But I also know that profitability and business models are at the very heart at what is WRONG with healthcare. No matter what the problem with the system, its roots are grounded in the need to make money by someone.

This statement holds true whether we are talking about those large corporations, like pharma manufacturers, large hospitals and treatment centers, insurers, or medical device manufacturers — or individuals like doctors or yes, even patient advocates. We all need to make a buck.

And making a buck is fair! Yes — at my heart I am a capitalist. And for many aspects of life, I believe that the profit motive and fair competition are fair and work well.

But making the buck at the expense of patients, rather than to the advantage of patients, is not fair and it’s not right. Profiting by hurting a patient is wrong. Profiting while providing no benefit is wrong. Profiting by withholding the truth is wrong. Profiting through non-disclosure of a conflict of interest is wrong, too.

Unfortunately, healthcare is not about health or care. It’s about sickness and money. And conflicts of interest go to the very heart of that statement.

One of the early recognitions of this problem came from the New England Journal of Medicine which, in 1993, attempted to define such conflicts and suggested remedies for them. The conflicts cited ranged from self-referral by physicians, to gifts from drug companies to physicians to research being sponsored by those industries that stood to profit by the results.

Hundreds of medical journals followed suit. They joined the legions of organizations that have their own policies about conflicts of interest, including the Canadian Medical Association, and the American Medical Association includes policies about conflicts of interest in its code of ethics.

But it seems that there are plenty of doctors who either don’t care, aren’t paying attention, or are just plain unethical. At the very least they don’t let some little conflict of interest get in the way of making a buck.

This article in the latest edition of Slate Magazine provides too many examples, making the hairs on the back of my neck stand on end. It asks the question, and proves the point; Stealth Marketers: Are Doctors Shilling for Drug Companies on Public Radio?

Cases in point:

Mike Taibbi, a former smoker and reporter for NBC Nightly News interviewed Dr. Claudia Henschke, a professor of radiology at Weill Cornell Medical College who reported that regular lung scans could prevent 80 percent of deaths from lung cancer. Other professionals called this claim outrageous. It turns out that Dr. Henschke’s research was being subsidized by tobacco companies which had a major stake in the outcomes of her statements.

Recently, PBS radio stations aired Prozac Nation, an edition of its award-winning program, An Infinite Mind. Four prestigious mental-health experts discussed the link between antidepressants and suicide, and all four concluded that the link was blown out of proportion. (Really? Tell that to Kim Witzcak, whose husband Woody died from taking an antidepressant which had been prescribed off label for his inability to get a good night’s sleep.)

What the program failed to reveal is that all four of the experts have financial ties to Eli Lilly, the manufacturer of the antidepressant Prozac.

Examples of these conflicts of interest could go on ad nauseum. The real point here is that we patients need to be aware of them, and know when it’s appropriate to ask questions about them. Here are some examples of times we may be the victims of conflicts of interest:

1. Many doctors who work in clinical trials may be receiving referral fees for finding patients who can participate. A conflict of interest may exist if there is no benefit to you, the patient, for participating. You may still choose to participate! But you need to be asking your doctor what’s in it for him.

2. Medical device kickbacks are rampant among doctors. Need a knee replacement? Ask your doctor if he’ll be receiving any payments from the manufacturer, or payments beyond his usual fee for doing the surgery. You may still want to get your knee replaced! But you should know if one type of artificial knee is being recommended or planned for over another based on how much your doctor will make from it, and you should have the option to choose the one that’s better for you.

3. Does your doctor travel a great deal? or speak at conferences frequently? If so, he may be receiving “speakers fees” for convincing his peers that a particular drug or device is better for their patients. The manufacturers love to pay doctors to take advantage of their credibility. But if you take that through to its logical conclusion, who do you think is paying for those kickbacks? We are. And is that drug the best for us just because the doctor is making money by supporting it? Maybe not.

There are no easy answers here — just awareness, and another opportunity to be wise and savvy patients.

One has to wonder how often patients have gotten sicker, or died, because some doctor or organization was involved in a conflict of interest?

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Mind you — we aren’t talking about breast enhancement surgery. No discussion of “boob jobs” here.

We’re talking about women who have had their breasts removed to remove cancerous cells, and who simply want to have additional surgery to reclaim as much of their femininity as they think they need to feel “whole.”

(Men — if you have trouble with this — picture losing your most manly appendage to cancer. Would you want a reasonable facsimile to replace it?)

In the United States, by federal law, a woman has a right to ask for reconstruction, and, by law, her insurance must pay for it. Sort of. Even Medicare or Medicaid must pay for it. Sort of.

The problem is, like with any medical service or procedure, these companies tell the physicians and surgeons what they will pay them, without regard to what those physicians and surgeons charge.

Think of that this way: it would be like you telling your auto mechanic what you will pay for repairs on your car, without regard to what your auto mechanic charges. Sounds like a great idea, right?

But — the problem is that at a certain price, your auto mechanic would just refuse. If you didn’t offer enough money, and if someone else offered more, then your mechanic would do the work for the person who was going to pay him more. That’s his choice.

And that’s how plastic surgeons, the ones who do breast reconstruction, look at it, too. Depending on how much cancerous breast tissue needs to be removed, the reconstruction surgery can take 5 to 11 hours. On average across the US, plastic surgeons charge $9300 per breast. Medicare and Medicaid reimburse at only $600. Is it any wonder that plastic surgeons won’t take breast reconstruction cases?

Even private insurance only reimburses a maximum of 80 percent — meaning — if both a woman’s breasts need reconstruction, then it will cost her more $5000 or more (don’t forget — the surgeon’s fee is only part of the cost. She must still pay for the hospital stay, meds, and all the other aspects.)

And some plastic surgeons will not work with private insurers either. If a woman wants the additional surgery, she needs to pay out of her pocket first ($18,600!) — and hope to get reimbursed by her own insurance later.

Of course, this becomes a very easy way to divide the haves from the have-nots…. and it made me wonder what would happen if we had a national health plan. Would it solve the problem?

Yes and no.

I looked to Canada’s national health coverage to see what the situation is there for women who want reconstruction surgery. From what I can learn, all Canadian women who choose reconstruction post breast cancer surgery can have it. It costs them nothing beyond what they are already paying into the system through their taxes — BUT — they have to wait up to two years before they get their “turn.”

And I believe the Canadian “haves” — the women who prefer to have the surgery immediately — are coming to the US to pay to have it done. Which, of course, means that those American plastic surgeons don’t have time to reconstruct the breasts of the have-nots in the US. They are busy being paid in cash by our Canadian counterparts.

The answers? No easy ones. No good choices. We Americans need to ask ourselves… is it better to pay cash and have the surgery immediately? Or is it better to wait for awhile and have it taken care of for us?

Or do we even have choices at all? I know I couldn’t afford it. Can you?

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Who’s Betsy McCaughey? Dr. Betsy McCaughey is the founder, president, CEO, chief honcho of RID: Reduce Hospital Deaths. She founded her organization in 2004 in reasponse to the alarming growth in the deaths of Americans due to hospital acquired infections.

She is a health policy expert, having concentrated on health legislation during her four years as Lt. Governor of New York State during the Pataki years. And how all she wants to do is save lives by making hospitals accountable for preventing the spread of infections which kill their patients.

I was first introduced to Dr. McCaughey (which is pronounced Mick-Coy) about 1-1/2 years ago when I wrote about MRSA for the first time. I wrote about specifically because my mother-in-law had been admitted to the hospital, had undergone surgery, and contracted MRSA after her surgery. What so very much frustrated me at the time was the fact that I had provided specific instruction and information to my sister-in-law (my MinL’s caregiver and in-hospital advocate) about making sure everyone washed their hands before they touched my mother-in-law.

I wasn’t there 24/7 — so I have no idea how the infection passed on…. but I can tell you that we lost my mother-in-law six months later. She was sick, she had cancer, and that’s how her death is recorded. But who’s to say the MRSA didn’t contribute?

And that’s part of the problem. For many years, patients at risk for easily contracting these infections have been dying in hospitals. They are at risk because they have compromised immune systems, meaning they can’t fight off the germs. They are at risk because they get catheters inserted to help them pass bodily fluids, but the catheters aren’t inserted hygenically, and the infection gets into a patient’s bloodstream. They are at risk because they have open wounds, including surgical wounds, and the infection is easily introduced through those wounds, directly into the blood stream.

But here’s the problem. Because those patients are in the hospital for other reasons — not infections — when they die from infections, their death gets blamed on their original reason for hospital admission. And that means the numbers are skewed, and that means nobody really knows how many deaths are attributable to MRSA or other hospital acquired infections.

Thus the Centers for Disease Control (CDC) coverup. They are conveniently looking at only the numbers that are reported. Those numbers reflect 1.7 million infections in American patients each year, including 99,000 patient deaths.

But those statistics don’t include the people who were infected before they died, who very likely died because of the infections and not whatever else they were hospitalized for. Dr. McCaughey estimates there are at least 880,000 deaths per year from infections — that’s 900% more deaths! Her data relies on statistics reported in the American Journal of Infection Control

Why is it important to state the problem correctly? Because without stats that are big enough, too little movement toward keeping patients safer will be made. As long as “only” 99,000 people die — why change things? At least that seems to be how the CDC is looking at the problem.

The answer — what will reveal the truth — are laws aimed at transparency. That means that hospitals will be required to report all infections, including the deaths of those who are infected, no matter what the hospital wants to say that person died from. Right now 22 states have laws, or are considering laws, to force hospitals to reveal the more realistic numbers.

One other step is important as well. Hospitals need to be testing patients as they enter the hospital — before they can infect others. MRSA screening tests are easy, are inexpensive, and their results are available within just a few hours. In a study released just a few months ago, MRSA screening was shown to reduce infection rates by 50 percent.

One positive forward motion is the fact that beginning in October 2008, American hospitals will no longer be allowed to bill Medicare for any services provided to a patient who becomes infected while in the hospital. the almighty dollar will be the catalyst for recognition of the problem.

But until the CDC begins to get real, other changes will be adopted way too slowly. And more patients will die.

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But when Mom gets sick, who takes care of her?

And when Mom gets sick, who takes care of everything else that needs caretaking — because Mom is too sick to handle it?

One day a year, we recognize Mother’s Day. Year after year, Hallmark and American Greetings hang their hopes for huge income on the number of cards and other, mostly sentimental doo-dads (maybe they should be called doo-moms?) — and we buy them, wrap them, sign them, seal them, mail them or hand them over….

And that’s how we respect Mom. One day a year. Mom gets to be queen.

But what about those other 364 days of the year? Does mom get the same respect?

For too many moms — no, they don’t. Thus that cliché. Mom doesn’t get enough respect, and therefore she’s never “allowed” to be sick.

I can hear the protests now! I hear all those husbands and kids saying, “Wait! When my wife (or mother) is sick, we leave her alone! We make her soup! We try not to bother her!

And, OK. That’s a start. But here’s what I’m talking about….

When mom gets sick, who’s really taking care of her? Is anyone else taking her temperature? Does someone else drive her to the doctor, or does she drive herself? Is anyone else cleaning up the house so she won’t have to deal with it when she’s finally back on her feet? Is the laundry getting done or will it still be piled up waiting for her when she’s got an ounce of strength back?

Granted, I know that families are often more participatory than they used to be. This isn’t 1955.

But I challenge you on this Mother’s Day…. if your mom or wife gets sick during the next 12 months, whether it’s a lousy cold, or a chronic illness or even if she breaks a toe…. show her that extra effort of respect. You know the extent she’s there to take care of you, so be there for her, too! Spoil her, or just let her sleep. When she’s finally on her feet, make sure the house is cleaned up, the dog is fed, and the laundry is done.

Kids — don’t argue with your siblings! Keep things quiet and on an even keel. Do your homework, too.

The real point is to treat Mom the way you want to be treated when you get sick. With love and respect.

365 days of the year.

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As a reminder, what makes a superbug is the bacteria’s ability to overcome any medicine developed to kill it. Methicillin was developed to kill difficult, hospital acquired strains of bacteria, and it was saving lives…. until the bugs it was killing figured out how to be stronger than the methicillin.

People began getting sicker and dying, by the tens of thousands each year, because no medicine was available to help them. Still today, estimates tell us that in the US alone, 1.7 million hospital patients are acquiring infections in the hospital. They are admitted for one thing (disease, surgery) and get sicker from the infection than when they went in. Almost 100,000 of them don’t make it out alive.

Enter vancomycin — an even stronger antibiotic — and found to treat MRSA in some patients effectively. It’s the drug of last resort being given to the sickest of the MRSA and otherwise infected patients in hospitals when other antibiotics won’t work — although sometimes it’s not enough either….

But now it seems that Darwin has won out again. Doctors in Michigan report Vancomycin-resistant Staphylococcus aureus — a new superbug that has overcome the antibiotic of last resort, vancomycin. Just like humans fighting a battle in war, and winning against their enemy, this superbug has figured out how to survive the efforts of vancomycin to kill it — and is now stronger, and so far, unbeatable.

So far in Michigan, nine patients have been identified with MRSA. They are chronically ill with diabetes or kidney disease. To date, none of them have died. But their doctors fear the VRSA will make it into their blood streams which will doom them. Vancomycin was the drug of last resort, and now it’s not good enough.

What this means for all of us is that we need to be even more cautious than we’ve been to now. Superbugs will continue to get stronger and overcome whatever we humans develop to kill them. It’s a war against germs — and right now some of those germs are winning.

Become aware of the steps necessary to protect yourself from them — insisting your healthcare providers wash their hands before touching you, at the very least.

Even if you don’t have a chronic disease, you need to remember that those superbugs have only one goal — to survive longer than you do.

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I explain all that today because news a few weeks ago about what the laws in Canada will allow, or not allow regarding the legal permission for Canadian doctors to apologize to patients for mistakes they have made, forced me to think of doctors and their apologies on a much broader basis.

You see — to this point, the question about doctors apologizing for their mistakes has never really been about right and wrong. The question has been about lawsuits. No matter where in the world a doctor harmed a patient, regardless of that doctor’s intention, the problem is never about the mistake or the mistake’s medical results. No, the question becomes one of whether the doctor can be sued, and how much money the lawyers will make in the process.

Let’s consider point of view for a moment:

When a patient has been hurt by the mistakes of a doctor, or if a patient has died and the family is left to grieve, then dealing with that hurt or grief happens first. But, like suffering from any error, we also look for places to lay the blame, as if finding the right target will help us handle the suffering better. THAT’s a basic of human nature — looking to offload our pain on to someone or something else. The next step is to expect that whomever we have blamed will at least own up to it — take responsibility for causing our pain and suffering.

And so (foolishly, perhaps) we expect an apology. An apology is the evidence that the doctor is taking that responsibility, and feels remorseful. Hearing a doctor say “I’m sorry” means we can now give up some of the pain and hurt because we know that the perpetrator has now taken some of that onto his/her shoulders.

[And, as an aside, please know that when I write this, I do so from my own experience. Having suffered a heinous misdiagnosis, and then, years later, having benefited from an apology. This is REAL personal, and very few people understand it as well as I do.]

From the doctor’s point of view — we can only imagine how difficult the situation is for them, because, until the past few years, doctors were taught never to apologize. Not only could they not apologize, they weren’t even allowed to disclose an error had been made! That was true in the US, Canada and other corners of the world. And yes, you know why. They could not apologize because that would give the patient or the patient’s family the evidence they needed to prove malpractice in a court of law. the policy even had a name, “Shut Up and Fight.”

Now, we know of course, for some doctors that was OK. We all know doctors with egos so large that there’s no room to admit they’ve made a mistake. THEY would never make a mistake! The problem was something the patient did wrong! Not only that, they don’t report other doctors’ mistakes either… they cover up for their colleagues, perhaps believing “there but for the grace of God…”

But for many doctors, and I believe the great majority of them, not being able to apologize was just as problematic for them as it was for the patient or his/her family. How do you sleep at night when you know you’ve killed someone, or caused them a lifetime of medical problems or debilitation? Being able to apologize would help them conquer some of their grief, too….

Then, just a few years ago, the University of Michigan did an informal study within its own academic hospital system, letting its doctors apologize for adverse events, and arrived at a startling (to them) result. The amount of money asked for in lawsuits dropped to one-third what it had been before.

Fast-forward — it’s six years later and — finally — doctors are being encouraged to apologize for their mistakes. On both sides of the US –Canada border. Mind you — it’s not for the cathartic or value-driven reasons — but for the money. More apologies = fewer lawsuits.

But in this case, it’s win-win for patients, doctors and the hospitals or other organizations involved in mistakes. Patients get the relief that comes from off-loading some of their pain to the apology. Doctors and others involved get the relief that comes from addressing their value systems and their need to offload some of their guilt by apologizing.

Now the laws are following the studies. Many states in the US, and now several provinces in Canada are allowing doctors to apologize without fear that their apologies will affect lawsuit outcomes. And yes, it seems that fewer lawsuits are being filed.

So yes. Everyone wins when a doctor is allowed to apologize. Well, except for the lawyers. Fewer lawsuits would mean less work for them, I suppose.

Well. OK. Maybe that means the ability of doctors to apologize is even sweeter?

Learn more about doctors and apologies for adverse events at Sorry Works.

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But you would be wrong. Counterfeit drugs may be found in your own medicine cabinet — and you have no way of knowing they are counterfeit.

Surprised? I was too — and because I too often have to be so cynical in my work — I never should have been so surprised. Why? Because so much of healthcare is about money. And counterfeiting is all about money — making it for the perpetrators, and saving it for those who have to pay, whether that’s a pharmacy or a health insurer. And who’s money and lives is it costing? Ours, because we are the patients.

I had heard of counterfeit drugs — but like so many, I pretty much dismissed any negative effect on my life. But it turns out that hundreds of thousands of us have taken them without knowing it, and across the globe, thousands of people have died. Yes. Died.

Drugs become counterfeit in a number of ways. They may be manufactured intentionally to be fake, often in other countries, then imported into the legal American or Canadian drug supplies. We know this happened recently with Heparin — and patients died.

And, too, you may be one of the thousands of patients who have purchased counterfeit Lipitor or been given Procrit after chemo…

Or, they may be adulterated after they were manufactured. Katherine Eban, author of Dangerous Doses, describes this phenomenon in detail, and it’s frightening. In particular, any liquid medicine that will be infused (think chemo) or swallowed can be watered down, or even replaced, then sold back into the drug supply. Unsuspecting patients, plus their doctors and pharmacists, may not know the drug has been watered down. Yes, patients die.

Sometimes they are simply stolen from distributor’s warehouses. Then the problem becomes one of storage. Drugs that are meant to be kept in dark places get stored in sunny locations, or drugs that are meant to be kept cold get stored in hot buildings… and then, of course, they are sold back into the legal drug supply. It’s like keeping raw chicken on a warm kitchen counter for days or weeks or even months. Ugh.

And don’t even get me started on what the FDA is ignoring about all this… or what the legal pharm manufacturers and distributors are doing to make sure their backsides are covered, while patients continue to be harmed and die….

A new website has been put online to help us track the latest in counterfeit drug news, so you may want to take a look and check back on occasion, www.NoToFakes.com. There is general information about counterfeiting of all kinds of products. Pharmaceutical counterfeiting is only a corner of that dark world… but perhaps the most deadly.

• Learn more about counterfeit drugs at About.com.
  
• Read this interview with Katherine Eban, following up on her book, Dangerous Doses
• Learn some ways to protect yourself from unwittingly being given counterfeit drugs, too.

This kind of topic always makes me wonder what horror anyone can think of next. I’m just not diabolical enough, I guess.

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In fact, healthcare can be dangerous, sometimes randomly through mistakes and missteps. It can be dangerous for what is ignored or through mere laziness. Other times it’s dangerous because of access questions — if you don’t have the right insurance, or if you are lacking insurance, you don’t have the same options as others.

I do not believe any provider or payer ever sets out to make it intentionally dangerous, but then, the road to heaven, etc etc….

Knowing how dangerous healthcare can be, a whole new “industry” has begun to build — an industry of professionals who provide tools and advice to patients to help them stay as safe as they can. That’s my world now — an advisor to those who may be unsuspecting, not even questioning whether their healthcare will help them, not understanding that in fact, it might be quite dangerous.

Among the aspects to my work is the fact that I read and research constantly. The bulk of my day is spent learning what’s going on in the world of healthcare. What’s out there that is dangerous? What new dangers have evolved? What is being done to keep patients safe? What can I recommend to patients to help them keep themselves safe?

One phenomenon I’ve witnessed in the past four years is a transition within providers themselves: from either ignoring or denying safety problems exist, to not only understanding them, but now jumping on the bandwagon to provide tools to patients to help them stay safe.

I have mixed feelings — very mixed. While I very much appreciate the fact that providers aren’t in so much denial as they used to be, and are willing to observe problems and suggest ways to alleviate them, I also feel it’s a little like asking the fox to explain to the chickens how they can keep themselves from being eaten…

And yet…. I appreciate the fact that they ARE trying to keep us patients from being ‘eaten.” I do understand that it’s not realistic to ask them to change their “diet” to begin with.

OK — so with that admission — this article arrived in my Inbox this week. From RNCentral — a website created for nurses and thos who would choose nursing as a career. The article is called 25 Tips to Protect Yourself from Medical Errors.

It’s good. There’s plenty of good advice in it. I’m very happy the link was sent to me so I can share it with you.

But I ask you — does my fox and chickens metaphor strike anyone else as appropriate too? For example, why are the professionals who are supposed to be the ones to KNOW to wash their hands to prevent infection, telling us it’s our responsibility to make sure they do?

Read it. You’ll learn from it. And yes, much of the advice is geared to patients to handle themselves when no provider is around to help, or for interface with professionals. These are patient responsibilities and have nothing to do with foxes, henhouses, or chickens….

::sigh:: I hate it when cynicism plays a role in well-intentioned advice. Welcome to my world….

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If you aren’t familiar with the Merck and Vioxx scandal, let me bring you up to date.

Vioxx was a drug released to the marketplace in 1999. It was cheered loudly by those who suffer pain from arthritis or other chronic pain-producing maladies. My mother, husband and daughter were among the millions of people who were beneficiaries of its relief, and swore by the drug.

… until a few years later when people with heart problems who were also taking Vioxx began to die. Enough of them died that in a very public spectacle (as it should have been), Vioxx was pulled off the market to save lives.

Pulling it from the market most certainly saved lives. However (and this is a big however) it also meant that all those people who had finally found relief from their pain were left without that relief. Today — years later — my daughter and husband have never found anything that relieves their pain as well.

As you can imagine, many questions arose. How could this drug go to market if it was unsafe? Why did the FDA approve such a drug?

The quick answer to those questions is — money. Merck made billions from the sale of Vioxx before their scam was uncovered. The FDA makes their big money from the big pharma manufacturers looking for approval. (The last figures I saw put the FDA’s budget at 51% supplied by approval seekers.)

A year or so later, it was discovered that Merck knew all about the problems Vioxx caused for people with heart conditions. But they didn’t reveal those particular studies to the FDA when they applied for approval. That decision cost too many people their lives — and now it has cost Merck money, too.

Since then, huge lawsuits have been won by patients, lost by Merck. Families of those who died, and those who were harmed, will now begin collecting billions from Merck (as will the lawyers, don’t forget.) In no way does that money make up for the loss of a loved one, but it certainly sends the message that scamming the public over drugs is unacceptable.

So now it’s time to learn how Merck pulled off its scam, and how they fooled the FDA, which brings us back to today’s report. It turns out that Merck hired medical writers — not the researchers and not the doctors — to write the reports that went to the FDA. Then they got prominent doctors and researchers to add their names to the submission. It’s called ghostwriting.

This means that Merck not only scammed and manipulated doctors and patients and the FDA, but it manipulated the medical journals in which the supportive research was published. Evidently nothing stands in the way of that profit. But then, of course, empowered patients already know that.

As you know, I like to bottom line these things to help patients. I’m fully aware that one voice can’t make much of a dent in heinous, profit-making activities. (Don’t get me wrong — I am not at all against profit. On the contrary, I own my own consulting business. I believe in capitalism! I just don’t believe in profit based on detriment to others.)

For individual patients, there are a few things we can do to protect ourselves from these kinds of later-discovered problems. We don’t want to be victims of drugs that have been approved by lies and deception. So here are some suggestions:

1. If your doctor prescribes a drug new to you ask if there are reports of any problems with it. You’ll want to make yourself very familiar with any drug prescribed — you can do that in a number of places including the FDA Orange Book, and you’ll want to do that before you take that drug.

2. Ask your doctor, or the pharmacist, how long the drug has been on the market. If it has been around less than two years, ask if there is an alternative. You don’t want to be one of the guinea pigs taking that drug if you can avoid it. Once the drug has been around for two years or more, it has a track record that you can review to decide — with your doctor — if it’s the drug for you.

3. If you invest in stocks, then consider NOT investing in companies like Merck and others who are willing to put lives at risk by adding dangerous drugs to the marketplace. Merck investors who owned the stock when the Vioxx scandal was exposed took BIG hits to their stock. Why feed those people who are so willing to let others die?

The shame about Vioxx is that I believe Merck could have done very well with the drug. Had it not covered up the heart-attack inducing problems, had it come clean about those problems to begin with and recommended the drug for people in pain who did not have contraindications because of heart problems, then those millions of other people (including my mom, daughter and husband) would still be finding relief from their pain today.

It makes me think fines and lost lawsuits just aren’t enough. Why isn’t anyone talking about prison time for the perpetrators?

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And now, a new addition to the website will make this website even more valuable to those of us who do our due diligence. I love this!

Patients are asked a series of survey questions as they are discharged. CMS will give the survey to 300 patients per hospital, per calendar quarter. Only short-term, acute care, non-specialty hospitals participate (not specialty or one-day outpatient type hospitals.)

Those questions are these:

1. How often did nurses treat you with courtesy and respect?
2. How often did nurses listen carefully to you?
3. How often did nurses explain things in a way you could understand?
4. How often did doctors treat you with courtesy and respect?
5. How often did doctors listen carefully to you?
6. How often did doctors explain things in a way you could understand?
7. After you pressed the call button, how often did you get help as soon as you wanted it?
8. How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted?
9. How often was your pain well controlled?
10. How often did the hospital staff do everything they could to help you with your pain?
11. Before giving you any new medicine, how often did the hospital staff tell you what the medicine was for?
12. Before giving you any new medicine, how often did the hospital staff describe possible side effects in a way you could understand?
13. How often were your room and bathroom kept clean?
14. How often was the area around your room quiet at night?
15. Did hospital staff talk with you about whether you would have the help you needed when you left the hospital?
16. Did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
17. Using any number from 0 to 10 (0 is the worst hospital possible and 10 is the best hospital possible) what number would you use to rate this hospital during your stay?
18. Would you recommend this hospital to your family and friends?

CMS then uses the results as a part of its hospital compare program, allowing patients to make determinations about which hospital will tend not just to their surgery and care needs, but how well they are treated by the staff at the hospital.

Why do I love this? Let me count the ways!

There is not a hospital in this country that doesn’t take care of Medicare and Medicaid patients. That means all hospitals in the US will be listed, and the experience patients have had with them will be recorded.

The information will be objective. Since patients are being surveyed randomly at the hospital, as they are being discharged, the rankings won’t be skewed like the rankings and input we typically find online. The online ranking systems haven’t found a good way to be objective yet. Disgruntled patients and doctor’s staffs can skew those results in one direction or another.

And yes — I do see some shortcomings. Two things: First, I think they would do well to survey patients’ loved ones, their caregivers, in addition to the patients themselves. Often its the caregiver who knows far more about how that patient was treated.

And second — there is one very important population not being surveyed at all. That’s the person who doesn’t get discharged. We have to imagine that many patients who acquire MRSA or other infections, for example, aren’t making it out alive. Their opinions are important, too. Perhaps the idea of surveying caregivers would make sure the deceased patient’s opinions are represented to.

Are you facing a hospital stay? Check out the CMS Hospital Compare website. And if your doctor is affiliated with the wrong hospital? Then ask him or her what your options are. You need the complete package, and this is one more tool to help you get it.

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