walkitout (walkitout) wrote,

we will screw you over, and charge you for it

I think we've all heard about wrong site surgery and recent efforts to put an end to it, mostly involving markers because it turned out that somehow, relying on verbal communication between the surgeon and the rest of the team including the patient is a disaster. Fine. Wonderful. Lovely. Magic markers it is.

Here's a little quote from Kenney's _The Best Practice_, which I'm almost done with and will hopefully remember to review in a later post. No page number; kindle location codes are 4089-96:

"scores of hospitals throughout the country are doing good work. A large group of hospitals in Minnesota, for example, got together and decided not to charge patients for a list of twenty-seven so-called "never events" -- mistakes such as patients falls that cause harm, leaving a foreign body inside the patient, transfusion of incompatible blood, wrong-site surgeries, and so forth. The Massachusetts Hospital Association pursued a similar course."

Let us pause for a moment and reflect. Yay, don't charge the person you left a clamp in. That's good. Yay, don't charge them for cutting off the wrong leg, or drilling into the wrong side of the head. Yay not transfusing blood that causes really, really bad things to happen to them. That's good. Definitely a good thing.

Great Goddess Who Smirks Down on Us All, you mean to tell me that until recently, they not only messed people up in the OR, they _charged_ them for it? And only a _very few_ hospitals have now finally stopped charging?

If there's a group of people out there in need of a little torture, I would not start with some guy who did the Hajj and has something in his pockets some indoctrinated teenager with a gun thinks is incriminating. I would start with a similarly randomly selected surgeon. I actually don't think anyone is in need of torture, but that paragraph did give me pause.

As long as I'm at it, I'd like to mention one of the reasons I think that quality improvement is Really Really Important in Health Care. Once upon a time, back in 1977 (not a typo, altho it's possible it was the year before or the year after), my dad bought a new Oldsmobile -- the last new American car he would ever buy. (And he's union, through and through, so this should tell you something.) It went through oil really fast. It stranded our entire family on the shoulder of I-5 between Seattle and Bellingham, late one night. Shortly thereafter, the cause of the problem was finally diagnosed: the car was missing its rings. There was a joke that it had been put together on a Friday (har de har har). But while I have some love for muscle cars, I have never bought a GM car and never, ever will. I'd fucking like to see those guys go out of business, and I don't mind punishing their union members, either, because I _know_ how those fuckheads voted in 1980 and 1984 and 1988 and those elections were really the root cause of why we're in a shithole now.

I'm carrying a grudge over 30 years later because someone screwed up one part on one car. When I started buying cars, I bought Hondas (and one Subaru). Whenever I've been a party to a car-making decision, I've always come down on the side of if you can't afford the safe, reliable car new, then buy it used. Don't by the not-reliable car. Ever. While I recognize that cars are really important in our culture, I hope we would all hesitate to suggest that they are more important than health care.

At least when it comes to wrong-site surgery, incompatible blood transfusions. . .
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