Wednesday, 3 April 2013

What Hospitals Won’t Tell You - Health Care Driven by ‘Perverse Incentives’

What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare
by Dr. Joseph Mercola

Medical errors are one of the leading causes of death in the United States, and what’s even more shocking is that the harm often is preventable.

Hospitals often make egregious errors ranging from minor mistakes to treating the wrong patient, leaving behind surgical tools in a person after surgery, or operating on the wrong body part.

According to the 2011 Health Grades report, the incidence rate of medical harm occurring in the United States is estimated to be over 40,000 harmful and/or lethal errors DAILY!

Variations in Quality Medical and Safety of Health Care Driven by ‘Perverse Incentives’
One in four patients in a hospital is harmed in some way from a medical mistake, according to the New England Journal of Medicine. Many doctors have been concerned about the quality and mistakes in healthcare, but the culture has been such that it dissuaded open discussion and transparency.

Dr. Makary says. “For the first time, we’re speaking up openly and honestly about this problem. We’ve got research now that supports it.

…When I was at a major medical conference once, I heard a surgeon at the podium ask the audience of thousands of doctors, ‘Do you know of somebody out there in practice who should not be practicing because they are too dangerous?’ And every single hand went up. Everybody seems to know about this problem. Everybody even knows of somebody who’s too dangerous to be in practice. Yet for a long time, we haven’t been honest about the problem.”

Dr. Makary goes on to tell a story from his days as a medical student. A young man came to the emergency room with a fractured humerus, and the doctor told him he needed an MRI, an X-ray, and a CAT scan. The young man replied he didn’t have health insurance, at which point the doctor suddenly changed his tune, telling him to just stay off his arm, wear a sling, and all would be fine.

Is Your Surgery to Satisfy Your Doctor’s Quota?
Doctors are under tremendous pressure these days. Not only are they asked to see more patients per hour, many surgeons even have surgery quotas to meet.

“They’re told they need to do so many operations in a month,” Dr. Makary says.

More Doctors Beginning to Realize What They Were Taught is Wrong
Many doctors are now beginning to accept that some things they were taught in medical school is simply wrong.

“I was taught, for example, that everybody has one million nephrons (the unit in a kidney). We now know that’s not true. We now know that it ranges from 200,000 to two million, and everyone’s different. If you have a lot, you may have more of a reserve. If you have few, you may be more frail in your ability to withstand an insult to your kidney.

We were taught fat was bad for you. We were taught, ‘Don’t eat fat. Fat is bad. Go low-fat everything.’ That was probably wrong advice that the medical community gave to the general public. We now know that what’s far more important than avoiding fat is limiting sugar, a highly addictive substance, which a driver of obesity and heart disease and has many detrimental effects, mainly the hormonal effect of changing your fat storage balance. Little did we doctors know that by demonizing fat we were encouraging high-carbohydrate foods because they are notoriously ‘low-fat.’ Obesity surged parallel to the ‘avoid fat’ era of medicine. We are now dealing with a generation addicted to sugar and we’re seeing the largest growth in obesity in the history of the country.

In terms of the percent of our population on disability and the average time on disability, we are now the most disabled country in the world. And one leading driver is obesity-related chronic diseases—a problem burdening our healthcare system. These are lifestyle diseases (medical problems that can be avoided with better behaviour). We’re now recognizing that some of the emphasis in the direction that we had in medical school was just not based on the solid evidence that we’re now seeing.”

Unnecessary Treatment is a Massive Problem
According to a report by the Institute of Medicine, an estimated 30 percent of all medical procedures, tests and medications may in fact be unnecessary – at a cost of at least $750 billion a year.

While overuse and misuse have become a deeply ingrained part of the culture of medicine, there are hopeful signs that things are starting to change. Dr. Makary points out a number of standard blanket recommendations that have been changed in recent years, such as daily aspirin regimen, PSA testing, and annual mammograms.

Helping Patients and Doctors Choose Wisely
For the past two years, the American Board of Internal Medicine Foundation, one of the largest physician organizations in the US, has released reports on the most overused tests and treatments that provide limited or no benefit to the patient, or worse, causes more harm than good. Last year’s report warned doctors against using 45 tests, procedures and treatments. This year, another 90 tests and treatments were added to the list. To learn more, I encourage you to browse through the Choosing Wisely web site,4as they provide informative reports on a wide variety of medical specialities, tests, and procedures that may not be in your best interest.

Read the complete article at: Waking Times

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