Many of you may have seen the recent article by @DrMartyMD, Marty Makary, in the Wall Street Journal, "How to Stop Hospitals from Killing Us." The lede:
When there is a plane crash in the U.S., even a minor one, it makes headlines. There is a thorough federal investigation, and the tragedy often yields important lessons for the aviation industry. Pilots and airlines thus learn how to do their jobs more safely.
The world of American medicine is far deadlier: Medical mistakes kill enough people each week to fill four jumbo jets. But these mistakes go largely unnoticed by the world at large, and the medical community rarely learns from them. The same preventable mistakes are made over and over again, and patients are left in the dark about which hospitals have significantly better (or worse) safety records than their peers.
The article is drawn from Marty's recently published book Unaccountable. This trailer will give you a sense of the themes. He notes:
It does not have to be this way. A new generation of doctors and patients is trying to achieve greater transparency in the health-care system, and new technology makes it more achievable than ever before.
I hope so, but I don't know. For several years, I have joined Marty, Peter Pronovost, Brent James, David Mayer, Lucian Leape, Jim Conway and others in advocating for changes in medical education, in clinical process improvement, in transparency of clinical outcomes. Those changes are all necessary conditions for a transformation of this industry, not only in the US but in all developed countries.
Unlike these people, I come to this field with a background in other industries, much more than in health care. I have seen and participated in the transformation of other sectors, where the hope was that changes in technology would render previous industry patterns unsuitable. Whether with gentle or forceful steering from the government, it was hoped that the disruption in those industries would result in more customer choices, greater value for each dollar (or pound or peso) spent by consumers, and an overall improvement of efficiency for society. The results in those other fields have been mixed, as is perhaps inevitable when any major sector with extensive vested interests is perturbed. But we can often see some change in the hoped-for direction.
But I have yet to encounter a field that is as recalcitrant to change as health care. While filled with people of the best intentions, intelligence, and extensive training, it is also characterized by self-satisfaction, denial of the underlying problems, and arrogance. Thus far, too, the patient advocates who have tried to cause improvement have not been unified or effective in purpose and plan. Thus, there does not yet appear to be a solid, sustained constituency for the result Marty predicts.
Sometimes, I remind myself to be patient. It is hard to change the medical system quickly. But, more often, I find myself agreeing with the words of Captain Sullenberger:
"I wish we were less patient. We are choosing every day we go to work how many lives should be lost in this country. We have islands of excellence in a sea of systemic failures. We need to teach all practitioners the science of safety."
When there is a plane crash in the U.S., even a minor one, it makes headlines. There is a thorough federal investigation, and the tragedy often yields important lessons for the aviation industry. Pilots and airlines thus learn how to do their jobs more safely.
The world of American medicine is far deadlier: Medical mistakes kill enough people each week to fill four jumbo jets. But these mistakes go largely unnoticed by the world at large, and the medical community rarely learns from them. The same preventable mistakes are made over and over again, and patients are left in the dark about which hospitals have significantly better (or worse) safety records than their peers.
The article is drawn from Marty's recently published book Unaccountable. This trailer will give you a sense of the themes. He notes:
It does not have to be this way. A new generation of doctors and patients is trying to achieve greater transparency in the health-care system, and new technology makes it more achievable than ever before.
I hope so, but I don't know. For several years, I have joined Marty, Peter Pronovost, Brent James, David Mayer, Lucian Leape, Jim Conway and others in advocating for changes in medical education, in clinical process improvement, in transparency of clinical outcomes. Those changes are all necessary conditions for a transformation of this industry, not only in the US but in all developed countries.
Unlike these people, I come to this field with a background in other industries, much more than in health care. I have seen and participated in the transformation of other sectors, where the hope was that changes in technology would render previous industry patterns unsuitable. Whether with gentle or forceful steering from the government, it was hoped that the disruption in those industries would result in more customer choices, greater value for each dollar (or pound or peso) spent by consumers, and an overall improvement of efficiency for society. The results in those other fields have been mixed, as is perhaps inevitable when any major sector with extensive vested interests is perturbed. But we can often see some change in the hoped-for direction.
But I have yet to encounter a field that is as recalcitrant to change as health care. While filled with people of the best intentions, intelligence, and extensive training, it is also characterized by self-satisfaction, denial of the underlying problems, and arrogance. Thus far, too, the patient advocates who have tried to cause improvement have not been unified or effective in purpose and plan. Thus, there does not yet appear to be a solid, sustained constituency for the result Marty predicts.
Sometimes, I remind myself to be patient. It is hard to change the medical system quickly. But, more often, I find myself agreeing with the words of Captain Sullenberger:
"I wish we were less patient. We are choosing every day we go to work how many lives should be lost in this country. We have islands of excellence in a sea of systemic failures. We need to teach all practitioners the science of safety."