Monday, January 13, 2014

Power Corrupts

For many years, the health care system generally and the medical profession in particular was left free to manage its own affairs.  “Doctor knows best” was a guiding principle and nobody wanted to be accused of interfering in the practice of medicine or in the doctor-patient relationship.

The result was the conferring of great power, and as Baron Acton observed a century and a quarter ago, power corrupts.

That principle was vividly illustrated in an article appearing in the January 11 edition of the Omaha World Herald and headlined “For ‘never events,’ stray surgery items are disturbingly common.”  The article, over the by-line of local columnist Matthew Hansen, was occasioned by a lawsuit brought by a lady in whom a fluid-filled surgical glove had been left following surgery at an Omaha hospital.

‘Never events’ are events that should never happen, like leaving foreign objects in patients after surgery.  The most common such items are sponges used to soak up blood.  Hansen quoted a number of apparently authoritative estimates of how often sponges are left in patients in US hospitals and the numbers ranged from 500 to 6,000 per year.

According to the article, techniques involving bar codes and tiny radio-frequency tags are available to prevent this from happening.  Using them. the Mayo Clinic has not lost a sponge in four years.  Indiana University Health System hasn’t lost one in five years.   

The cost is about $10 per procedure but no hospital in Omaha is using the technology.  I consider that to be inexcusable negligence attributable to the power granted to those institutions.  Corruption in the sense of an erosion of standards seems like a suitable word to describe the condition.

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