Commentary—

Getting Sick Can Be Really Risky

By William A. Collins

 Time for patients,

To Beware;

When they’re under,

Doctor’s care.

Let’s start with the bad news: 100,000 patients die each year from hospital-acquired infections. Another 100,000 die from medical error. And according to the Institute of Medicine, two in five adults get misdiagnosed. Unfortunately there isn’t any good news. Well, I guess there is good news if you get well, which most of us do.

The problem is that society has set up some serious road blocks to getting well. Just try, for example, to find out from the Connecticut Department of Health whether your doctor has had complaints filed against him. Or if you have a medical dispute that goes to court, just try to find a doctor who will testify on your side. Sorry, they’re not into that.

And those are the good guys! When we cross over the bar and fuss with insurance or drug companies our odds worsen. Since no one wants to insure us if we’re sick, many folks can’t afford treatment if they get really ill. And since drug manufacturers want us to buy their product whether it does us any good or not, they find ways to subtly (or not so subtly) bribe doctors to prescribe their stuff even if it may not be quite right.

Further, when corners are cut, or bad practice is introduced, or plain old mistakes happen, you can probably imagine what happens to the whistleblowers who point that out. At last count the Justice Department had a backlog of 500 cases of health fraud.

And now comes a New York Times report that the Food and Drug Administration scarcely bothers even trying to test new medical devices. In fact, any kind of regulation at all only dates back to 1976 and the deaths that resulted from the infamous Dalkon Shield. Since then the FDA has been empowered, but not adequately funded, to make sure that new products won’t poison, injure, or infect us. But producers often concoct creative incentives for doctors to go ahead and use their devices anyway.

Nor are doctors, hospitals, and corporations the only dangers in our care system. Pharmacists are a secretive lot as well. Though generally of very high type, they, like the rest of us, also make mistakes. Also like the rest of us, they prefer to hide them. The big drug chains won’t talk about this, let alone provide data. Thus there is no tool for consumers to use in comparing pharmacies or in getting a handle on the scope of the error problem. (Though by way of endorsement, a Stop & Shop pharmacist did recently drive out to our house to pick up a misdirected prescription.)

Medicare has now gotten into the act, too. It is refusing to pay health providers for medical mistakes. Nor will it allow them to charge the victims. That’s dandy, but since most hospitals are nonprofit, losses have to be made up by someone. That means higher rates or larger government support. Not much incentive there to tighten up. The better answer is stricter regulatory supervision and closer record keeping. Somehow government rarely seems to find money for that sort of thing. Too many lobbyists against it.

So worse luck, a lot of responsibility for our own care falls back upon us. Who else is going to ask the doctor if he washed his hands? Who else is going to verify our prescription labels? Who else is going to check that someone has marked the right body part for surgery? And who else is going to grouse to our legislators that we can’t get any info on malpractice, complaints, corporate gifts, infection rates, or whistleblowing. Medicine can be a grubby business, and pending real reform, we have to put up our own defenses.

(Columnist William A. Collins is a former state representative and a former mayor of Norwalk. )