Medicine is sick.
I know. I just spent nine days in the hospital. Of course, I was pretty sick, too. I’m thankful that I got the correct diagnosis and treatment, or neither this column nor this columnist would be here today.
Medicine in America is not as lucky. I think it has received the wrong diagnosis. So Medicine grows more ill. Now we are at a point where it is commonly accepted that hospitals are dangerous places. It used to be that hospitals were places of healing and respite. When someone had surgery, they were better off spending a day or two in the hospital away from their stressful lives. Now their stressful lives are an improvement.
The hospital I was in has one of the best reputations in the city. And I have no doubt that many are worse and few are better.
After running a high fever for three days, I was taken by ambulance to the emergency room of this teaching hospital, where I remained for 10 hours. After four hours, I was examined by a neurosurgeon who said I had an infection and needed surgery. I waited six more hours before being transferred to a hospital room.
One of the symptoms of Medicine’s illness is emergency care. At one point, a nurse told me there were 110 people in the waiting room, many of whom use the emergency room as their primary-care physician. There are many reasons for this, including inadequate health insurance or none at all.
According to Baizer Kolar P.C. what is worsening the problem is the fact that many hospitals that provided emergency care to uninsured people have closed, so the few that remain are overcrowded. And we all know that physicians have left the state because of the malpractice insurance crisis.
During my hospital stay, I caught eight medication errors that would otherwise have gone undiscovered. Why? Nursing supervisors or hospital administrators would say there are no excuses, but we know there are too few nurses and too many patients to make hospitals as safe as they should be. Check out https://www.myinjuryattorney.com/locations/philadelphia-office/ to know how to behave in such cases.
Or as clean. During my stay, I was in a regular patient room, a step-down unit (less intense than intensive care), and an isolation room. Not once were the floors cleaned. Not enough staff, too few people doing too many things for too many patients.
Because I need long-term intravenous antibiotics, I needed to have a PICC (peripherally inserted central catheter) line put in, an intravenous catheter that goes in the arm and up the vein about two feet into the major vein in the chest wall. The procedure is typically done by technicians in the radiology department. These kind and competent technicians stuck my arms six times before calling in the radiologist, who brought me into a much more sophisticated area with very high-tech ultrasound and fluoroscopy equipment and ran the line on her first attempt.
And this symptom, perhaps more than any other, reflects the misdiagnosis of health care in America today. This policy of having patients stuck six times before more expensive and sophisticated equipment can be used is certainly cost-saving. And although this policy may contribute to keeping that particular radiology department in the black, will it contribute to fixing medicine? Certainly not, because the problem has been misdiagnosed.
Medicine thinks its diagnosis is Financial Insufficiency and the treatment is More Money.
This reminds me of The Rocking Horse Winner, a short story by D.H. Lawrence. In this story, Mother was unable to love her children. The children thought the answer was to bring in more money and then Mother would love them properly. So her son Paul would get on his rocking horse and rock until he went into a trance and was able to pick the number of a horse that would subsequently win its race. More money came into the house. But Mother still was unable to love them, so Paul worked even harder. One day, he went so deeply into a trance that he died. A misdiagnosis had cost Paul his life. How many lives have been lost because of Medicine’s misdiagnosis?
If one looks at only some of the symptoms, such as financial difficulties, and ignores the symptoms of human suffering, we can never get to an accurate diagnosis.
Certainly, money is part of the problem. Many managed-care companies have essentially become robber barons dictating to hospitals how much they will pay, while executive staff, chief executive officers, and boards of directors make fortunes. Medicare is certainly part of the problem as it has become so top-heavy with bureaucracy and so politicized that many of its policies are unfathomable and illogical. Not to mention the fact that most hospitals could not survive if they relied exclusively on Medicare reimbursements. Health-care institutions large and small have become overburdened with meaningless and expensive programs such as HIPAA which cost fortunes to implement, yet do nothing real for patient protection of their confidentiality. And of course the sky-high medical school tuitions and fees for malpractice insurance simply lay the groundwork for doctors to charge outrageous fees.
Because we have learned so much in medicine and because we so value technology, most medical schools overvalue technical skills and undervalue compassion and kindness. Many departments of psychiatry no longer teach psychotherapy. Instead they emphasize the biology of mental illness and psycho-pharmacology.
Almost all the direct-care people in hospitals went to school to learn their trade because they care. And, now, they have no time to care. Too many obligations; too many responsibilities; and too little time to sit and talk with people who are ill, most of whom are in desperate need of their caring and compassion.
My diagnosis? The people who care about money have too much power. The people who care about people don’t have enough.
I was quite ill last week. Fortunately, I turned the corner.
Medicine is quite ill. We don’t know yet whether it will turn the corner.