Being booked into a hospital for treatment or tests is often an unpleasant experience despite the usually excellent efforts of the staff responsible for your care.
What most people might not realize, however, is the risk which they are taking when booking into hospital, a risk which is exacerbated by the systems and procedures in place and a lack of transparency.
Amongst the realities of hospital treatment which are really only now being openly discussed and accepted by doctors are the following shocking facts:
- Some doctors are given monthly quotas of treatments and operations which they are harried and hounded into meeting, irrespective of the actual clinical requirements of individual patients.
- Mistakes made by clinicians amount to one of the leading causes of death in the USA, and perhaps the most disturbing aspect of this fact is that many of the mistakes being made could easily be prevented.
- Many laboratories pay doctors to refer patients to them, creating incentives for tests which are unnecessary at best, stressful for the patient concerned and, in some cases, actively harmful.
- Drug companies offer financial incentives to doctors to prescribe certain medication, irrespective of whether it is the best choice for the case in hand.
Whilst all of the above, regrettably, may have been happening for many years, what is different about the current climate is the fact that recent research, and a willingness on the part of some doctors to speak out about such matters, has helped to change the climate. Patients and potential patients are now able to learn much more about the hazards which they may face when they require hospitalization.
A report published in the New England Journal of medicine found that 25% of patients in a hospital are subject to harm caused by a medical mistake. The errors in question can range from minor matters to things as grievous as leaving tools inside a patient following surgery, operating on the wrong part of the body or even delivering treatment to the wrong patient entirely.
The danger created by this tendency to get things wrong is then exacerbated by a culture which encourages doctors to keep quiet and close ranks. Ask almost any doctor off the record and they will admit that they know of at least one colleague whom they would regard as being a danger to patients, but the public image projected is one of competence and calm proficiency.
Perhaps more worrying is the fact that many doctors are choosing to order tests on patients and prescribe medication, not because they represent the best clinical choices, but because they are driven to do so via a combination of managerial pressure and financial incentives. The US Department of Justice has intervened in several cases and handed out multi-million dollar fines to laboratories found to have been paying doctors far in excess of the standard $3 fee to take blood tests from patients. Coupled with this ‘bribery’ is the fact that the clinical systems set up in many hospitals involve computers automatically suggesting a set of tests which the doctor in question simply has to sign off on. This ‘mechanization’ of the diagnostic process removes the traditional personal link between doctor and patient and imposes a ‘one size fits all’ model which may well be applicable to many commercial operations but goes against the grain of best medical practice.
If a patient feels that the treatment received is problematic, whether for the reasons listed above or not, it’s imperative that a second opinion is sought. Research reveals that 14% of the people who launch a claim for medical negligence are persuaded to do so following an intervention from another doctor, and claims of this kind, as well as benefiting the individual, help impose checks and balances on the wider system.
Whilst the vast majority of medical practitioners are devoted, hardworking and diligent, mistakes can sometime still happen. Until a fully transparent system is created, with a free exchange of accountability and information, expert advice is set to remain the best means of asking the right questions, seeking the right treatment, and being aware when mistakes are being made.