Monday, May 16, 2005

Medical Malpractice in critical condition

This is way old but I want to post it anyway.

The condition of medical practice is not only in financial crisis, it is also in an intellectual and moral crisis. For example, an April 20, 2004 article in the Marion Star in Marion, OH regarding medical malpratice costs indicates that capping malpractice lawsuit awards in California is keeping the costs of malpractice insurance down. In other words, there is nothing wrong with bad doctors and poor medical care but there is something wrong with those who seek justice for having been harmed by bad doctors and poor care. Given that the Hippocratic oath begins: "First, do no harm," I find that capping malpractice awards ironic and hypocritical.

Looking at the bigger picture, medical students are trained with 36 hours shifts. Medical knowledge about the effects of sleeplessness shows that such practices are inherently detrimental. Yet, nothing has been done about these long shifts. This is an intellectual crisis where knowledge is not used in the very profession that develops it. The moral crisis is in the deliberate flouting of konwing right from wong in the way people ourght to be treated as human beings. Just because doctors "survived" the ordeal does no make it any more moral than slavery or indentured servitude.

At the other end of the spectrum, the increasing incidence of malpractice should be a red flag within the profession, not about the rising costs of insurance, but about the rising incidence of malpractice. In my experience, the best doctors were military or U.S. Public Health Service Hospital doctors. ER docs are also pretty good mostly because the protocols are so well developed, but even they can be schlockey having witnessed an incidence of poor diagnostic judgement myself as a unit secretary many years ago.

My world is governed by the principles of craftmanship. That the practice of medicine is less craft and even less science and more plug-and-play technology, pill popping, and slice-and-dice surgery bodes poorly for the state of health of human beings and the advancement of medical wisdom.