Thursday, April 2, 2009

Sleepless in North Carolina

I love the sound of peace as my dad gets a good night of sleep. I hate missing dad's peace and good rest by sleeping.

Dad had a great day. He asked me specific questions about why he has not had the last orthopedic surgery and what exactly he needs to do to make sure everything goes according to plan.

Great attitude. I love hearing dad talk about the future and how he foresees the future as positive and worthwhile. Yippee.

I tread lightly when I explain to dad that there is an infection that has been in his foot since at least his August 2008 hospitalization. I make sure that dad does not blame any of his Duke Clinic doctors. I explain that there is a break-down in communication between the (nice, calm, deep breath) Duke Hospitalists and dad's Duke Clinic doctors.

It is absolutely critical that dad trust each and every Duke Clinic doctor and surgeon. If I did not trust those professionals, I would have dad on an airplane to Chicago and Northwestern University quicker than you could say "arrogant Duke Hospital hospitalists."

But the list of Duke Clinic doctors that have saved and improved the quality of dad's life is very long. I pray for and thank each of them every day to God. And then, whenever necessary, I stay by my dad's side to make sure he is properly cared for.

I am convinced that the concept of "Hospitaist Program Model" (whereby your personal and admitting physician hands off all responsibility for your medical care to a stranger doctor when you are in an in-patient) is a means for all patients to become accustomed to and shrugging as they accept that the person making medical decisions for you is first and foremost focused on cost effectiveness and sees your medical condition in the vacuum of the specific hospitalization.

Next rational step -- strangers n Washington DC making decisions about your medical care. The US Government firmly believes that "hope" and emotional get in the way of cost effective medical care.

Next rational step -- stop providing medical care to older Americans who are retired and, therefore, contribute very little to society. They are an expensive burden and the original Medicare system certainly never expected they would love so long. So, universal health care can remedy that quirk. (See in a public library - don't buy it and give him more $ - Tom Daschle's Book Critical.)

1. Stop (or demand major reforms to) the Hospitalist Program Model.

2. Demand that admitting doctors assume responsibility for his or her in hospital patients. That doctor knows the patient's history. Sure, hospitalists are rpoud that they reduce hospital stays. Now let's study the re-admits within a week and the complications. Bingo!

3. Respect physicians and demand that insurance companies and medical facilities cease the nonsense of random billing depending on the insurance company. We must demand transparency in medical costs.

4. Why does the US Government need access to all of our medical records? The Government wants to create a Medical Review Board (betcha Medco's David Snow would get that gig).

5. Discipline bad doctors (I know a few . . . hmmm IMHO Carle Clinic Association's orthopedic surgeon Chris J. Dangles, MD . . . Dangles' admitted errors and 3 failed and unnecessary surgeries required that I underwent 4 repair surgeries, lost my career, and now need 2 additional surgeries. It has been over 8 years that my life has demanded the scarce medical resources)

Stop the bad doctors and medical costs will be reduced. More importantly, patients will feel a sense of accountability and safety . . . as opposed to pure arrogance.


  1. Here's a patient safety story:

  2. Everyone should red this. Thanks very much for sharing, Dan.

    God Bless you.


  3. Nathania -

    I am respectful and very pleasant with doctors who treat my family with respect in return.

    I could care less if I am harsh. You are right - I probably irritate some medical care providers. So what? If those medical care providers who act with disregard to patient safety and continuity of care PUNISH my dad because of my strong advocacy than they should be removed from the medical profession.

    If it were not for my advocacy and making sure that my dad does not fall between the cracks then he would be DEAD. Period.

    I go to Duke because they have the best surgeons and physicians. The problem is the Duke Hospitalists. They may not be "bad doctors," but each any every experience I have with Hospitalists involves the "stranger doctors" telling me outright that they would not communicate, coordinate or cooperate with my dad's Duke clinic physicians.

    The philosophy of "stranger doctors" is to be cost effective and that is fine UNLESS the cost effectiveness is at the expense of patient safety and continuity of care.

    I appreciate your suggestions and wish you the best of luck and good health.