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| The June 10, 2000 issue of the British Medical Journal reports on an interesting statistic that has occurred in Israel. It seems that three months ago physicians in public hospitals implemented a program of sanctions in response to a labor dispute over a contract proposal by the government. The article stated that the Israel Medical Association began an action in March to protest against the treasury's proposed imposition of a new four year wage contract for doctors. Since then, the medical doctors have cancelled hundreds of thousands of visits to outpatient clinics and have postponed tens of thousands of elective operations. To find out whether the industrial action was affecting deaths in the country, the Jerusalem Post interviewed non-profit making Jewish burial societies, which perform funerals for the vast majority of Israelis. Hananya Shahor, the veteran director of Jerusalem's Kehilat Yerushalayim burial society said, "The number of funerals we have performed has fallen drastically." Meir Adler, manager of the Shamgar Funeral Parlour, which buries most other residents of Jerusalem, declared with much more certainty: "There definitely is a connection between the doctors sanctions and fewer deaths. We saw the same thing in 1983 when the Israel Medical Association applied sanctions for four and a half months." In response Avi Yisraeli, director general of the Hadassah Medical Organization, offered his own explanation, "Mortality is not the only measure of harm to health." He goes on to say that, "Elective surgery can bring about a great improvement in a patients condition, but it can also mean disability and death in the weakest patients." |
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| As reported by Reuters Health on May 08, 2001, according to the results of a national survey released by the Robert Wood Johnson Foundation, more than 70% of healthcare professionals believe that fundamental changes to the US healthcare system are needed toimprove the quality of care delivered to patients. Even more drastic, another 11% of survey respondents said the system's quality flaws are so deep that a complete overhaul is needed to remedy them. In the study, researchers asked 600 doctors, 400 nurses and 200 top-level hospital executives from around the nation about the quality of healthcare. They wanted to know if the professionals considered healthcare safe, effective, timely, patient-centered, efficient and equitable. In response 58% of those asked said that the quality of the US healthcare system is good or fair, while 2% said it is poor and forty-two percent said that the system had very good or excellent quality. David Richardson, the executive vice president of Wirthin Worldwide, a New York-based research firm that conducted the survey said, "In almost any industry, this lukewarm self-assessment would be seen as a sign of serious shortcomings." This issue became headline news in November 1999 when the Institute of Medicine (IOM) released a report blaming medical errors for up to 98,000 deaths per year. Donald M. Berwick, the president of the Institute for Healthcare Improvement said, "Healthcare is in trouble. The quality is not what we need it to be and people in healthcare know that." |
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to manage some common conditions |
| The September 5, 2001 Reuters Health story leads with the statement that says "Many physicians completing their residency training feel unprepared to treat conditions common to their specialty." This report was based on a report in the September 5th Journal of the American Medical Association. Dr. David Blumenthal from Massachusetts General Hospital in Boston told Reuters Health, "One important lesson of our study is that objective data on the preparedness of residents to practice as they complete their training are scarce and that we have a professional responsibility to measure the outcomes of graduate medical education more thoroughly and carefully." Dr. Blumenthal and colleagues surveyed 2626 graduating residents in primary care including internal medicine, family practice, obstetrics/gynecology and five other specialties to assess their self-perceived preparedness to provide common clinical services. The report said that the graduating residents felt ill prepared to manage many common situations. Dr. Blumenthal concluded. "Those who enter routine community practice should be aware that there may be gaps in their preparedness that they will need to remedy later in their practice lives, or that they will need to compensate for in some other ways." |
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doctor caused diseases still high |
| From the Archives of Internal Medicine January 11th 1999, comes the headline, "Despite high-tech medicine, diseases from medical treatment still significant cause of Intensive Care Unit admissions." Doctor caused diseases are referred to "iatrogenic" diseases, and according to the article are a major cause of ICU admissions. Surprisingly, the problem has not changed since 1980. This suggests that even with alleged advances in medical technology the results for the patient were just as risky. In another study in 1994, French researchers reviewed 623 patients admitted to ICU. Of those 10.9% were determined to be iatrogenic disease admissions. A majority of those were drug related and next in incidence were medical acts. Of these 13 died and the costs for all were $688,470.00 in the studied cases. This study concluded that 51% of these were preventable. Groups outside medicine have claimed that the numbers are much higher than medically reported and that the costs of iatrogenic diseases overall run into the hundreds of billions. |
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