2nd in a series Risk analysis: What’s going on in our care?

by • November 1, 2007 • UncategorizedComments Off on 2nd in a series Risk analysis: What’s going on in our care?1750

OPINION By E. Patrick Moores, Esq.

© 2007 The Medical-Legal News

It has recently been reported in the media that not only our healthcare institutions, but also our schools, are becoming breeding grounds of serious outbreaks of emerging infectious diseases, consisting principally of staph infections — methicillin-resistant Staphylococcus aureus (MRSA) – that are drug resistant on an alarming scale. Antibiotics that worked in the past can do little to prevent the outbreaks today — the primary prevention advice being given, in an effort to prevent nosocomial (hospital-acquired) infections is to “wash your hands.”

Recent reports from Great Britain disclose that in three hospitals in Kent, at least 90 people have died from a “superbug” infection, traced to filthy conditions. It has even been reported that nurses were telling patients with diarrhea to “go in their beds.” This attitude in a country with socialized medicine should cause all of us grave concern for what the future holds for us if government takes control of our healthcare system.

In my previous commentary I reported that during my recent long-term hospitalization, my wife inquired of a nurse as to the reason my bed linens had not been changed during the week. She was informed that the staff was under instructions from the administration not to provide a change of linens unless requested by the family. When my wife requested that they please bring some clean linens to change the bed, the fresh linens were brought to my room and left, with the attitude, “you asked for them, you change them.”

Is cleanliness really the issue? Have the advances in medical science brought us full circle back to the great plagues of the middle ages? Or is it a matter that the crisis being faced in healthcare today is emerging because of the cost-cutting controls facing the healthcare industry and a serious change of attitude among the providers? This raises the question as to what extent healthcare workers are still consecrated to the service of a suffering humanity. Is it no longer a vocation, but merely a job that provides a paycheck?

The caregivers

Healthcare professionals were once viewed as ready and willing to serve in the most intimate existence of mankind, as an extension of the compassionate healing work of Jesus. When we are in the supreme trial of our lives, we want to believe that the healthcare worker has a vision of the dignity of humanity that provides dedicated compassion and commitment to tending to the needs of the sick.

Yet, few today are unmarked by the scars of memories of the deep loss or serious impairment of a loved one from some failure to deliver the service entrusted to the participants in the “system.” Reports of daily losses from “mistakes” are raising a confidence issue of major proportions in our nation’s ability to deliver quality healthcare. A recent televised report on the Public Broadcasting System (PBS) stated that every day more than 500 patients die in hospitals due to preventable errors.

What is going on here? What is happening to the healthcare industry’s moral duty to provide the public with the necessary protection at every level of possible care for the individual life? The medical profession used to consider that every human person was to be accorded the dignity of a creature of God, from conception until natural death. Have the arguments of a person’s right to abort a baby, of the sick or elderly’s right to die, so numbed our minds as to remove us from even caring to participate anymore in the discussion of appropriate care?

Governmental involvement

Politicians today are debating measures to save healthcare costs. Under the label of “allocation of reasonable healthcare expenses,” discussion is now being focused on saving costs by preventing needless expenses for care of the terminally ill.

In essence, as this country enters the debate to adopt a socialized medical system under a government-controlled national healthcare program, we will soon be made aware that our social security and healthcare will eventually succumb to a bureaucratic determination that selects those who deserve to be provided treatment — and shuns those who do not possess the required quality of life to deserve to be kept alive. Eventually, those patients determined not to justify the level of care necessary to keep them alive will essentially be abandoned to a process of selective euthanasia.

The politically correct justification under the emerging debate centers on the issue of “quality of life.” Is this where our medical profession is heading? Have the bean counters so gained control of the provision of care that they can subjectively determine that no one will even get clean sheets unless demanded by the family? What about the poor soul who has no family present to advocate for him and therefore must lie in his own filth and germs? What about the elderly who are banished to the nursing home and virtually ignored? How does all this equate to “quality of life?” These questions are disturbing, yet they are raised not only by my clients, but also by my own personal experience.

Moral duty

The healthcare system requires the recognition that the importance of public care is a moral duty of every physician, nurse, therapist, technician, hospital worker, administrator, politician, judge, lawyer and other professional involved.

The starting point is the acknowledgment that when we took the oath of our professional position, at whatever level of service, we were placing ourselves accountable to providing respect and our best service to those we are called upon to serve.

As professionals, we must commit ourselves to focus on those needing care — that they be given the most fundamental, competent and continuing care available, which is based on our skill and compassion for our fellow man, and not whether an insurance company is going to provide the coverage.

Reinventing service

That PBS broadcast followed a hospital in St. Louis that has adopted a method of quality management utilized by Toyota Motor Manufacturing. The hospital has redirected its focus onto the patient, which in turn helped the hospital staff, and costs issues, to take care of themselves. During my stay at Saint Mary’s Hospital at the Mayo Clinic in Rochester, Minn., I was struck by the signs, note paper and documents that confronted me at every turn, which all said, “The needs of the patient come first.” Talk about constant focus — this was unbelievable contrasted with what I had previously experienced in another hospital.

The records deficit

This appropriate level of care does not mean repeating all types of diagnostic tests. During my recent long-term illness I was admitted to three different hospitals in a four-month period. All performed some of the exact same diagnostic tests. I have in my desk the copies of the results of those tests from the hospitals, which produced the same information. When I asked the supervising doctors why this repetition was necessary, I was told each time that the records were not readily available and that it would take too long to obtain them. Is this the best the medical institutions can do to deliver information necessary to provide quality care?

Insurance in the mix

Next, something has to be done about a healthcare system that is controlled and essentially owned by the insurance industry and driven by administrators focusing on the bottom line instead of the needs of the patient. Years of debate over the appropriate level of care and how to pay for it appears to have produced little motivation for our most intelligent professionals to sit down and brainstorm until they come up with a solution. We must demand more from them in resolving this conflict.

While I acknowledge that I do not have the answers, this cannot be an impossible mission. It is a matter of demanding that our best leaders in government, medicine, and all other involved provider systems wake up and step over the different political opinions in order to develop an appropriate method for delivering affordable and competent healthcare for all of us. There is no question that the needs of the elderly and the poor impose a heavy burden on the system, but that is just an excuse, not an answer. It certainly does not constitute justification for what we are faced with at present.

In the process of seeking that solution, we must not forget that our system of government, acquisition and expenditure of capital, and taxation of the use of our money, has provided the culture in which our level of healthcare has become recognized as the best in the world. But is a socialized healthcare system really the best we can do?

The next obligation in finding this solution rests on each of us as individuals utilizing and relying on the system as potential patients and participants in the care-giving situation. Not only must we become involved in the level of care, but as I reported in my previous commentary, we must actively plan the care and accept the responsibility to accumulate the information, on an ongoing basis, that will be needed to deliver and oversee an appropriate level of healthcare for our loved ones and eventually for ourselves.

I plan to share my thoughts on this in the next column. •

E. Patrick Moores is an attorney in Lexington, Ky., and a member of this newspaper’s editorial board. He concentrates his practice in insurance coverage issues, employment and elder law;patrick@epmooresattorney.com.

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