A recent medical error of a wrong-site surgery that occurred in one of the country’s best hospitals, Massachusetts General, reminded me why doctors need to be less like Chuck Yeager and more like Captain Sullenberger.
Growing up, I always wanted to be a fighter pilot, years before the movie “Top Gun” became a part of the American lexicon. My hero was World War II pilot Chuck Yeager, who later became one of the country’s premier test pilots flying experimental jet and rocket propelled planes in a time when they were dangerous, unpredictable, and unreliable.
Much like the astronauts in the movie “The Right Stuff,” Yeager and his colleagues literally flew by the seat of their pants, made it up as they went along, and never really knew if their maiden flight in a new aircraft might be their last. They were cowboys in the sky wrangling and taming the heavens.
Fast forward to January 2009, when shortly after takeoff, a one-in-a-million chance, a double-bird strike completely disabled a US Airways jetliner. Captain Chesley Sullenberger, with the help of his co-pilot Jeff Skiles, ditches the aircraft in the Hudson River in under four minutes even as the nation surely expected a tragedy. But not on that day. Not with that pilot. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
I read this article about a young child with heterotaxy syndrome with great interest. Not because I find heterotaxy syndrome something of great fascination, but because of the lack of communication — on both ends of the spectrum:
Even though 5 other Dr. all came in and listened to his lungs and said that he didn’t sound like he was wheezing and that his lungs sounded really good. But because this hospital is overly political, process driven, bureaucratic, and in a constant state of litigious fear they are unable to make any conclusions based on actual medicine and patient care. Common sense is blown out the window when you have a system were a hospitalist one year out of medical school has an opinion that is as valuable as a cardiologist with 25+ years experience.
But in fairness, they all had to “really consider her opinion.”
So they went and got a pulmonologist to evaluate him, which Scott and I were very happy about because there was nothing in the world that would’ve made me more happy in that moment than to have her proven wrong. Which she was.
The whole article is a case study in stress, distrust, and legalism. Read more »
*This blog post was originally published at The Happy Hospitalist*
Some patients struggle to communicate effectively with their doctors and some doctors and nurses find it difficult to communicate and collaborate with each other.
Historically, the dynamic symbiotic relationship between doctors and nurses has been a little shaky, evidenced by the lack of engagement and respect for one another.
Hospitals are chaotic and stressful. Working in such an environment can lead to frustration and it can take a toll on the staff. Instead of a good working relationship (which may never have been fostered to its full potential from the start), doctors and nurses become a fractured team. As a result, the fractured team will not effectively communicate and patient care may suffer devastating consequences. Read more »
*This blog post was originally published at Health in 30*
I present interesting cases to colleagues often because it’s educational and good for patient care and because I like to. But it has been many years since I was mandated to present a case.
It seems that I’m not the only doctor exasperated by a pesky new barrier to patient care: Doctors in cubicles.
An old friend and mentor, Dr. Richard Kovacs, now chair of the American College of Cardiology’s Board of Governors (and IU guy), has written about these same pre-certification barriers. Dr. Kovacs, being a professor and distinguished ACC official, kindly terms these obstructionists “radiology benefit managers” (RBMs). Read more »
*This blog post was originally published at Dr John M*