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“Adverse events”

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Occasionally I get urges.

Today I have one which will see me sink my critical yet professionally unqualified commoner's boot into the medical profession.

I acknowledge that the vast majority of doctors do not lack compassion, competence or dedication, yet their services (despite Australia's generous health care rebate system) are increasingly unaffordable to many of us.
 
The "Doctor Industry" however, still insists upon retaining it's unethical and incestuous business relationships with pharmacists, pathologists and pharmaceutical big business.

In coming years because of their unaffordability not only to us as individuals, but also to the nation as a whole, they will be forced to take a long hard look at themselves.
Either that or the Government will probably need to do it for them.

The concept of "elective surgery" is not something that I understand.
 
I will never "elect" to have someone stick a knife into me if there are softer alternative treatments available, or modifications which I can make to my lifestyle to alleviate a problem, or preferably prevent it from occurring in the first place.

Last year Australian Health officials were unable to deny the claims of an insider that there were "more than 10 jumbo jets-full of adverse events in Australian hospitals each year."

For "adverse events" please read "unnecessary deaths".

The whistleblower also suggested that we should never schedule surgery for January or February for this is the time of year when new anaesthetists and doctors were most "unfamiliar with equipment".

Even proponents of elective surgery admit that whilst such procedures can bring about great improvement in health, they may also result in disability and death, especially in weaker patients.

There is consistent evidence to suggest that when unnecessary surgical interventions cease, the overall death rate in communities decreases.
Such was the case when doctors went on strike in Israel in 1983, then again in 2000, Finland in 1984 and for a period in Toronto during 2003 when all elective surgery was cancelled at 4 hospitals because of the SARS epidemic.

Until now, doctors seem to have been afforded immunity to prosecution for surgical ineptitude, because of their long entrenched powers of influence within successive Governments.

For the first time, at least in my memory, a doctor is now facing the courts in Australia charged with killing people by surgical malpractice.  He was eventually extradited to Australia after hiding out under the protective skirts of America's medical fraternity and legal system for some years.

I hope that a satisfactory precedent will be set with this trial.

For far too long doctors have remained unaccountable for their mistakes, and accordingly behaved with an aloofness, arrogance and air of "untouchability" which is no longer appropriate or acceptable.
 

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About GOF

"Life is like a sewer. What you get out of it, depends upon what you put into it." (Tom Lehrer)

28 responses »

  1. So true. I have friends that have suffered at the hands of surgeons that they later found out had had many lawsuits filed but were able to win in court every time. It should not be that way. I am fortunate that, for the most part, we have been able to find good and compassionate doctors. It took some looking. I am on my third internist, my third pulmonologist, my second infectious disease doctor. But, I have a very good team now. I really liked the pulmonologist at Duke and she is calling at 12:30 Monday. I am interested to hear what she has to say. She will be working with my doctors here so that I don't have to make that very long drive over and over.

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  2. I know an electrical contractor who has left strict instructions with his wife that, even if work is quiet, she is to tell any doctor requesting his services that he is too busy. Too many bad experiences with "bombastic bastards" in his words.

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  3. I had to have my gall bladder removed several years ago, which necessitated my taking off work. A co-worker asked me if it was elective surgery. I pretty much answered the way you did above – "I'm not going to 'elect' to have anybody slice me open!"It stands to reason that fewer people would die with a moratorium on 'elective' surgeries in place. People die from "simple" procedures everyday.

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  4. The hospital I work in (I am in the lab, running diagnostic tests on all kinds of bodily fluids) is constantly trying to "save money". I couldn't tell you how many millions of dollars the top executives of the hospital get for salaries, but I do know (from talking to many department people throughout the hospital) that the Anesthesiology Assistants have been laid off. The "Contract" anesthesiologists and Nurse Anesthetists have been told that they have to maintain and clean all of the equipment that has to do with anesthesiology. They have refused. Ok…..to me this means that respirators, tubing, gas valves…..anything to do with keeping a patient safely asleep will be at risk of not working or passing on infections to other patients. I sent outraged emails to the execs of our "system". How freaking much is saving money going to come before patient safely? I am afraid the answer to that is "always".

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  5. I have had to have surgery three different times in my life and all three times, something went wrong. All three times, I almost died from someone's mistakes. I'm sure I could have sued, but I was too happy to be alive and out of the hospital. That doesn't include the many times I have talked to other people about problems they have had. I can deal with doctors not being perfect. I realize they are human and they are going to make mistakes eventually. What I can't deal with today is the outrageous prices of everything. I am one of those thousands of people without insurance and you are definitely left out in the cold. While the good doctor may seem caring and compassionate about you, his true care and compassion is for his pocket. I've never heard a story where someone said, "Hey, this doctor really cared about me. He knew I didn't have the money and he took care of me anyway." They shove you out the door and that's it.

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  6. I am sorry that you have had these bad medical experiences Freedom.I am sure it should not be this way, but as medicine is not my field of expertise I am at a loss to make suggestions as to how the system should be improved.My hope is for you at least that your new Pulmanologist at Duke will provide some caring professional advice to help in managing or curing your illness.

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  7. Too many bad experiences with "bombastic bastards" in his words. I think I'd like your electrical contractor friend Snowy. 🙂

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  8. "I'm not going to 'elect' to have anybody slice me open!"I'm presuming your gall bladder removal was not "elective" in that to NOT do it could have been life threatening……similar to appendectomies."It stands to reason that fewer people would die with a moratorium on
    'elective' surgeries"The doctors response to this is that, while fewer people died while the doctors were on strike, the patients' standard of life was poorer without the surgery and they just lingered on a little longer before they eventually died.

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  9. Thank you Lauri for your somewhat frightening story. I have a cousin who is a highly qualified nurse who left the hospital system to work in a geriatric unit.She also tells similar stories to yours.Her primary frustration was that the cost of drugs consumed so much of the hospital budget that there was little left for the essential staff and equipment to run the place.

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  10. When I wrote this piece I did not expect to receive much in the way of comment. I am sorry that my Vox neighbors have experienced these things first hand.Even with our relatively good health care system, it is only free if you go to a hospital or one of the few "bulk billing" medical centres which send their fixed-fee accounts directly to the Government. The remaining doctors charge up to, or more than double the recommended fee (in our case $60 for what might in effect be only a 5 minute consultation for a simple ailment.)While the good doctor may seem caring and compassionate about you, his
    true care and compassion is for his pocket.Well said.The only general practitioners I consistently admire are those who choose to give their time and skills to disadvantaged people….eg Doctors Without Borders…….oh yes, and while I feel like giving out compliments, there are quite a lot of doctors who choose to live and work in Australia's outback….they deserve a very big pat on the back for the often unpaid work they do in difficult situations.

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  11. Thanks GOF. We have some doctors that go and do charity work. But those aren't the ones that are in the phone book when you need to go to the doctor. When people loose everything they own because they had a heart attack, well, it causes them to have another heart attack. It shouldn't cost you your entire life savings to go to the hospital. It also shouldn't cost you a weeks worth of pay for insurance, or in the case of people on a fixed income, it shouldn't cost you your entire monthly check. I am especially vulnerable because I am in an age bracket that is basically forgotten. Right now, I am laid off from a job. I've always worked and paid my own way. I didn't do anything to cause myself to be laid off, but here I am. I am on unemployment which nets me $170.00 a week. Not much to live on in this day and time. I am lucky enough to have a home that is paid for but I have utilities and food to pay for and I have to put gas in my car because I do go to school in hopes of improving my chances to get another job. I don't have any money left at the end of the week. Because I don't have any children at home in my care, and I am not old enough to collect Social Security, I am out in the cold. I am not eligible for any assistance that is offered to many other people. If I had a major illness right now, I would be sunk. I would loose my home and that would be that. The "Good Doctors" wouldn't care that they were taking a little old ladies home away from her. I've had people say to me, "Well, I can't believe you don't have health insurance!" Well, believe it. You come home with me and show me the math where I can afford health insurance for myself at my age and I'll buy it.I also have dental work that needs to be done. I can't afford to do anything about that either. I have had a tooth bothering me for a while now. I would really love to get it fixed, but it costs about 6 or 7 hundred dollars for a root canal and 6 or 7 more for a crown. So I was just going to get it pulled even though I don't want to. It's 300 just to pull it. That's two weeks of unemployment. And do you think when I called about that and said, my tooth really hurts and I can't afford that, that they said, oh we're really sorry, come on in and lets see what we can do to help you? No way. They said sorry, that's our prices. They said oh, well if you can't afford that, you can apply for this medical credit card to pay for it. Well, let me see…you won't extend me credit to have the procedure done, but you think a credit card company is going to give me credit with me on unemployment. Smart thinking. They say sorry and they hang up. I live every day with the fear that something could happen that I couldn't afford to fix. I'm sorry but this is a very real and very upsetting subject for me. I could go on and on about it, but it's like talking politics. It's a waste of breath. You aren't going to change anything because it is what it is. What's going to happen when they force me to buy insurance? Lets see…should I quit school so I can use my gas money for it? Should I turn the electricity off and use that money? I already don't have cable, but I do have internet so even though I need that for school and to look for a job, maybe I'll turn that off and use that money…maybe I'll just stop eating and use that money for it…very very frustrating! Sorry.

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  12. That is a really distressing situation for you Ladywise. I can only
    think that stories like yours drove your President to put so much effort into getting health reforms passed. I don't follow your politics (or ours either) very closely but I hope changes are made very soon that will enable you to access affordable health care.If we can get ourselves to a public hospital in Australia all treatment is free….although waiting times can be long.The only weak link is dental care. In theory hospitals have a dentistry department for low income earners but in reality they have trouble luring dentists away from lucrative private practise to staff the clinics, and public dentists can often be booked out for 2 or 3 years ahead.Like you, we find dental treatment too expensive and we only go when we are in excruciating pain, and often choose extraction ($120) rather than root canal treatment ($800+) or crowns ($2000+)I really hope the reforms make a great difference for you.

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  13. Thank you GOF. I hope so too. I didn't mean to unload on your post, but it is a very frustrating subject for me, one I normally avoid discussing. However, every now and then, it seems somewhat appropriate, as was this case.

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  14. You are welcome to unload here at any time on any subject.It is all a learning experience for me too.Take care.

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  15. Nice one GOF.A nice read and lots of good stories from the comments too.I'm trusting my memory here (dangerous I know) but I seem to recall that breast cancer survival rates improved after full masectomys fell out of favour. As always stats can say what you want them to but I wouldn't be shocked to discover a procedure was not as effective as first thought.Liz is waiting for Elective Surgery on her knee. It's a quality of life issue which will make her more mobile but here is the thing that bugged me.The surgeon said the new knee will last 10 years and then you will need a new one. When I asked won't the advances in technology mean in 10 years time things will last longer? His reply was knees are made by Businesses not Governments. A Government body would keep improving the product while the business is happy with the bottom line.Government being involved in Health seems to bug some folk, especially Americans, but it has its advantages. I prefer my CSIRO without the business focus thankyou very much.

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  16. Oh fantastic, they sent him here? LOL, he'll blend right in. Seriously though, this is a great post and it's nice to see you took an analytical approach with studies and all that. Now I'm ticked off that America is flooded with elective surgeries. It's so disrespectful to those who need real medical care!
    Interesting you mentioned the fraternity element – after widespread (media) alerts about hospitals making zillions of fatal blunders and many people catching infections from hosptials, people overwhelming looked to how interns and new doctors are kept on 48 or more hour shifts with no chance to sleep.
    Personally I think it's a fraternity atmosphere, one big party for some. Meanwhile nurses are picking up the slack, some of them, sorry to say, have very bad attitudes and don't even bother to wash their hands. Patients have witnessed this. Not to badmouth nurses, my sister is one, and many are heroes in my eyes. But being short staffed that makes a huge difference.
    I've seen this stuff firsthand, fortunately I've never been hospitalized but I had a friend who caught an infection after an operation, it turned out the hospital was under investigation for 2 other patients who caught the same infection that week. Really freaky.
    I'm sure Australia's not perfect but I can assure you, from where I stand it looks like Australia's government cares about a thousand times more than anyone around here does.
    Excellent post.

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  17. Isn't dental care outrageously expensive? And most plans don't even cover it, last year I paid $500 for a dental for my cat. Mine, forget it, my dentist emails me every week saying I need something else done, usually $374 each time I show up to the place. My sympathies, it's awful I know.

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  18. Thanks Emmi. It really is frustrating!

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  19. Ladywise, I am so sorry. I know that must be very stressful. I have been thinking about you and I am sorry about the situation you find yourself in! Love you!!

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  20. Thank you, GOF. I am hopeful of that as well. I had a good talk on the phone with my doctor at Duke today and I think she is on the right track to figure out what my real diagnoses is. Hopefully we can then get a more successful treatment plan in place.

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  21. I can TOTALLY believe he was hiding in the US. His level of care is the given norm around here.

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  22. Thanks Peter for your contribution….I have also seen figures which suggest that the long term survival rate of breast cancer patients has not improved as much as the spin doctors would have us believe. I share your dismay that the CSIRO is no longer the organisation which it once was.Hope Liz's operation goes well. A friend of ours had a new hip installed…they said it would need to be replaced after 15 years……it is now 20 years and it still does not need replacing.

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  23. Thanks Emmi,Oh fantastic, they sent him here? LOL,He sneaked off to the US, but we got him back eventually….the trial is still in progress.I was very interested in your comments about nurses…..I would hope also that the majority of them are conscientious and caring…..I suspect the time will come in the future when nurses will be allowed to perform many of the duties now restricted unnecessarily to doctors. The doc's fraternity will whine and cry and probably take all their toys back home for a while like spoiled little brats when that change is legislated.Let's hope Obama's new health care reforms make a real difference for you.

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  24. I can TOTALLY believe he was hiding in the US. His level of care is the given norm around here. He apparently had a tarnished reputation in the US before we allowed him to come here and leave an additional trail of carnage.

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  25. I guess I have been lucky in the hands of doctors I've seen here as I've only had positive experiences (a couple of surgeries and my recent ambulance and emergency room visit). But my primary care doctor (GP equivalent) is so busy that appointments are so far in the future that I think I will be better or dead by then!

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  26. I guess I have been lucky in the hands of doctors I've seen here We have also been fortunate to receive competent treatment…..it's just the increasing cost of GP's and waiting times in hospitals which gives us concern for the future.

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  27. You mentioned Doctors Without Borders – my doctor is a member. He's a real gem. He runs the clinic where I'm treated. There's a sign in the waiting room: "No one will be denied vaccinations due to their inability to pay". He also pracitces complementary medicine, it's saved me a fortune to take fish oil capsules for my asthma instead of having an expensive inhaler (I have one though, just in case – he gave one to me for free).
    I also have a pharmacist who uses his own discount card for people who come in with no insurance.

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  28. It's like a breath of fresh air to read good stories like yours Emmi.
    Whenever I see the work of Doctors without Borders it renews my faith in
    human nature.

    Your doctor sounds like someone special. Also an unusual pharmacist
    too. Financially disadvantaged people here get a special card which
    enables them to get medicines at virtually no cost. We should be very
    thankful.

    Really happy the fish oil works for your asthma. Are you able to
    teaspoon cod liver oil directly (cheaper) or do you need capsules. I
    shovel a teaspoonful in every morning which disgusts Mrs GOF because she
    can't stand the taste or smell of CLO. I find that mixed with
    orange juice or milk it has no taste or smell.

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