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[–]Consumer451[S] 280 points281 points  (44 children)

The researchers caution that most medical errors aren't due to inherently bad doctors, and that reporting these errors shouldn't be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.

correction: as u/redheadedwoodpecker pointed out - Actually, the article says it's third behind cardiac and cancer, and ahead of respiratory, which is fourth

[–]plural_of_nemesis 55 points56 points  (17 children)

reporting these errors shouldn't be addressed by punishment or legal action

The researchers may be right, but with our existing legal system, it seems like nearly every case would end up with some sort of legal action.

[–]poonter5000 19 points20 points  (10 children)

Seriously. My best friend was having one doctor tell him he has the mumps, another saying mono, then 3 months later a new dr told him it was Leukemia.

[–]Ballersock 107 points108 points  (6 children)

Sounds like basically all that was presenting was an elevated white count. In 3 months, more symptoms may have presented themselves, allowing the doctor to make a more accurate diagnosis. Mono is a go-to for weird white counts because it's relatively common and almost every other thing that could elevate your white count is much rarer and much worse.

[–]tyreck 3 points4 points  (1 child)

I’m hoping one of the first two were right (or at least the last one was not)

[–]poonter5000 2 points3 points  (0 children)

The last one was right, unfortunately. He worked at a restaurant for a few months goin from doctor to doctor. It wasn't until he went to the last one when they found it. Every place he went they ran plenty of tests on him from what I remember. This was in 2011 so some of it is a blur.

[–]dajesus77 0 points1 point  (0 children)

That escalated quickly

[–]StrongMedicine 2 points3 points  (4 children)

It's amazing that most true medical errors don't result in malpractice, and that most malpractice cases weren't the result of a medical error.

[–]Toptomcat 5 points6 points  (3 children)

It's amazing that most true medical errors don't result in malpractice...

Is it really so remarkable that there’s a substantial gap between an error and an error that shows sufficiently horrible incompetence that a court takes away your medical license and makes you pay the patient? Doctors are highly trained human beings making judgement calls about extraordinarily complex problems, not flawless automata.

[–]StrongMedicine 0 points1 point  (2 children)

Sorry, I should have specified that what I meant is that it's amazing most true medical errors worthy of a malpractice lawsuit don't result in one...

[–]Toptomcat 0 points1 point  (1 child)

That's an interesting statistic that I would like a source for.

[–]StrongMedicine -1 points0 points  (0 children)

Personal experience. I'd estimate I've seen about a dozen cases of legitimate malpractice coupled with a poor outcome over the past 10 years. Not one resulted in a lawsuit.

It's probably the consequence of patients being very forgiving when docs are honest about a serious mistake, and patients not fully understanding the magnitude of the error that occurred when docs are not incompletely honest. (I think it's relatively uncommon for patients to be totally left in the dark with errors)

[–]brobafett1980 1 point2 points  (0 children)

Welcome to tort reform of the 90s and 00s. Very few attorneys will even touch medical malpractice now days.

[–]Herbivory 15 points16 points  (2 children)

I think the definition of medical error used is also helpful in understanding the findings.

Medical error has been defined as an unintended act (either of omission or commission) or one that does not achieve its intended outcome,3 the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning),4 or a deviation from the process of care that may or may not cause harm to the patient.5

http://www.bmj.com/content/353/bmj.i2139

[–]D74248 6 points7 points  (1 child)

So someone needs immediate care, and then long after fact a review with the benefits of hindsight and time finds that the care given in the heat of the moment was not perfect?

[–]ha5zak 3 points4 points  (0 children)

I'm no expert, but I think that's right. "Medical error" means a lot of things, including events where their information was not complete enough at the time to perform the procedure what would have been best. So, it wasn't a "mistake", per se, because if they were in the same situation again, they'd make the some decision, but in theory, better detection or more timely tests could have caught it. Regardless of whether those tests are technologically possible yet - though usually the reason is that it's simply too invasive, unnecessarily risky, or simply too expensive to bake into the process for everyone, from a statistical standpoint.

[–]Shippoyasha 69 points70 points  (2 children)

Oh boy. Reminds me of my time going to the emergency room the past October when I fainted and fell face first in the doctor's office after getting my blood drawn. When I was at the ER, they had a nurse or an intern for every single procedure from getting my phone number to my insurance ID, getting Xray for my forehead/rib bruises, getting blood drawn for tests, getting a tetanus shot and finally a nurse telling me the results and where I need to go after the care session. I can easily see why there could be massive confusion and misinformation happening in the ranks just due to how hectic a hospital environment can be. Good thing I turned out okay and it wasn't anything serious.

[–]DeLaNope 11 points12 points  (0 children)

Despite everything you see on TV dramas, doctors don’t do every single task in the hospital.

[–]jqueb29 16 points17 points  (0 children)

Your case sounds extremely simple.

[–]hdidhbeb 0 points1 point  (3 children)

I wonder what the total will be if you include deaths caused by side effects of correctly prescribed meds

[–]ORA_ORA_ORA 12 points13 points  (2 children)

But if they were correctly prescribed then it wouldn't be a medical error, just expected (and unfortunate) adverse drug reactions.

[–]swimfast58 50 points51 points  (24 children)

I'm currently involved in a study on medical errors (particularly prescribing errors) as part of my MD. I would take this result with a gigantic grain if salt.

There are dozens of articles which try to inflate the number of errors and their impacts, usually through creative definitions.

In this study, the definition essentially included any situation where results differ from the clinical plan. Outside of palliative care, death is very rarely part of the clinical plan so that could include just about every death in hospital as a medical error.

The type of research they're doing is important (that's why I'm doing it!) but only if it's used to improve systems which prevent or catch errors. Fearmongering like this is just a cheap way to get references to your paper.

[–]whatIsThisBullCrap 94 points95 points  (22 children)

Note that medical error does not mean the doctors actually made an error. It could also mean an issue with diagnosis or incomplete information. If a patient didn't know they were allergic to a certain medication and end up dying because they were prescribed it, this is a medical error and yet everyone did everything perfectly right; there was just no way to know that this patient would react poorly to medication that normally works perfectly.

[–]Xura 20 points21 points  (3 children)

RN here: I worked with a nurse in the ER that accidentally hung a bag of Heparin (anti coagulant) as if it were a bag of normal saline. Standard protocol for that medication is over the course of hours but it finished in under 30 minutes. The kid ended up being fine and the nurse got put on probation.

We always always scan our medications before giving them but when shit hits the fan you start to cut corners. We often grab a bag of fluids and hang them without a second thought. In this particular case the pharmacy had switched the Heparin with another fluid that was in the slot next to the normal saline. Normally we check to make sure it's the correct fluids but since the nurse was so used to grabbing that particular bag in that general area of the medication dispenser they didn't really think twice.

There's a lot of reasons why the med error was made. Obviously the nurse should have scanned the barcode or even double checked the name of the fluids. Pharmacy typically labels "high risk" medications with red tape or they are in their own section of the medication dispenser (pyxis) isolated from the rest. This doesn't happen often but when it does they always fix what was wrong. In the end it's fortunately/unfortunately always the nurses responsibility.

Idk where I was going with any of this but thought I'd share that story

Edit: The other day the ER doctor ordered fentanyl on a cancer patient complaining of a 1/10 pain. Normally we use our critical thinking skills and questions certain orders such as if he had ordered it on a kid. This all seemed legit and I gave them fentanyl. Turns out he ordered it on the wrong patient. Nobody got in trouble but now I always double check narcotic orders

[–]pertinentpositives 33 points34 points  (0 children)

bless you and all the RNs asking me and all my fellow residents if we "really meant to order" that. you are awesome.

[–]DeLaNope 3 points4 points  (0 children)

I mean I wouldn’t have second guessed fentanyl in the ED, even on a kid. We do it a lot, and so does the ED

[–]scutbutt 30 points31 points  (0 children)

It's interesting to read this thread. Doctors often try to remember that many people coming to the hospital - especially the emergency department, where I work - are having the worst day of their life to date. And the frustration expressed in many experiences recounted here is understandable.

I think there are two things to keep in mind: first, that a "medical error" in this context is not saying that the patient would not have died anyway as the ultimate outcome of their illness, but rather that preventable errors in their care - including errors of omission - can be identified as precipitating factors in how they died. So, if someone had an infection but failed to get an appropriate antibiotic within the timeframe that is standard of care, their death could be attributed to medical error. The patient still might have died even if given the antibiotic, especially if they had other complications - but we can't know. And no matter what caused the delay, it doesn't change this label.

Second, errors do happen, and they're common. It's scary. However, just because the story changes during the course of your treatment - you were told one diagnosis, and then another by a different doctor, for example - does not mean you experienced one. It's vital that we revisit what we've learned both from tests and the patient's response to therapy, but when it's busy we don't always communicate our logic well. It can be infuriating to experience - why didn't the first doctor say it could just be a muscle spasm? I've been here for hours, and they're not even going to do anything! And didn't the nurse say I was supposed to get an MRI? - and it's a bummer to have that be what you remember about your visit or appointment. That doesn't mean it's unreasonable. Many diseases have little or no objective data that define them. Many diagnoses are diagnoses of exclusion, meaning we have to rule out a bunch of other stuff before it can be applied. Maybe you were only supposed to get an MRI if your blood test was positive, but a lot of information was thrown at you and you didn't catch that. You can leave saying you got bad treatment and that's fair - good patient communication is something we aspire to. But in most cases, that failure to communicate was the only error, and everything else behind the scenes was within standard of care.

[–]redheadedwoodpecker 34 points35 points  (4 children)

Actually, the article says it's third behind cardiac and cancer, and ahead of respiratory, which is fourth.

[–]kacmandoth 99 points100 points  (18 children)

When there are thousands of possible diagnoses and an incorrect one without the proper tests leads to death within several hours. And you also have the public breathing down your neck about wasteful tests driving up healthcare costs. Do you want affordable healthcare, or do you want $50,000 in tests for every person entering the emergency room.

[–]ms4eva 61 points62 points  (7 children)

This guy medicines. Also, the data is completely misrepresented by a single one liner. What they consider medical errors is pretty broad. This "study" gets brought up constantly on Reddit. Hell we bring it up to the medical students every year, and the initial reaction is "OMG the sky is falling!!!"... until one actually reads and interprets how this number was generated. We have problems, absolutely, but damn does this get apocalyptic on reddit every month or so.

[–]eanx10059 8 points9 points  (2 children)

Diagnosis and treatment is made with limited information but the panel determining if there was medical error is made afterwards with much more information available. It's a load of bullshit.

[–]ArtificialJared -4 points-3 points  (1 child)

I thought the medical errors were based on available information at the time. Where did you read it was based on unavailable information, I couldn't find it in the article, where did you find it?

[–]ms4eva 6 points7 points  (0 children)

Oh no, this is absolutely data from retrospective inquiry.

[–]ArtificialJared 1 point2 points  (1 child)

What do they consider "medical errors", the exact criteria, it wasn't in the article but I thought you might know since you are talking about how broad it is.

[–]ms4eva 4 points5 points  (0 children)

There are many articles written on this, when I have some time I'll try and share one. Remind me if I don't get back to you.

[–]onacloverifalive 14 points15 points  (0 children)

What these types of articles fail to consider is that people are supposed to die. The error in most cases is continuing futile efforts for the sake of profit on the provider part or poor understanding and naivete on the patient or surrogate's or everyone's part, rather than appropriately transitioning the patient to hospice and palliation. These studies classify any action that does not result in the perpetual immortality of a person as an error.

People don't just die of one thing, even with heart disease and cancer. Even those conditions are frequently survivable without intervention. Almost everyone has basal cell and thyroid carcinoma and tons of others at some point and doesn't die. You scratch it off with a fingernail, maybe your immune system knocks it down. People die only when their overall health has over the course of their life of permissive abuses and neglects of self accumulated to a point when the body fails to recover from insult. You die when so much of you is diseased that the disease becomes you and your ability to maintain homeostasis fails.

Sometimes with heroic efforts you can be coaxed back to stability tempprarily until the next insult. Sometimes not. The sicker you get, the more thousands of things go awry. A really sick patient with a prolonged inpatient course can be discharged with hundreds of active diagnoses. The current coding system ICD-10 codes for over 68,000 unique disease states.

At some point the dysregulation proceeds where with even unlimited resources for diagnostic and therapeutic interventions, it is impossible even to diagnose let alone treat the ever expanding cascade of illness. At that point, failing to identify and correct a problem isn't an error, it's an inevitability. And this is what most people die from, because their doctors are naive and think they can fix most things regardless of the circumstance.

They can't, but they can get paid for trying, and if you insist that they do, they will. And familys over 95% of the time in my humble experience insist upon it. It takes a wise sage of a treating physician to guide them with confidence to palliation and comfort which pays him or her nothing rather than the highly profitable torture and expense of futile treatment. Medicine has let the world of business creep in on every level, and you should expect treatment decisions to be increasingly in line with profitability by and large.

When I am consulted on a patient that has had a protracted course of decline in function, failure to thrive, accumulation of morbidity and disability, even if they have a problem that is correctable with interventions, the family and I have a discussion about whether what we would be doing is just prolonging the inevitable. Sometimes family memebrs need to travel from afar to pay their respects, atone for fallings out, or come to terms. Sometimes then we will expend the resources for the wellbeing of the surviving family. Other times we transition the patient to hospice care which is by far the best and least expensive end to life.

[–]516584354687 76 points77 points  (6 children)

I've been a healthcare worker for several years now. Let me tell you why I think this is a problem with no signs of improvement.

Over the past decade or so and on into the future the healthcare industry is being consolidated into fewer businesses. Many claim to be nonprofit organizations, and may be on paper, but believe me they are very much for the profit of an elite few. Think of it like the food industry, there is now a McDonalds EVERYWHERE, they are huge, yet their food is shit. You may eat there, sure but their food is shit. Fast food is designed to squeeze every penny out of the business. The fast food industry works this way to get profit at the least expense, this includes staff, safety, quality.

Everyone knows the joke that the box of tissues was the cheapest the hospital could find and they will charge you as much as they can for it.

The worst of all is the staffing. They cram so many patients into the least amount of staff, because this is the biggest expense to a healthcare company, the staff. So you have nurses and doctors taking care of more patients than they can keep track of. It is like someone trying to boil 100 pots of soup at a time, stirring in ingredients with every pot with the lid on tight and trying to keep them all from boiling over. This is healthcare. Pots boil over all the time because staff are just spread way too thin to save money on staffing. As the healthcare industry continues to get consolidated into fewer and fewer organizations (corporations) this problem will remain and may get worse.

Because you're reddit I know most of you have seen fight club and the story about the choice of a recall as cost equation instead of a life saving measure. This is what healthcare is becoming, and let that really sink in.

I currently work for one where my workflow is so high that it is literally impossible to perform all of the duties I have. The critical thinking that everyone always hears about in healthcare is most applied to which corners can be most safely cut without endangering my patients because to provide every single measure of care and fulfill all of my duties just isn't possible. My coworkers and I are constantly lectured because we don't clean beds fast enough, or turnover patients fast enough or don't get patients to radiology fast enough. Most of the time this is by a boss that is forced to scold us for failing to perform responsibilities that he or she even knows aren't all possible but their superiors make them pressure us anyways.

Frankly I'm a bit scared to see which of the many things I've seen is the thing that takes my life one day. Mostly I'm mortified about the care that I will receive when that time actually comes.

Go ahead and downvote me for being grandiose or embellishing, or saying the insurance companies are the problem (and they are one of many diseases of healthcare). I'm not telling you all this for the internet points, I just really want change because I got into the field to help people and it is a depressing state things are in.

[–]hangmanstree 14 points15 points  (0 children)

this is a reality for me in the ED as well. It seems so many people are quick to judge medical staff when errors are made without considering that we are all fallible and more often than not given responsibilities that we cannot reasonably bear. Being legally liable for mistakes in these situations is such a dark cloud over an already gloomy scene. Most medical personnel i know do not encourage others to get into the field, and often express regret over getting into the medical field to begin with. It's as if so many of us are so invested in the system that it's hard to leave

[–]Aesomatus 6 points7 points  (0 children)

It's sad when you take a moment to realize what's really going on - and you must remember that the mass public is none the wiser.

I remember a while back, during a visit to the hospital, there was a family that was screaming and shouting at a poor nurse for spilling a small drop of the wife's blood while she was collecting it. Now, when I say screaming, I mean yelling down the hall waking up sick patients on the other side of the building.

[–]Flabs_Mangina 2 points3 points  (0 children)

Sounds like you need a union.

[–]MoobyTheGoldenSock 18 points19 points  (0 children)

I take issue with the language of the article in claiming medical errors are a major cause of death.

If a patient is having a heat attack and it is misdiagnosed as heart burn and the patient dies, medical error did not kill the patient. The heart attack did. Proper medical intervention may have changed the outcome, but failure to provide it was not the cause of death.

Medical error should only be listed as the cause of death if a medical decision directly kills the patient. Such as a surgeon accidentally slicing an artery or a nurse administering a massive dose of the wrong medication.

Conflating the two to inflate numbers is asinine, does no one any real favors, and muddles the discussion about how to properly address medical error.

[–]D74248 5 points6 points  (0 children)

This could have been written by Captain Hindsight.

[–]C1K3 58 points59 points  (34 children)

So we have a system that consistently falls short of providing essential care and overcharges for the care that IS provided. In many cases, the only way people can pay for the procedure(s) they need is if they sue someone. Call me crazy, but I think this is the exact opposite of the way it should work.

[–]ROBOT_OF_WORLD 20 points21 points  (8 children)

good thing it doesn't work like that.

hell the main reason hospitals drive up the cost is because how much insurance gives them the finger with the bill. they just drive up the cost because the company will only pay for X% of the whole bill, and the hospital has to just eat the cost. so driving up the price usually just allows the hospital to collect more.

[–]HRzNightmare 9 points10 points  (5 children)

This. Having worked in a hospital for 12 years I agree. But there's more to it. Medicare and Medicaid only pay a fraction of the COST of providing care. That is, is an MRI COSTS the hospital $1000 to provide (random number), Medicare and Medicaid only reimburse a fraction of that. So the hospitals lose money on each procedure, under the guise that the government gives them funds in other payments.

The hospitals charge private insurances much higher rates, and the insurers negotaite set rates. This screws self-pay patients, as they get hit with the inflated fees.

If you are not wealthy, and you get an enormous bill from a hospital, my advice is to apply to the "free bed" program at your hospital. Over 80% of patients how applied to my hospital's free bed program were approved, and it waived all the fees that weren't covered by insurance.

[–]ROBOT_OF_WORLD 1 point2 points  (0 children)

My family comes from a long line of ER nurses and I just occasionally overhear what they've got to say about insurance compaines, most of which isnt nice.

[–]chevymonza 0 points1 point  (2 children)

My mother's in rehab, and her medicare ran out; currently transitioning her to medicaid, but it's more complex and taking way longer than expected (her county is one of those extra-paperwork places, it turns out).

We don't want to send her home, but are trying to find assisted living that takes medicaid- another surprisingly complex task. Supposedly medicaid can pay the rehab center retroactively, but the bill is going to be outrageous. I'm really nervous about this whole thing.

[–]HRzNightmare 1 point2 points  (1 child)

Don't fret. The nursing homes generally won't take residents if they don't believe they will get approved for Medicaid. My stepmother was in one for almost a year before the Medicaid was approved, and everything was taken care of retroactively.

[–]chevymonza 0 points1 point  (0 children)

Thanks!! I thought it would've been done weeks ago, had no idea it took this long.

[–]1burritoPOprn-hunger 0 points1 point  (0 children)

Over 80% of patients how applied to my hospital's free bed program were approved, and it waived all the fees that weren't covered by insurance.

Which the hospital claims as a loss in order to stay profitably non-profitable. The entire system is hopelessly broken.

[–]anarchography 0 points1 point  (1 child)

Insurance companies usually have fee schedules, meaning they'll pay maximum of $x for a certain service. Paying a certain percentage would still allow the hospital to set the payout arbitrarily high, so insurance companies don't do that.

[–]ORA_ORA_ORA 0 points1 point  (0 children)

It's definitely not insurance setting a percentage payout or something but I think it's a pretty similar concept. The thing with setting a maximum is that insurance can, and almost always do, pay less than that. Setting the costs higher than what actual operating costs are gives you a higher chance of actually getting back the return you've put into it.

Most private primary care practices would barely break even, let alone make any profit at all, with their overhead costs if they listed prices that uninsured patients would be able to pay out of pocket.

[–]CommissarAdam 35 points36 points  (18 children)

Agreed, our NHS in the U.K. has it share of fuck ups, but at least we don't have to pay through the nose for the care they provide.

[–]Yellowhorseofdestiny 31 points32 points  (3 children)

Same here in Sweden.

From what we've seen every attempt to let the free market play with Healthcare has lead to higher prices and worse service for the needy (but larger profits for the companies). Hardly surprising...

[–]CommissarAdam 14 points15 points  (2 children)

Yep, definitely not surprising.

How is the healthcare in Sweden by the way? Just wondered if you have similar issues to ours like with understaffing and budget cuts.

[–]snurrff 8 points9 points  (1 child)

Understaffing and budget cuts are universal problems in most countries, I think.

[–]CommissarAdam 1 point2 points  (0 children)

Aikona, it's a shame really.

[–]Avarian_Walrus 5 points6 points  (1 child)

US healthcare is the most expensive in the world at $10000 per capita. The average universal healthcare country spends $4500. Even after insurance costs American paid a shit ton of their tax into it.

Universal healthcare in America would save both Americans and their government a great deal. Or they could spend what they did now and get three times the result.

[–]ArtificialJared -1 points0 points  (0 children)

Jesus Mary and Satan, are these the actual figures, and still our healthcare sucks so bad for many people.

[–]invenio78 8 points9 points  (9 children)

we don't have to pay through the nose for the care they provide.

Correct me if I am wrong, but I was under the impression is that taxation in Europe is generally significantly higher than in the US. In the US we typically buy insurance whereas in most nations people pay for this via taxation.

[–]C1K3 33 points34 points  (0 children)

Even with a lighter tax burden, we Americans pay significantly more per capita for healthcare than citizens of any other country.

[–]xsplizzle 10 points11 points  (6 children)

hah no, your money goes to creation of a military that is larger than the rest of the world combined, we spend more of it on healthcare

[–]invenio78 3 points4 points  (0 children)

I think we actually spend more on healthcare per person than any other country.

[–]dev_c0t0d0s0 -3 points-2 points  (4 children)

Imagine if you had to fund a military to protect yourself rather than just living under our umbrella.

[–]Avarian_Walrus 3 points4 points  (0 children)

Universal healthcare is vastly cheaper. Even if they didn't "live under our umbrella" they would still have it because it is cheaper and more effective.

[–]circomstanciate 5 points6 points  (0 children)

Imagine living in a country that doesn't antagonize countries with natural resources so that a few get rich.

[–]circomstanciate 1 point2 points  (1 child)

You don't actually believe that do you?

[–]TheDubiousSalmon 4 points5 points  (0 children)

Isn't that entirely true? America spends far more on its military than is necessary, but the fact that it's by far the most powerful army on the planet means that other NATO countries don't feel like they need to spend as much on theirs.

[–]CommissarAdam 0 points1 point  (0 children)

Nah not really, tax doesn't take the piss here so much, it's the universal bollocks like private rent and house prices that are a pain in the arse.

I will admit that many upper middle class and above do employ certain tax fiddles, but I assume that's a universal thing to.

Personally I don't pay any at the moment, that's the only plus of earning below the line of taxation. Although I do opt to pay a voluntary £150.00 a year to secure my pension if I ever get to retire.

[–]greenisin -1 points0 points  (1 child)

So being free makes it OK to kill people?

[–]CommissarAdam 2 points3 points  (0 children)

Of course it's not, that's not what I was saying, but I'd be unforgivably dishonest not to say that the NHS and its faults don't lead to people's deaths. I lost a brother and a grandad to this kind of thing, so I know how fucked up it can be.

I would like to see the actual data to comparing the British and American healthcare systems and the deaths due to malpractice in both, it'd be interesting to see which has the most. Taking the difference in population size into account of course.

[–]RUBI44 10 points11 points  (4 children)

At least in Canada if I fall down and break my arm I don't pay anything.

[–]HRzNightmare 1 point2 points  (3 children)

Yeah, but how long does it take for you to receive non-emergent care? I have many Canuck friends who love the emergent care, but the other care takes forever.

[–]RUBI44 4 points5 points  (0 children)

If I call the doctors office I get in the next day.

There are some rural areas that have trouble getting doctor's. Because doctor's don't want to live in small towns and limit their income after 15 years of college

[–]Avarian_Walrus 5 points6 points  (0 children)

Non emergency care might have a wait time but it isn't anything drastic. Sure there are a few horror cases but for the most part it is fine.

And it isn't like you can't get private healthcare like in America. Most time tax deductible.

[–]amc178 0 points1 point  (0 children)

Emergent care is prioritised because it's emergent. There are also ways to set up a health care system where if you want to pay for non-emergent care to be provided quicker you can. Australia is an example of a hybrid healthcare system.

[–]The_Quibbler 0 points1 point  (0 children)

That’s commie talk

[–]Kingsolomanhere 22 points23 points  (11 children)

All it takes is one little mistake. My mom started a stroke right in front of me. Couldn't talk or move her left side. At the ER no one came to her room for 10 minutes ( there is a 3 hour window to give tPA which breaks up a clot like Drano for a sink). Turns out when a clerk entered arrival time they accidentally hit the 1 on the keyboard before 2.30; the nurses and doctors thought she arrived at 12.30. Not enough time left to CAT scan to rule out aneurism. I showed my 911 call on the cellphone and within 5 minutes had two doctors and two nurses on it. She got it (tPA) within the 3 hours and within 10 minutes was talking and moving again.

[–]Consumer451[S] 21 points22 points  (10 children)

As someone that works in IT, it blew my mind how uncoordinated everything is data-wise. We live in the goddamn Information Age, but hospitals consider their record keeping scheme proprietary knowledge, and won’t sync anything. There should a national standard schema for patient records, and the 911 call should be part of the record.

[–]PutRedditNameHere 11 points12 points  (1 child)

I work in IT also, and it amazes me how the most sophisticated systems can fall victim to one bad keystroke.

Business requirements (which frankly, are sometimes based in sheer ignorance or stupidity) often overrule our best attempts at good data hygiene.

I work in transportation, and one incorrect character can determine if something is routed correctly or not. When we try to tighten our input validation, we get shot down because it might slow down a data entry clerk.

I guess it is more fiscally sound to dispatch a driver, waste fuel and piss off a customer. /s

[–]Igloo32 1 point2 points  (0 children)

I get weekly infusions at a top 5 cancer treatment center. Computers went down and patients were sent home (incl me) because apparently there's no manual backup plan to treat patients. It's a double edge sword I suppose. Now if we're talking AI for big data analysis for best treatment outcomes er al, that shit is gonna be huge and already is to some degree.

[–]theBrineySeaMan 8 points9 points  (1 child)

Seriously. A regular customer at my restaurant was telling me how she spent a week going to all of the different places she's been treated here and in her home state (she's got some severe brain and vision problems) just so she can bring a complete list to the out-of-state specialist. I never knew before that they weren't operating on a shared information standard. It explained why I have to fill out a complete medical history at every freaking place.

[–]Consumer451[S] 5 points6 points  (0 children)

The biggest joke is that while your healthcare provider does not have access to your medical history, insurance companies do! IIRC, there are two companies in Massachusetts that have all of our medical histories, but docs don't have access to it.

[–]Cabana_bananza 7 points8 points  (2 children)

Mayo Clinic, which is frankly the pinnacle of American medicine, has been tackling this very issue. They are spending big money on smart hospital rooms that will help coordinate patient care.

Unfortunately outside of Mayo there isn't an incentive to apply best practices or move to innovate for most hospitals. Occasionally a company will come through and try to "disrupt" how they operate with some IT solution, but when you apply the silicon valley disrupt model to healthcare people could die.

[–]Consumer451[S] 4 points5 points  (1 child)

This needs to be a legislated at the national level. The National Medical Records Standards Act. A standard database schema, API standard, and requirements for 911, EMTs, all docs and hospitals to have synchronized systems. Some tweaks to HIPPA would probably need to be made to allow it, you can't sign away your right to privacy when you are unconscious.

edit: If we had single payer, or at least a public option, that could be the de-facto standard maker, and could really push this through.

[–]hipaa-bot 3 points4 points  (0 children)

Did you mean HIPAA? Learn more about HIPAA!

[–]ms4eva 2 points3 points  (0 children)

Fucking thank you, please, get to work on this.

[–]bigred_bluejay 1 point2 points  (1 child)

The VA has been really cutting edge on electronic health records for a few decades. They started their VistA system back in the 70s.

By making records centrally maintained and universally accessible to doctors in all departments, the VA has a much lower rate of many of these accidents, such as multiple doctors prescribing conflicting medicines, etc.

The American Legion commissioned a great write-up recently.

[–]Rarvyn 1 point2 points  (0 children)

So "cutting edge" that VistA/CPRS is being phased out over the next couple years in favor of CERNER (which is awful, but less out of date and not as difficult to maintain).

[–]brock_lee 24 points25 points  (12 children)

My father died after a sterilization protocol was not followed, he got an infection, and died.

[–]oomio10 25 points26 points  (3 children)

do you exactly what protocol was not followed?

[–]hangmanstree 14 points15 points  (1 child)

how dare you ask for relevant details!!

[–]CommissarAdam 1 point2 points  (7 children)

That's awful! So sorry that happened to him.

[–]brock_lee 11 points12 points  (6 children)

I will say that he was 81, his health wasn't all that great, dementia was setting in, and he was just starting to become a burden on mom. It's never good to celebrate a death, but at least it was relatively quick--2.5 days from when he said "I don't feel well" until he died--rather than having him linger and waste away over months or years.

[–]24681632 13 points14 points  (4 children)

Whoa, an 81 year old with dementia died? Must be a medical error!

[–]CommissarAdam 3 points4 points  (0 children)

Oh I see, I'll agree with you there, I'd much like to go out that way myself, that was exceedingly fast and peaceful. My grandad had a similar thing happen to him at 76, just as he was starting to lose his faculties and become in need of care. Took him a month to pass away from renal failure caused by a viral infection, there's definitely worse ways to go.

[–]CipherTheTerminator 7 points8 points  (4 children)

When someone in our house goes to the hospital, someone else from the house is there with them until they leave, 24x7. The care is worlds better when someone's watching.

[–]hangmanstree 13 points14 points  (3 children)

just so you know, this is not always the case. The best part about having a visitor is that there is another patient advocate. That being said, most nurses (in my experience) will do whatever is highest on their priority list for patients without regard to visitor status. I would imagine the care is better with a visitor more often when the staff is just tired/lazy and putting off duties to sit for a bit or socialize with coworkers

[–]deevmtb 8 points9 points  (2 children)

My dad's in the hospital right now recovering from a stroke. I would hate to see him become another statistic due to negligence. He's already had untrained staff working with him, and they've introduced a handful of (albeit non-life threatening (yet)) complications to his recovery. I understand the challenges that come with managing an enormous staff pool, but you would think one of the top medical facilities in PA would have their shit together..

[–]Consumer451[S] 17 points18 points  (0 children)

Sorry about your dad. My mom had a bad stroke 5 years ago. The first day after, she had forgotten English, and reverted back to her native tongue. It took a couple years, but she has recovered to 100%.

I was able to take a month off of work and go to each appointment with her after she left the hospital. One thing I did was to get a hard copy of each visit’s results on paper and CD for scans, and made a binder. I would present that binder at each office, and the nurses would be amazed by my 7th grade Trapper Keeper technology.

I also fired her neurologist that left work early on a Friday instead of waiting on a result to come in. I finally got her into a “system” that had coordinated records and care. That made a world of difference.

The whole thing made me realize that there is such a thing as a Medical Advocate, and I was her’s. Don’t be afraid to ask questions and represent your dad’s best interests!

Edit: clarity

[–]mikenmar 1 point2 points  (0 children)

The title of the post is incorrect. It should say "cancer" not "respiratory illness."

[–]rikijamie 7 points8 points  (5 children)

Given how much it costs in the US thats absolutely disgusting.

[–]celica18l 1 point2 points  (4 children)

Had my gallbladder out. Hospital Outpatient. Was there for less than 4 hours $12,000.

I had a baby c-section was there for 3 days 16,000. Same hospital.

My first baby was $14,000 4 years previous.

[–]hangmanstree 1 point2 points  (0 children)

shame on you for not having medicaid

[–]Avarian_Walrus 3 points4 points  (2 children)

All would have been $0 in a sane country. All for 1-2% extra tax. Which is worth it to have all your fellow country men and women cared for.

Any truly patriotic American should be for universal healthcare.

[–]rikijamie 0 points1 point  (0 children)

Im from the UK but now live in Canada. $0 for all that. The only thing that cost was after care pain meds and antibiotics and even that's cheaper than the US.

I had a hernia op a few years ago $0 Wife had surgery for 2-3 hours 2 days ago $0

I will say though. The health care system in Canada is far superior to the UKs NHS

[–]celica18l 0 points1 point  (0 children)

Yep. Lucky for me my husband has a great job with benefits we pay $2400 a year for insurance premiums.

I would love National Healthcare but the current regime doesn’t believe that poor people should have healthcare.

[–]TheMechanicalguy 3 points4 points  (17 children)

I used to work at a name brand hospital. I was friends with a few of the doctors. One night I went to the unit one of them was working to bring coffee and chat a bit. I asked her what she was doing. She said the patient was going downhill and she was rewriting the chart to show a gradual decline rather than a fall off the cliff decline that was now happening.

[–]gloveshack 6 points7 points  (5 children)

What's a "name brand" hospital?

[–]_Z_E_R_O 2 points3 points  (0 children)

Probably one of the mega-corporations that is buying and merging small hospital systems into large ones nationwide.

[–]MyLifeInRage_ 1 point2 points  (0 children)

Costco Clinic. Aisle 3 for Cardiology OPD.

[–]TheMechanicalguy 0 points1 point  (2 children)

One that is well known & huge.

[–]chevymonza 1 point2 points  (0 children)

There's a hospital a few towns over that's practically a county in itself. Pretty intimidating, very easy to get lost inside/outside.

[–]gloveshack 0 points1 point  (0 children)

So a sandwich spread?

[–]Rarvyn 5 points6 points  (2 children)

Somehow I doubt the veracity of this story.

It may have been the doctor said they were documenting in the chart to show that there was a gradual decline, rather than the fall off the cliff that there appeared to be down (as the events in between had not been adequately documented). That's normal, standard, and not an error in any way.

[–]TheMechanicalguy -1 points0 points  (1 child)

Dude I'm telling you the truth. I'm only relating what I saw and was told. If that was normal for medical people to do that than it's normal. I did'nt go into it with her. At the time I was thinking about going to school to become a physician's assistant she was my soundboard. In hindsight I always wondered if it was unethical for her to do that. Maybe it was SOP I don't know. That was 20+ years ago. If your in the field and you say it's ok SOP so be it.

[–]Rarvyn 4 points5 points  (0 children)

What I mean is I think you misunderstood the comment:

Documentation in the hospital setting by a physician is typically done once daily, in the morning, to summarize what happened over the previous day. As results trickle in, they're acted on, but often no new note is written.

If the patient had a decline over the course of the day to the point that they were now critically ill, there might be minimal written documentation of that between the morning (where they were fine) and the critical event itself. So on the chart it may just look like the patient "fell off a cliff".

What my guess is with regards to your described event is that she was going back and documenting the slow decline, so it doesn't look like it came out of nowhere/was missed by the medical staff. In addition, she would presumably be documenting her actions/orders over the course of that decline.

If she was truly falsifying documentation, that would be unethical fraud. But going back and actually documenting in the chart to reflect what actually happened is not fraud - it's standard operating procedure.

[–]Belrick_NZ 1 point2 points  (2 children)

Pretty sure you will find that illnessess killed these people and the us state healthcare wasn't up to the task to cure them

[–]Sean_P_McDermott 0 points1 point  (0 children)

i was an EMT and despite many sanitation procedures in place there were still many obvious disease transmission vectors. For example the computer screen that every patient finger signed on, never got cleaned.

[–]mm_hmmm -4 points-3 points  (0 children)

Given the cost of U.S. health care, this is an industry disgrace.

[–]Marcuscassius -5 points-4 points  (0 children)

The last three times I've been to Emergency, I was misdiagnosed and overcharged. But the bills were perfect every time.

[–]ALR3000 -4 points-3 points  (0 children)

Interesting comments (apart from the bogus nonsense about most people having to sue in order to afford proper care... that was pulled out of someone's butt). The only thing to add is the sidelight that most systems are not HEALTH care, they are DISEASE care. The investment in actual health care is tiny.

[–]314159265358979326 -1 points0 points  (0 children)

Does anyone know how that compares to other countries?

[–]trojanfl -1 points0 points  (0 children)

Medical "practice"......practice doesn't make perfect.....constant practice