dying unnecessarily every year
instead of two hundred thousand patients? They are not saints. They are in
denial about the extent to which medicine puts self-interest ahead of patient safety.
98% of adverse events go unreported not because
medical professionals are honest
and objective and selfless. They claim to hold the safety of patients as their highest
goal. Their most fervently held belief might be that they do, but they don't.
They will go to meetings about patient safety. They will sign initiatives
promising to promote patient safety. They will believe in their hearts that
there is nothing more important to them than the safety of their patients. But there is a
disconnect between what they believe and what is true. They call for better communicationAlso, the extent to which better communication can be a two-edged sword is not something it is in their interest to understand. Better communication frequently is used in ways that are unfriendly to patients. Sometimes getting diagnosed and treated is possible only if failures of communication enable patients to get objective information from new healthcare providers who have not been influenced by the assumptions or prejudices formed by previous providers. That is part of what blacklisting is about. Especially if the patient unnecessarily was injured by previous healthcare providers who as a result now have an active interest in protecting themselves by making sure that no one creates diagnoses that reveal the injuries. It is not by accident that 98% of adverse events are not reported accurately. The culture in medicine is setup to protect itself first. I’m sure lives will be saved by the superhuman efforts of the founders of sites like this. I don’t mean to discredit them. It’s only that I get frustrated with living in a milieu in which there isn’t even recognition of the biggest problems. We are suffering and dying and being abused while being told how 3% of us can find lawyers. What if we just need help?
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