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Two articles of interest

BluebirdOne's picture
BluebirdOne
Posts: 195
Joined: Jul 2018

 

Reulators cite care deficiencies at MD Anderson after patient's adverse event. 

https://www.houstonchronicle.com/news/houston-texas/houston/article/Regulators-cite-care-deficiencies-at-MD-Anderson-13969785.php

This was a scary article to read as it seems like the deficiencies were major for Medicare to get involved. 

 

Radiation Plus Chemotherapy doesn't improve endometrial recurrence-free survival.  (A study from Northwestern University which will be published in the New England Journal of Medicene June 12, 2019)

https://medicalxpress.com/news/2019-06-chemotherapy-doesnt-endometrial-cancer-recurrence-free.html

The initial article does not state exactly what type of cancer, but it seems to be type 1, and the study was done on stage III and IV uterine cancers. I don't have a link to the Journal's article. 

 

 

 

MAbound
Posts: 859
Joined: Jun 2016

Before I go any further, I just want to warn everyone that I was once a competive debater and just love the back-and-forth of these kind of discussions. I really don't want anyone to think I'm personally attacking their opinions because I believe opposing viewpoints are equally informative and helpful for others to form their own conclusions.

I had to go back and re-read the article to make sure I wasn't going off on a tangent. The article specifically states its discussing "systemic safety lapses" that are concerning "given all the advancements in technology and safety protocols over the past three decades, how can such errors still happen at even the most prestigious hospitals?" 

"Sometimes we forget that perfection is not a human quality. There will always be things that go wrong." While it's true that perfection is not a human quality, it is not true that we all expect that from each other. We can be pretty forgiving when we know that we couldn't live up to that standard ourselves. The article itself states " Humans are inevitably going to make errors, but there should be systems in place to prevent those mistakes from leading to harm". Those systems are policies and procedures with adequate and the right kind of staffing to carry them out. That doesn't happen...a lot.

The issue in the article was discussing blood transfusions to make a point in the role hospital policies and practices play in patient safety. While it is true "that millions of transfusions are given safely", what many don't know is that transfusion reactions are more common than you think and thus the need for careful patient monitoring while receiving one. Fatal reactions these days are rarities, but there are other kinds of reactions of varying degrees. No one ever hears about them in the news anymore than you hear about chemo patients needing their infusions adjusted because they have a non-fatal reaction. It's the sensational stuff that gets attention.

Some may find this article from February 2019 interesting about transfusion reactions:

https://www.ncbi.nlm.nih.gov/books/NBK482202/

Getting into private pay vs. socialized medicine is a whole different debate with pros and cons of it's own. All that  I'm convinced of at this point is that what we have isn't working very well and it's not currently as safe to recieve care in a hospital as you would expect it to be at even the most reputable places. My thinking is that when you do go in and are vulnerable, you really need someone there at your bedside to watch what's going on (is everyone washing their hands like they should, etc.) and to be a witness to and an advocate for how you are or are not being cared for. It shouldn't come to that, but that's the way things are. I refuse to blame front line staff for all that goes wrong because it's articles like this one that show that there's plenty of blame to go around when things like Bobbi and I experienced happens. I'm sure there are plenty of other's with tales they could share of things that happened to them that shouldn't have. 

 

MoeKay
Posts: 206
Joined: Feb 2004

Yes, there are certainly plenty of medical treatment issues, the pros and cons of which we could probably debate forever!  I'm glad that your nephew was able to get a prompt colonoscopy and found out that his symptoms were nothing serious.  I understand that there are differences in how soon patients in Canada can get an appointment, especially with certain specialists, and that the wait is longer in some provinces than in others.  No doubt, that is a serious issue, especially for someone with an undiagnosed, potentially serious condition or someone in pain. 

My takeaway from BluebirdOne's article was that it is important to recognize that serious, even life-threatening medical issues can develop as a result of care and treatment (or lack thereof) during a stay at even the top-rated cancer hospitals.  So with this information, what is one to do if declining hospitalization is not a realistic option?  While perfection is not attainable, I thought that this article, "Tips from the Trenches:  How to Survive your Hospitalization," makes some good points on how increase the odds that your hospitalization goes as well as possible:  https://www.forbes.com/sites/judystone/2015/04/21/a-doctors-top-ten-tips-for-surviving-your-hospitalization/#7cd47536477f. 

On a personal note, I remember one hospitalization in which the nurse brought me my blood pressure medicine.  It looked a little different than usual, but I just wrote it off to possibly being a different generic brand.  What I found out after I was discharged and obtained a copy of my hospital record was that I was given the wrong (lower) dose of the medication.  While in my case, the error did not become life-threatening, in other situations it could have.  That incident taught me an important lesson:  Trust But Verify. 

Also, I think it's important to recognize that a hospital is a business.  If you've had a bad experience, after you've had a chance to reflect on the experience, think about writing a letter to the CEO of the hospital and voicing your concerns.  I listen to Doctor Radio and there is a talk show on health care insurance coverage and billing issues.  The Vice President for Medical Center Clinical Affairs and Affiliates who does the show often advises callers to write to the CEO of hospitals and institutions with whom they have had issues.  The VP said that he is tasked with resolving billing issues that come across the desk of the CEO.  He said that hospitals really do listen; they do not want to lose business.  If what the VP says is true about billing issues, I believe it would be equally true about quality of care issues. 

 

Forherself's picture
Forherself
Posts: 185
Joined: Jan 2019

Health care has become so complicated that its hard for patients to take in everything and remember it.  An advocate is awesome if you can find someone to do this. I  am not sure an advocate would have saved this patients life.  We just don't know because we don't know the detaiils.  That is my point.  And I will wait for the details before I pass a judgement on the hospital, that otherwise saves lives every day with caring hard working personnel.  BUT, patients need to give written complaints when receiving poor care so the admistration is aware of it.  

Hospitals are not business like every other business.  They are highly regulated.  They are forced to give care to any person who enters the ER whether they will be paid or not.   Most business do not operate like that.  

 

MoeKay
Posts: 206
Joined: Feb 2004

Hi, Forherself!  After rereading my post, I deleted the words "like any other business," as I realize now that that the deleted language wasn't the most clear and was subject to different interpretations.  My point was that, in general, hospital executives do not want to lose patients, at least paying ones, to other hospitals, so that a patient's legitimate complaints to the CEO would in all likelihood be taken seriously and investigated.  To make sure this is the case, if a response addressing my concerns was not received in a reasonable amount of time, I would send a follow-up letter inquiring about the status of the matter. 

MAbound
Posts: 859
Joined: Jun 2016

I think I've read similar advice before or maybe even this article since it's from 2015. I think that's why I brought up about having an advocate whenever you need to go into a hospital.

Even with such a person, things can still go wrong, but at least you might have better odds of getting out with fewer problems. The sticking point is that when you are sick or injured you are not always able to follow all of that advice and even an advocate might not feel comfortable being as assertive as is sometimes needed. Not everybody is a knowledgeable as this doctor is.

It's just not right that patients are being burdened with expectations of monitoring the care they receive or in some cases administering it to themselves because of staffing or procedural inadequacies. Moekay's advice to bring problems to administrator's attention is important because these guys aren't in the trenches to experience the issues with some of the policies and procedures they enact. For some reason I had an administrator checking in and surveying me when I was in the hospital, so she got an earful about was happening to me. I appreciated that, but never got any feedback as to whether or not any of that made a difference.

janaes
Posts: 760
Joined: May 2016

I havent had the chance to read this thread as well as i could but i think i get the gist of it. Im not sure how many of you know that i went with out external radiation for my stage 2 grade 3 MMMt uterine cancer. It has been over 3 years since my hysrerectomy. I have been clear wirh no reaccurances. I went with out radiation in my reslasoning was because radiation given to me for my first cancer over 20 years ago caused my uterine cancer my doctor said. I didnt see the point doing radiation again. Either way i could get cancer. My radiation doctor wouldnt do it anyways because the trearment was going to be to close to where i was radiated before. Im glad i didnt do external radiation. Thats my opinion.

Kaleena's picture
Kaleena
Posts: 1961
Joined: Nov 2009

my radiation oncologist advised against pelvic radiation for me even though my gyne oncologist wanted it.  He indi that they did not know the long term effects of radiation but given how much I scar that getting pelvic radiation Wouk did be detrimental to my health.   So they agreed only on brachytherap.   Which did eventually cause issues with my ureter.  

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