The treatment which has been proven over the past years for heart attack, pneumonia, and congestive heart failure is NOT being given to many patients in the United States.
The treatments are now standard. They have been agreed upon over decades as life saving procedures for patients suffering these serious ailments which are often (or, in the case of congestive heart failure, normally life-threatening). There is an article this week in the New England Journal of Medicine showing that are the norm in most medical practice and are not being used for the patients appropriate for them.
The Detroit News recently reported that:
" Reviewing data from the Centers for Medicare and Medicaid Services on 10 indicators for quality of care at 3,558 hospitals in the first half of 2004, researchers at Harvard School of Public Health found that simple, universally accepted treatments were not provided for:
• 11 percent of heart attack patients.
• 19 percent of those with congestive heart failure.
• 29 percent of pneumonia sufferers."
There is a problem in modern medical practice (more than one, actually). While there are "evidence based guidelines" for these most serious afflictions and conditions, it is not always possible to get 100% of the practicing physicians to follow them.
Another member of the accreditation group was quoted as saying, "The studies illustrate a problem in modern medicine. While there's a growing list of scientifically supported protocols for specific conditions called "evidence-based medicine," physicians and hospitals don't always follow them.
Making the shift requires creating evidence-based guidelines, getting hospitals and doctors to accept they're the right thing to do, agreeing how to measure results, and finding processes to make sure they happen, Loeb said.
Those processes are likely to involve financial incentives, he said. "As much as we like to think of medicine as an altruistic profession, green seems to be the color of the (needed) elixir."
Article comments
1 - Lisa Lindell
Yes, our hospitals fail us miserably at the most basic level...and it goes much deeper than not giving aspirin to heart patients 100% of the time. Our hospitals have deteriorated to become nothing more than inefficient and ineffective bureaucracies. I'm speaking from my 108-day experience during my husband's hospitalization following a severe burn injury. He was admitted to was is reputed to be one of the best burn units in the country. Please visit the website, www.108days.com
2 - alpha
Lisa. Thank you for the comment and sympathy and empathy for your pain and your husband's injury.
People should visit your site where you tell of your ordeal and the book you wrote about it.
I recently reviewed a book on writing as a form of therapy and initially was not impressed but changed my mind. Also I have just been through 2 months of living in my wife's hospital rooms (more to come) so it is too painful for me to read now. She has made me promise not to write of her ordeal.
It is wonderful to see that you intuitively knew to write of the experience to help deal with it for yourself and speak to others.
My post was "Writing as a Form of healing":Review . At about the same time Dr. Pat wrote a post on blogging linked to my earlier article.
3 - Joanie
It should be noted that a large factor in the success of any treatment (of any condition) is patient compliance. While it's easy to always blame hospitals and doctors, the patient factor is often overlooked.
As a nurse who works with cardiac, diabetic, and transplant patients, I know from experience that all the best technology and science amounts to nothing if the patient and the family do not comply to the prescribed regimen.
Are there doctors who err? Yes. But more frequently, the greatest complication in treating patients comes when the patients themselves do not adhere to their medication schedule, dietary changes that may be necessary due to disease processes, and the inconsistent pattern of follow up with their doctors.
4 - alpha
Your comment on patient compliance with medical treatments goes so much without saying that I neglected to say it. Along with the necessity of magnet hospitals and honors for good nursing.
My first trip to the coronary ICU broke my smoking habit, made me mostly vegetarian, a stickler for medications exactly as prescribed (when prescribed well) -- everything but stree reduction. That is how I have survived 11 years (with some high tech help).
However, there were stories of people sneaking off ICU to buy cigarettes. When my wife was in the hospital I met people walking and smoking pulling rolling IV units behind them.
The importance of patient understanding of treatment and medication and the incredibly important role of nursing care is so important I regarded it as out of the scope of this article. Thank you for adding it.
5 - Lisa Lindell
Joanie:
"It should be noted that a large factor in the success of any treatment (of any condition) is patient compliance. While it's easy to always blame hospitals and doctors, the patient factor is often overlooked."
While this is certainly a factor, again, I am only speaking from my own experience, my husband was comatose, so he could do nothing but comply with treatment and therapy, however, the topic we're addressing is healthcare failing us at a basic level. It would have been really nice if doctors, nurses, etc WOULD have prescribed appropirate therapy and treatment for my husband when he so desperatley needed it. My sister and I begged and screamed to get him the care he needed, to no avail most of the time. The blame, in our case, is placed right where it belongs, on the shoulders of the "healthcare professionals" who failed us at almost every opportunity. And it's happening everywhere to thousands of people in hospitals across the country. There are catastrophic failures in our nations hospitals. They are very dangerous places to be when you're sick or injured and at your most vulnerable, and that is not a result of patient non-compliance.