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Notes_15

 

Another thing entirely

Early settlers of the American colonies used to complain about the three great annoyances: wolves, rattle snakes and mosquitoes. These would be annoying in part because of the difficulty of protecting your children from them.

When caregivers discuss patient safety problems, they only will discuss issues in which innocent errors are committed by well-meaning people. If someone brings up crimes committed against patients, they say that that is another thing entirely and does not part of this discussion.

That is like colonists talking about protecting their children, but being willing to discuss only the mosquitos and saying that wolves and rattle snakes are another thing entirely and not part of the discussion.

 

Patients Pooling Data

as a mean of finding quality and safety in health care

Thoughts under construction

Not that anyone should be surprised by it, but for those who might, there is discordance between patient satisfaction and outcomes. Asking three friends how they liked a facility or a caregiver or a treatment is not a reliable source for information about quality or safety, according to the article "Patient Satisfaction at America's Lowest Performing Hospitals" in the journal Circulation: Cardiovascular Quality and Outcomes.

It still is the standard advice given by caregivers when asked how to choose a surgeon, or whatever. "Ask three friends." It is foolish advice, but for those who need a footnote to an academic study to figure that out, there it is.

"Ask 300,000 patients whose outcomes are known and have been controlled for severity of original malady," would be better advice. At least then you'll learn from the ones who died or got groped or went bankrupt as well as the ones who thought their doctor was hot.

Unfortunately, that is information is not available and patients still have no choice but to rely on the direction of caregivers who made the choice for them by asking three of their own friends. Do you think any of them know about the patients who were groped or bankrupted or unnecessarily injured or worse? If you do, I need to find another footnote for you.

 

 

 

Thoughts on Latin words to use to describe the illness afflicting medicine that results in so much injury, death and bankruptcy for patients.

Nequam is a Latin word meaning worthless, good for nothing, or bad.

Nocens has many meanings, mainly: bad, wicked, injurious, culpable, evil.

Nequam has many meanings, mainly: worthless, good for nothing, bad

Plumbeus has many meanings, mainly: leaden, made of lead / dull, stupid, heavy, oppressive, bad.

Improbus has many meanings, mainly: inferior, bad, wicked, persistent, perverse, bold.

 

 

 

You have a responsibililty

It seems silly to have to footnote the fact that if you know there are snakes in the grass, you have a duty, but psychotherapists and other medical professionals continually persuade patients that they have no duty to anyone else. That their only duty is to get themselves better and move on. Sigh.

Here is one of many sources that disagree with that. At this link to the journal "Practical Ethics" from Oxford University Press is an article about the duty one has to report dangerous doctors, especially if you are a doctor.

 

 

 

 

 

Harvey Fineberg, M.D., president of the Institute of Medicine and former dean of the Harvard School of Public Health, has said that between 30 percent and 40 percent of our entire health-care expenditure is paying for fraud and unnecessary treatment. - Marty Makary in Newsweek at this link

 

 

 

Pump elevator music into hospital rooms. Patients will be too distracted by the bad music to recognize bad care. And when they do get bad care, the double negative of two bad things will make one good thing. Won't it?

 

What you do is what you are plus what you want the world to be.

 

An artist is not paid for his labor but for his vision. - Whistler

 

 

"...if we look not wisely on the run itself, it smites us into darkness."
― John Milton, Areopagitica

 

 

Pump elevator music into hospital rooms. Patients will be too distracted by the bad music to recognize bad care. Two bad things make one good thing.

What you do is what you are and what you want the world to be.

An artist is not paid for his labor but for his vision. - Whistler

 

Misdiagnoses
In the British Medical Journal of Quality & Safety
Published Online First 22 April 2013
BMJ Qual Saf  doi:10.1136/bmjqs-2012-001550

A 25-Year summary of US malpractice claims for diagnostic errors 1986–2010: an analysis from the National Practitioner Data Bank

By Ali S Saber Tehrani1, HeeWon Lee2, Simon C Mathews2, Andrew Shore3, Martin A Makary3, Peter J Pronovost4, David E Newman-Toker1

Conclusion:
Among malpractice claims, diagnostic errors appear to be the most common, most costly and most dangerous of medical mistakes. We found roughly equal numbers of lethal and non-lethal errors in our analysis, suggesting that the public health burden of diagnostic errors could be twice that previously estimated.

http://qualitysafety.bmj.com/content/early/2013/03/27/bmjqs-2012-001550.abstract