Leaders Need to Diagnose Woes of Medical System

My dad died because of a misdiagnosis. Instead of listening to complaints that his leg hurt, the doctor called my dad a wimp.

You see, dad had broken his tibia and fibula after a slip on the ice in the parking lot of our New Jersey apartment complex when I was 9 years old. The break was so bad, doctors had to install a metal plate, complete with screws.

When dad went in for a cast change, he complained of discomfort. That’s when the doctor resorted to the “wimp” word.

Dad had trouble breathing later that night. Mom called the doctor, who proceeded to prescribe the exact opposite drug dad needed. Dad’s face was B-L-U-E the next morning, and yet mom still had to argue with the doctor that something was terribly wrong.

By the time dad arrived at the hospital, it was too late. An embolism caused by a blood clot that formed around the metal plate in dad’s leg had cut off the blood supply to the brain and killed him.

The doctor told the judge that this was a rare occurrence. It only happened in 20 percent of cases with similar breaks. I guess 20 percent was rare to this doctor.

It turns out 20 percent is another key statistic: doctors misdiagnose fatal illnesses one-in-five times, reports The New York Times. And that rate hasn’t changed since the 1930s.

Despite huge advancements in medicine, doctors still struggle to get diagnoses correct. Is there something wrong with medical schools or with the people who become doctors?

Maybe, but I don’t think that explains the problem. Most doctors I know work very hard for their patients. But the medical system does not.

Here’s one scenario, as explained in the Times:

Joseph Britto, a former intensive-care doctor, likes to compare medicine’s attitude toward mistakes with the airline industry’s. At the insistence of pilots, who have the ultimate incentive not to mess up, airlines have studied their errors and nearly eliminated crashes.

“Unlike pilots,” Dr. Britto said, “doctors don’t go down with their planes.”

That may be a bit unkind. I think most doctors suffer internally whenever a patient gets sicker or dies. But the system encourages doctors to keep quiet about mistakes out of fear of malpractice lawsuits. The result: doctors often fail to learn from the experiences of their colleagues.

That’s not the only way the medical system is structured to work against the patient:

• Medical costs discourage patients from seeing their doctors in the first place.


• Doctors spend so much time fighting government red tape and trying to negotiate payments with insurance companies, there is little time left to treat patients.


• The medical system is financially geared toward treatment rather than prevention. After all, no one makes money if everyone is healthy.
  
  Worse, insurance companies financially lose when preventative programs help sick people get better. That’s because a successful preventative program attracts costly sick people to the insurance plan.


• There are simply not enough doctors, who are overworked, to go around in this nation.


• The lack of truly standardized billing and paper work practices means that crucial information never gets relayed from doctor to specialist to clinic to hospital.


• The medical system financially rewards doctors who perform less necessary procedures such as elective cosmetic surgery and punishes those who choose to be family doctors and pediatricians.


• Pharmaceutical companies push drugs in favor of other treatment programs, such as exercise and healthy eating.


• As a result, the health care system most benefits the wealthy and punishes the poor, which you can read about in this New Yorker article.

Studies vary on just how dangerous America’s health care system is for its users. As many as 98,000 Americans die each year as a direct result of medical errors, reports USA Today. If adverse drug reactions were included, the numbers would be much higher.

In the meantime, parents and children pay the price: expensive care that can threaten lives. There is no simple solution. This sick medical system is deeply entrenched in our culture, economy and political system. An exceptionally strong leader is needed to tackle this beast and heal it.

Comments

[Jon]

My wife's father died in the hospital...from dehydration. How is this possible. Salt poisoning. In a hospital. Just change the IV bag!!

Medical Schools, Hospitals, etc....all it's about is $$$$, and that's very sad.

- Jon
- Daddy Detective
- www.daddydetective.com

[Nadine]

I almost had surgery on my spinal column but decided not to after this pre-surgery interchange with the doctor:

[Looking at X-ray of a skull and neck]
Me: That isn't my X-ray.

Doc: Yes it is.

Me: No. My head is shaped differently. I also have lots of metal dental fillings. This head doesn't have any.

Doc: THIS IS YOU! ...(then coninues to tell me what he's going to in surgery)....

Me: This ISN'T my X-ray!

Doc: Stop complaining. By the way how is your son?

Me: I don't have a son.

[brettdl]

Jon and Nadine: Both your stories are really scary.

[Nadine]

Brettdl-
Scary yes, but that 'This-Is-Not-My-XRay' conversation may have saved my life. That same doctor had me scheduled for a second cortisone spinal injection for the next day. The first injection had made me EXTREMELY ill and I told him that I thought it was contaminated.

He had dismissed contamination as a possibility... I didn't.

This guy didn't skip a beat...He had all the answers... And he thought I knew nothing.

I didn't trust him therefore I canceled the appointments for the injection and surgery.

The very sad thing is that some of the people who got injections that day died....

The cortisone was contaminated. It was being formulated by a private pharmacy across the street from the hospital.

What I learned from all this:
DOCTORS HAVE TO EARN MY TRUST!

[brettdl]

People died from the injection? Boy, it's a good thing you trusted your instincts.

Does this sort of thing happen often?

[Nadine]

Brettdl-
If cortisone for injection is "formulated" (this is mixing crystaline cortisone with distilled water) under non-sterile conditions, then yes there is the possibility for an infection which could prove fatal.

The pharmacy in Walnut Creek that was responsible has been closed.

There is a large issue with disclosure of the source of "formulated" perscriptions. Most patients have no idea that a medication may have been from a private source.

[brettdl]

That's reassuring. It just reinforces my belief to avoid medicine except in dire emergencies.

[chip]

I just read today that malpractice costs are no higher in the US than they are in Canada, Australia and other countries. The problem here is that the insurance companies have to make a profit. And as the great article from the New Yorker that you link to points out, the Republican "solution" of abolishing insurance is not going to help the situation, but rather will make it even less likely that people will seek out help preventatively or when they need it.

Stories like your dad's also point out the need for second opinions; as it is now the hmo or the insurance company may not agree to pay for those...

Until we get some civilized people in charge in Washington though I don't see this problem getting any better.

[brettdl]

I agree Chip. Btw, thanks for pointing me to that great article in The New Yorker. I should have credited you.

[Odysseus]

While one most often hears of cases of undetected illness, there are also cases where cancer is wrongly diagnosed, and the consequences can be severe.

My wife and I recently spent two months worrying because of a false cancer diagnosis, and because of this diagnosis, she underwent pointless and potentially harmful radiation treatment. Specifically, my wife had been diagnosed with thyroid cancer five years earlier and had had it removed. A routine scan performed at Mt. Sinai in Manhattan this past December seemed to reveal that the cancer had recurred. Despite our own doubts, my wife's physicians were unwilling to admit the possibility that the scan could produce a false positive. However, six weeks later, contrastive CT scans and ultrasound (performed at M.D. Anderson in Houston) refuted the initial diagnosis, and while unwilling to acknowledge fault in that diagnosis, the endocrinologist at M.D. Anderson made it seem quite obvious that false positives are possible.

Is anyone interested in starting some sort of forum or even a database so that we could let people know about which doctors to avoid?

[brettdl]

Man, another really scary story. I'd love to start such a forum, but I need to give up the day job, first.

[nida]

wow...i just found this web site, and now i know that misdiagnoses is more common than i thought... my dad is in the hospital right now, and they told us that he had a pulminary embalism..and started treating him for it, and had tubes in his lungs and cut a hole in his throat..(w/o our consent) and after they did that they told us it was just a bad case of phenmonia, and since they cut the whole to put him on a ventilator(which was down his throat just in case he stopped breathing) and now he is no longer able to breath on his own. not only that but he has an infection in his throat, and now due to the infections, he is at very high risk of not surviving, not only that but they still have no diagnosis

[nida]

wow...i just found this web site, and now i know that misdiagnoses is more common than i thought... my dad is in the hospital right now, and they told us that he had a pulminary embalism..and started treating him for it, and had tubes in his lungs and cut a hole in his throat..(w/o our consent) and after they did that they told us it was just a bad case of phenmonia, and since they cut the whole to put him on a ventilator(which was down his throat just in case he stopped breathing) and now he is no longer able to breath on his own. not only that but he has an infection in his throat, and now due to the infections, he is at very high risk of not surviving, not only that but they still have no diagnosis

[brettdl]

Nida, that's just awful. I hope your dad pulls through.