New York Medical Malpractice

Philadelphia Bulletin reports:

For example, he says that 90 percent of all hysterectomies don’t meet clinical guidelines, the best evidence of quality medicine. This means that about 90 percent may be unnecessary. He says that 50 percent of Caesarian sections, 50 percent of prostate removals and 33 percent of heart bypass surgeries are unnecessary. In addition, Mr. Inlander and other medical authorities say that there are many other operations that produce high rates of unnecessary surgery, such as those for removal of cataracts. (See my “Shopper’s Guide to Cataract Surgery” at thedenenbergreport.org.)

Mr. Inlander says the medical profession is in denial and will not admit the significance of the issue. He also says the medical profession will not disclose the facts on unnecessary surgery and other health-care misadventures. Change will come about by consumers demanding information and reform, and that takes strong and sustained pressure.

The big money is in surgery, and the more invasive, the more profitable. You can’t make much telling someone they don’t need surgery, but the sky is the limit when it comes to surgery. That’s where the big bucks are, and that’s one of the great drivers of the entire health delivery system. The big bucks are not in telling patients to exercise, handle stress, eat healthy foods and make all the lifestyle changes that are the key to good health. The big money is in the high-tech, high-cost, high-risk and highly invasive. Surgery is the perfect example of that.

Herb Denenberg, is a professor at the Wharton School, is a longtime Philadelphia journalist and consumer advocate. He is also a member of the Institute of Medicine of the National Academy of Sciences. His column appears daily in The Bulletin.

This fascinating portrait of a Brooklyn, N.Y., hospital is about much more than white coats and beeping consoles – it’s 21st-century America in a microcosm.

A new book, Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids, captures the whole spectrum of factors that determine what kind of medical care people receive in this country.

Respect – or rather, the lack of it – may be the single most persistent theme in “Hospital.” It’s hard to say that respect matters more to the people at Maimonides than money, because in this market economy, money is increasingly the only way we measure worth. A former chair of orthopedics says that he fell out with Brier because he wanted to give priority in the waiting rooms to patients who paid out of pocket or who had full insurance: “People who pay for health care don’t want to sit in a room with fifty people. They want to be seen in a timely manner. I think that’s very reasonable.”

One key risk area for medical malpractice is breast cancer.American Cancer Society suggests specific warning signs:

The most common sign of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but some cancers are tender, soft, and rounded. For this reason, it is important that any new breast mass or lump be checked by a health care professional experienced in diagnosing breast diseases.

Other possible signs of breast cancer include:

* swelling of all or part of a breast (even if no distinct lump is felt)
* skin irritation or dimpling
* breast or nipple pain
* nipple retraction (turning inward)
* redness, scaliness, or thickening of the nipple or breast skin
* a discharge other than breast milk

Sometimes a breast cancer can spread to underarm lymph nodes and cause a lump or swelling there, even before the original tumor in the breast tissue is large enough to be felt.

The Five Towns Jewish Times had an excellent article that outlined how to protect yourself during your hospital stay.

Upon admission, get yourself a copy of the Patients’ Bill of Rights.

This documents all the rights to which patients are entitled, including the right to be kept apprised of medical care and the right to a safe, clean environment.

Ask questions

It is not unusual for medical staff to be too busy to speak to patients. If you feel someone is not giving you the answers you request, ask to speak to someone else (a supervisor or patient advocate).

Be aware

If you know what medications you are supposed to be on and a nurse comes in offering something “new,” have them double-check your chart just to make sure you are getting the correct medication and dosage.

Stay vigilant

This may mean being perceived as a “pain,” but keep on top of your own care; medications, treatments, and tests all create the potential for errors.

Don’t accept things unquestioningly

Remember, you always have the right to ask for a second opinion and even a third if you do not agree with the answers provided. Sometimes the worst errors occur when one merely parrots what his predecessor says.