Seeing With A Physician's Eyes

CNN reported yesterday on the upcoming edition of Time Magazine featuring a cover story entitled, "What Doctors Hate About Hospitals" .

Well there's one hospital in particular that I (as a former staff member AND twice-burned "customer") don't care for. It's why I'm in the blogosphere.

Various promos on CNN and/or Time entice the reader with lines like, "What insiders know that the rest of us need to learn." Or (better yet), "seeing healthcare through the eyes of the physician may help us find our own ways to fix the system".

Well. Yeah. Duh.

I look forward to reading the article. Because I'm wondering how lay-people are supposed to get past the veil of secrecy that surrounds nearly everything in medicine these days (from HIPAA to peer review to medical & legal privilege) in order to see the medical world as a physician sees it. Most Americans seem to be getting their medical information (and forming their expectations) from television shows like "ER" and "House" .

And "House" ain't the way it is.

I stopped watching "ER" a long time ago . . . after seeing an episode in which an infant presented to the Emergency Department critically ill . . . a consequence of a congenital heart defect called "Left Hypoplastic Heart Syndrome". If memory serves (it's been a while and this one is hazy), the child was status-post the first (or second) of several staged procedures to "correct" the extremely serious, all-too-often fatal defect. The very studly ER Pediatrician (played by George Cloney) showed up, immediately diagnosed the problem (a blocked surgical shunt if I'm remembering it right), and proceded to crack the child's chest right there in the ER to fix it. There was no pediatric cardiology consult . . . no call to the cardiothoracic surgeon . . . and nothing that remotely resembled what would happen in the real world. I don't remember if the TV baby lived or died. I think it lived.

At any rate, I was dumbfounded by what I had seen. No Pediatrician anywhere would have tried a stunt like that - and if they had, they'd be up to their eyeballs in lawyers regardless of the outcome. I wondered, did the show actually have a medical consultant and was he/she awake . . . or smoking crack? Compounding my befuddlement was a sense of outrage, as two very dear friends of mine had recently lost their newborn son to this particular heart defect . . . the seriousness and treatment of which was trivialized by a TV show.

I think George Cloney is an honorary member of the Academy of Pediatrics now.

I suppose the article in Time is a start in the right direction. But it would seem to me that if people (specifically oversight agencies or legislators & politicians) really wanted to know how doctors feel about the system . . . and about hospitals in particular . . . they would make it easier, not harder, for real doctors to share ideas and feelings and knowledge and experiences amongst themselves and with others.

Of course, if that happened, it would be harder to "feed" the system fresh meat . . . for if doctors had a way to "rate" hospitals (the way some insurance companies are now wanting to "rate" doctors) . . . younger doctors would have a better way to judge what they were getting into . . . and some hospitals would, over time, have to deal with the consequences of their (bad) reputations . . . and might find physician recruitment difficult. Some areas would likely become even more "under-served" than they already are.

So it's best to keep the "disgruntled" doctors muzzled and disconnected - called up only when the AMA needs them to "march" on Washington.

We all process the world through our own experience. The promo for this article caught my eye for that very reason. As an observation, in Asheboro, sharing what I knew about the local hospital . . . even in confidence, and with oversight agencies that asked me to share . . . got me sued for "libel". Prior to that, trying to address a problem got me fired.

So much for fixing the system by listening to an insider.