Entries for December 2007

Paul Levy, head of Beth Israel Deaconess Medical Center in Boston, enjoys stirring up a fuss on his blog, Running a Hospital. He loves tossing out challenges—twisting people's heads around a little so they have to regard a question from a different angle.

Now he has proposed that U.S. News give extra credit in the "America's Best Hospitals" rankings to hospitals that let everybody see how well or badly they're doing at keeping patients safe. Compared with other hospitals, for example, what is the rate of infections related to surgery and central venous lines? Thanks a lot, Paul. I can't wait for the outraged calls and E-mails from hospitals if we take you up on it.

I've said many times, only partly joking, that every doctor's training should include a few days in the hospital being treated exactly like any other patient. (After that, a day or two every 10 years should be a continuing education requirement.) There's no other way to taste the fear that comes from half-overheard mumbling just outside your door, the frustration from pressing a call button that might as well be disconnected, the fury from being patronized ("And how are we today?"), and the passivity that comes from being treated as a condition and not a person.

Ask and ye shall receive. Not mandatory hospital stays for budding M.D.'s—those are still on hold. But a new book by psychiatrist Robert Klitzman, When Doctors Become Patients, burrows inside the heads of physicians who have been seriously ill.

Even though everybody gripes about healthcare, physicians rank just behind firefighters in "most-admired" polls. A new survey of more than 3,500 doctors could chip away part of that pedestal we put them on, however. The results, to be published tomorrow in the Annals of Internal Medicine, reveal a disconnect between how much the 1,662 physicians who responded said they subscribe to generally recognized professional standards of competence and ethical behavior on the one hand and how they reported they act on the other.

It would be nice if the magic (if expensive) solution to dangerous errors in hospitals were largely a matter of bringing in technology like electronic medical records and bar-code readers. But, as an entry by a nursing consultant on a patient safety listserv run by the National Patient Safety Foundation reminded me, adding seemingly fail-safe technology is no guarantee that harried people will use it properly. Take, for example, how medications are distributed to patients.