Some Sobering Thoughts from a Thoughtful Doctor

The following question comes from the opening lines on the inside jacket blurb of a recent book title, Unaccountable; What Hospitals Won’t Tell You and How Transparency Will Revolutionize Health Care*,  by Dr. Marty Makary, described as “a leading surgeon.”

“Are you risking your life when you go to the hospital?” The next sentence reads, “Consider this: One study found that 1 in 4 patients are harmed by medical errors. Another reported that doctors operate on the wrong person or the wrong body part as often as 40 times a week.”

Based on information Dr. Makary gathered he feels that perhaps 2% of the nation’s 1 million doctors are, “seriously impaired by drugs, alcohol abuse, or other major impairments (and most experts agree that 2% is a low estimate), that means 20,000 impaired doctors are practicing medicine.” He goes on to estimate that each doctor sees at least 500 patients each year therefore there may be as many as 10 million people seeing impaired doctors each year. Another important quotation refers to a Dr. Leape’s axiom, “every doctor knows at least one other who is too dangerous to be practicing.

Given independent verification of these types of figures in sources such as Centers for Disease Control reports and other government statistics reported in earlier posts in this blog, where it appears the American medical establishment ranks up in the third most prevalent cause of death or injury, it seems obvious the impact of impaired doctors does contribute to hospital dangers.

According to Dr. Makary, the reason so little is done about this situation is there is no single body that polices medical care in this country. The FDA, which does such a poor job of protecting Americans from big pharmaceutical companies that care more about profits than patient safety as documented in case after case of patient harm, has nothing to do with doctors. Medicare just pays bills and supposedly watches for billing fraud, although in many cases there is a clear perception that an individual case must be huge to be worth the time pursuing. Most small cases of improper or incorrect billing probably pass through the system since it is cheaper to pay than investigate.
Hospitals have no real impetus to police poor practices, since many hospitals profit from errors that in turn lead to more hospital stays. Dr. Makary says the American Board of Medical Specialists just give out certificates if doctors pass exams. Doctor associations certainly do not care since their function, again according to the author, is running medical education forums and “lobbying for higher Medicare payments for doctors.” The author’s information about state medical boards implies that most are reluctant to pursue any licensing censure and seldom report serious problems to other states. If a doctor is guilty of damaging malpractice, all the doctor usually has to do is relocate to another state.
There are many insightful remarks in Unaccountable that can help patients entering into the dangerous world of hospitals such as his chapter on the importance of communication between all levels of hospital staff. As he points out, many patients’ lives are saved or serious injury prevented in surgery, if a nurse feels comfortable speaking up about potential errors. Unfortunately, too many surgeons became irate if questioned. The typical culture in many hospitals punishes rather than rewards good communication.
In the concluding chapter of his book, Dr. Makary offers some hope, writing about “a new generation of doctors and nurses moving up through the ranks with little tolerance for the immature behavior once modeled by the surgical elite.” He goes on to claim that “the new generation of students wants to be more honest with patients than the last.”
Dr. Makary’s book is worth reading by anyone concerned about medical care in this country. Unfortunately, the question many seniors might ask themselves is “Will I survive current medical care long enough to be treated by these new doctors?”
On an encouraging note, it appears at least the Canadians are finally taking a look at the effects of nationalized medical care—the type of medical care Obama and his cohorts hope to establish in this country through Obamacare. An article on the CBC News: Health website, reports on the results from one part of a major health survey, “Rate My Hospital.” In one specific survey of responses from 4,500+ registered nurses at 257 hospitals across the company, “Nearly 25% of Canadian nurses wouldn’t recommend their hospital.”
*Bloomsbury Press, c2012.