Friday, June 4, 2010

Warning: Journalist may pose health risks

On my igoogle home page I have a feed from Scientific American, which included this morning an item entitled "Warning: New Doctors May Pose Health Risk." it is a jaunty little essay that reports on a statistic which indicates that there are more mistakes made in hospitals regarding medications during July that any other month, and it implies that this is because July is the month when freshly minted doctors hit the ward. The survey does not seemed to include any statistics on freshly inebriated barbecuers.

I will leave it to Dr. Funk to opine whether this is a causal relationship or not- she lurks amongst the anonymous followers here. I'm sure we will have an amusing diner talking about the incidents of barbecue burns and fish hook wounds, to say nothing of firecrackers during July 4th weekend, or the difficulties in obtaining accurate information on a person's medication from a sober patient, never mind one who has spent the day at the beach drinking "be-ahs" (excuse the dialect, just couldn't help myself.)

What concerns me is the idea that all doctors would have started their career with the seasoned knowledge of an experienced clinician. Obviously we all hope that at the end of that ambulance ride we will be put in the hands of the particular hospitals most experienced doctor. I doubt that would do us much good if the venerable doctor had been work 24 hours a day for the last 20 years and so some of us will have to accept he might be at home asleep- or even at the beach himself- when we are delivered to the emergency room.

This report, I acknowledge I haven't read the study itself, doesn't mention emergency rooms. I think they must be the scene of the errors, however, because if your doctor has admitted you he will be monitoring your case. That is if you have chosen your doctor well, and that my friends, is your own responsibility. And if you are in the hospital and you don't enquire about what they are administering to you, and question if it is different than what you are accustom to, why that is also your own responsibility.

My problem with this jaunty little report in Scientific American is actually a responsibility issue. In it's largest sense, the "it takes a village" sense it has to do with our responsibility as a society to foster the quality of the young professionals. I am often reminded of an essay by Eleanor Perenyi in her book "Green Thoughts." It is titled "Partly Cloudy" and comments on our attitude toward weather. This is a garden book, and she talks of gardeners who complain about rainy days, and then goes into a rather detailed description of what the world and our gardens would be like if we never had to have another rainy day. You may anticipate one of my pet themes here- rainy days are beautiful. It seems a very unfortunate thing to me that people will ignore both the misty pastel colors and vital supplies of the one element that we can't survive without that rainy days bring us. So too with the influx of young doctors, who will become deeply experienced doctors and who, by the way come, in the lack of experience, with the most up to date knowledge, fresh in their minds and right at their finger tips. You, we, are lucky to have them.

So here is my own report on new doctors.

My primary care doctor (I just can't use the acronym PCP, it sounds too much like a toxic chemical) went on Sabbatical last year so I had my check up with one of the "New Doctors" who was covering for him. As you know, I spend a lot of time with doctors, each has his specialty and interest, the older ones have, yes, experience. What I was having was an unsteadiness in balance- I was having to use a cane. At the time I was being treated with interferon, and every one was looking at that as the source of all ills, but this "new doctor," Dr. Petty, took about 5 seconds to question my B12 levels. Surprise, low B12 can cause all sorts of problems with your nervous system, which become permanent if not attended to. No surprise, my B12 levels were in the basement and in a very quick and easy fix Dr. Petty got rid of the cane.

So I say, rejoice if you get one of the New Doctors, and if you don't know what your medications should be you'd better learn. It takes two to tango.

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