Saturday, September 22, 2012

A 'code of silence'

Is there a medical code if silence? Apparently not as much now as there was in the past but it still exists. Dr Marty Makary wrote a book called 'Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care'. At first he was told he would be hated for the book but now his colleagues praise him.

He describes three key problem areas:
  • Dangerous doctors
  • Out of date doctors - who don't keep up to date
  • Profit hungry doctors and hospitals who aim for the bottom line instead of a healthy patient.
Here are two additional statistics:
  • One in four hospitalized patients are harmed by medical by a medical error
  • 20-30% of medical care is unnecessary.
This all makes you stop and think. Let's look at each one individually.

Dangerous doctors are scary. They probably cause a good portion of the medical errors as well. These are the doctors who operate on the wrong body part or order wrong medications. They are really scary. And there is a code of silence reinforced by malpractice fears,

Out of date doctors who do not keep up to date on new treatment protocols and procedures. This is akin to learning from a history teacher who stopped learning in 1960 - and missed the whole Cold War, Vietnam, and a million other changes. They know they old stuff but not the advances since. What they have missed could kill you.

Any hospital and doctor who is not there for the patient and focuses on the bottom line should be avoided. There are for profit hospitals out there and you will never catch me in one. I know a couple around here and they aren't for me. And I don't recall them being on the top of any patient care list either.

The last statistic is the scariest and it cannot be blamed completely on the doctors. Yes there are doctors who are using the CYA approach to order more tests or procedures (see malpractice above). But there are also patients and their families demand procedures and surgeries to 'solve' their problems. 

How can we help solve these problems:
  • Select your doctors carefully. Ask for referrals and do research. Don't stay with them if you don't like them and how they treat you. They don't need to be your best friend but you have to believe in them and feel comfortable with how they treat you.
  • Educate yourself. Become the most educated patient you can. Research your ailments, ask questions, be assertive (in a very nice way).
We also need to call for transparency in our care. Why are procedures or medications ordered? If hospitalized, how many nurses are there to care for you? Who is in charge of your care while an inpatient? Speak up!

We are responsible for our care. We need to speak up and help break any code of silence.

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