Tuesday, November 16, 2010

How It's Spun

I read this morning's New York Times article entitled "Mistakes Chronicled on Medicare Patients" and wondered what would this article be like if it was spun toward the positive, rather than the negative?

So I decided to write a different story based on the positive aspects of the government's data, rather than the former article's negative spin, just so we might consider our quality overlords' agenda:
US Hospitals Remarkable Achievements

Six out of every seven hospitalized patients over the age of sixty five receive remarkable care, according to a new study from the Office of Inspector General for the Department of Health and Human Services. The study said that despite the aging of the general population, their multiple medical problems, the increased oversight and regulatory burdens on today’s physicians, the overwhelming majority of patients who enter today’s hospitals receive exceptional care and can be expected to recover fully.

While there remains areas that we can improve clinically, we should not underestimate the remarkable achievements in outcomes of our patients with cancer, heart failure, pneumonia, and acute myocardial infarctions. “These common conditions occur is patients who are the sickest of the sick,” said Dr. Mortimer T Schnerd, study coordinator. “To achieve such progress in the fight against these diseases is remarkable despite the limitations of the imposed governmental quality measures. Patients today are living longer than ever before and typically present with co-morbidities during their hospital stay. All too often it seems the government quality oversight bodies are not happy with our successes. The seem to feel it's better to continue to expend innumerable resources to assure the unrealistic goal of immortality,” said Dr. Schnerd. “But then again, how else will they rationalize reduced payments for our excellent care to more and more people?”
Funny how we never hear how much money we expend on new hires and the total cost to hospitals for implementing quality measures as a counterpoint to the cost of errors that occur in today's hospitals (ie, the "value" to our health system that these measures represent). Recall that Mr. Berwick, our current head of the Center for Medicare and Medicaid Services, managed to skim $1,404,776 in retirement benefits in just seven short years above and beyond his annual salary from his Institute for Healthcare Improvement in 2008 - a quality managment organization. I dare say that's a sizeable amount for most mortal humans.

No, dear doctor, please don't mention this. That's too unseemly and isn't said in the name of quality care!

But to not mention the cost of implementing and maintaining quality measures dodges an important issue. Where should we draw the line in paying for quality measurement rather than spending that money on the frontline caregivers themselves?



Keith said...

Dr. Berwick makes what all our great and powerful leaders make for their amazing abilities and talents (regardless of whether their performance is measurably good or not).

What we truly need is quality control for hospital, corporate, and other non profit leaders to benchmark their jobs and provide them with the proper incentives.
Maybe you could devise a set of parameters on which we will judge all corporate executives, and they will be required to enter the data in their shiney new corporate software packages that they will all be mandated to have, or suffer financial penalties for not doing so.

Anonymous said...

Dr. Wes,

Now how about using your same talents to do a positive spin on health care reform. THAT would be a pleasant change of pace!

Anonymous said...

"The most frequent problems classified as adverse events, it said, were those related to medication, like excessive bleeding, followed by those related to patient care, like intravenous fluid overload"

What in the name of god? Now "IV fluid overload" is an adverse event? To quote a salty old ICU attending, "nobody ever died of peripheral edema but they've sure died of hypovolemia". And somehow I doubt more Swans to accurately gauge resuscitation is this crew's demand either.

This reeks of more attempts to get a paper published in JAMA/get more micromanaging power through Medicare by inflating numbers. Over TEN QUADRILLION adverse events in US hospitals yearly!

Anonymous said...

I'm one of the patients that had an adverse event. While recuperating in an assisted care facility (paid by Medicare) I was overdosed on warfarin - INR was at 9. I was ready to be discharged but had to stay 4 more days before my levels got down to the acceptable levels. They had the testing ability right there, but the doc orders didn't call for it. What a waste of money!