Our Medical Systems Are Broken

Our medical systems are broken. Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus: actually treating people ~ Dr. Atul Gawande, surgeon and professor at Harvard Medical School.

 

We have now found treatments for nearly all of the tens of thousands of conditions that a human being can have. We can’t cure it all. We can’t guarantee that everybody will live a long and healthy life. But we can make it possible for most.

But what does it take? Well, we’ve now discovered 4,000 medical and surgical procedures. We’ve discovered 6,000 drugs that I’m now licensed to prescribe … And we’ve reached the point where we’ve realized, as doctors, we can’t know it all. We can’t do it all by ourselves.

We’re all specialists now, even the primary care physicians. Everyone just has a piece of the care. But holding onto that structure we built around the daring, independence, self-sufficiency of each of those people has become a disaster. We have trained, hired and rewarded people to be cowboys. But it’s pit crews that we need, pit crews for patients.

There’s evidence all around us: 40 percent of our coronary artery disease patients in our communities receive incomplete or inappropriate care. 60 percent of our asthma, stroke patients receive incomplete or inappropriate care. Two million people come into hospitals and pick up an infection they didn’t have because someone failed to follow the basic practices of hygiene.

There’s another sign … the unmanageable cost of our care. Now we in medicine, I think, are baffled by this question of cost. We want to say, “This is just the way it is. This is just what medicine requires.”

But I think we’re ignoring certain facts that tell us something about what we can do. As we’ve looked at the data about the results that have come as the complexity has increased, we found that the most expensive care is not necessarily the best care. And vice versa, the best care often turns out to be the least expensive — has fewer complications, the people get more efficient at what they do.

But when we look at the positive deviants — the ones who are getting the best results at the lowest costs — we find the ones that look the most like systems are the most successful. That is to say, they found ways to get all of the different pieces, all of the different components, to come together into a whole. Having great components is not enough, and yet we’ve been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don’t think too much about how it all comes together. It’s a terrible design strategy actually.

There’s a famous thought experiment that touches exactly on this that said, what if you built a car from the very best car parts? Well it would lead you to put in Porsche brakes, a Ferrari engine, a Volvo body, a BMW chassis. And you put it all together and what do you get? A very expensive pile of junk that does not go anywhere. And that is what medicine can feel like sometimes. It’s not a system.

Now a system, however, when things start to come together, you realize it has certain skills for acting and looking that way. Skill number one is the ability to recognize success and the ability to recognize failure. When you are a specialist, you can’t see the end result very well.

 

Hospital Error Death by Medicine is the third leading cause of death in the U.S.

Death my nedicine

Did you know that avoidable medical errors are the THIRD leading cause of death in America? Most of us already knew that the leading cause of death in America is Heart Disease. This is followed closely by the “Big C” (cancer). But most are shocked to learn the third leading cause of death…. Hospital Error. Death by Medicine has become the third leading cause of death in the U.S.

When you enter a hospital, you’re looking for help and expect to be safe, right? What you may not know is that you are literally putting your trust into a system that is broken.  Tragically thousands of people die every day from the “care” they receive … rather than from the emergency, disease or medical need which brought them to the hospital in the first place.

This information is strategically pushed “under the rug” and not openly discussed. Of course hospitals don’t want the public to know how statistically risky their hospital or healthcare facility may be.

Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, said in an interview that the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another.

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” Makary said. … His calculation of 251,000 deaths equates to nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.

When there is an airplane crash and passengers are killed, there is a thorough investigation and, if need be, new laws are passed to help prevent the same problem from occurring in the future. The medical system is completely different. Hospitals habitually hide their “accidents” and the patient’s families don’t know where to turn for help.

Whenever possible: Stay out of the hospital. Remember… the people can be friendly and kind. It’s the system that is broken.

Paula

Read more:  http://www.paulablack.org/blog/2016/5/9/death-by-medicine-by-paula-black

 

 

Scientist accused of fabricating stem cell research to retract papers

TOKYO, June 4 — A Japanese stem cell scientist accused of fabricating research has agreed to retract papers published in the respected journal Nature, an official said today. Haruko Obokata, 30, would withdraw two papers at the centre of the controversy, according to a spokeswoman for Riken, the respected research institute that sponsored the study, marking a steep fall from grace for the young researcher.“We confirmed that she agreed to retract both articles,” the spokeswoman said.

Read more:  http://www.themalaymailonline.com/features/article/scientist-accused-of-fabricating-stem-cell-research-to-retract-papers

Financial Conflicts of Interest and Reporting Bias

In our daily lives, we frequently rely on the results of scientific research to make decisions about our health. If we are healthy, we may seek out scientific advice about how much exercise to do to reduce our risk of a heart attack, and we may follow dietary advice issued by public health bodies to help us maintain a healthy weight. If we are ill, we expect our treatment to be based on the results of clinical trials and other studies. We assume that the scientific research that underlies our decisions about health-related issues is unbiased and accurate. However, there is increasing evidence that the conclusions of industry-sponsored scientific research are sometimes biased. So, for example, reports of drug trials sponsored by pharmaceutical companies sometimes emphasize the positive results of trials and “hide” unwanted side effects deep within the report or omit them altogether.

Read more:  http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001578

CONSULTATION FEES HIKE: Doctor, heal thyself (of greed)

I WAS reading a report in a local news daily that private doctors are requesting a 30 per cent increase in consultation fees. My immediate thought — has greed infected all of society?

Medicine has always been viewed as a noble and sacred profession, in the sense that ultimately it deals with the most precious commodity, a human being’s life.

We naturally give our full trust to medical practitioners when our loved ones or ourselves are in need of medical attention.

Unfortunately, as much as there are many dedicated doctors who carry out their duties out of passion, there is also a significant number of them who do it for financial rewards.

I have often heard the argument from doctors and non-doctors that to be a doctor, one would need to dedicate one’s life to study, thus, when finally able to practice, the rewards should compensate all the hardship in acquiring the status of a medical practitioner.

This is probably the beginning of the greed factor among doctors.

Read more: http://www.nst.com.my/opinion/letters-to-the-editor/consultation-fees-hike-doctor-heal-thyself-of-greed-1.341098#.UhSLH3X_4DA.email

 

Japan university reveals more claims of fabricated drug data

A Japanese university on Wednesday said it would retract a study that touted the effectiveness of a blood pressure drug made by Swiss pharmaceutical giant Novartis because it was based on fabricated data.

The move was the latest chapter in a growing scandal over allegations that bogus data were used in a string of Japanese university studies for the drug Valsartan, which exaggerated its effectiveness in preventing strokes and angina.

Read more: http://www.channelnewsasia.com/news/health/japan-university-reveals/762106.html?utm_source=twitterfeed&utm_medium=twitter

Susan Lim issued bills in ‘arbitrary, opportunistic’ manner

SINGAPORE – The Court of Three Judges, after analysing the bills issued by Dr Susan Lim, said the invoices were issued in an “unsystematic, arbitrary and, ultimately, opportunistic manner”.

Dr Lim has lost her battle to overturn her conviction for overcharging a royal patient from Brunei.

Dr Lim faced a total of 94 charges of professional misconduct …. found her guilty of professional misconduct over the $24 million bill.

http://yourhealth.asiaone.com/content/susan-lim-issued-bills-arbitrary-opportunistic-manner