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Basic errors cause of much malpractice
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Fhqwhgads



Joined: 11 Jul 2006
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PostPosted: Wed Oct 04, 2006 11:43 pm    Post subject: Reply with quote

Halen wrote:
I was in an interesting course on Tuesday. The guy was friends with a consultant who worked at two hospitals. He was a cutter - did amputations. One of the hospitals put an X on the leg he was supposed to cut off. The other hospital put it on the leg he was supposed to NOT cut off...

OH DEAR LORD. That made my spine actually tingle in horror right there.
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sporko



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PostPosted: Wed Oct 04, 2006 11:44 pm    Post subject: Reply with quote

Halen wrote:
The guy was friends with a consultant who worked at two hospitals. He was a cutter - did amputations. One of the hospitals put an X on the leg he was supposed to cut off. The other hospital put it on the leg he was supposed to NOT cut off...


you'd think they'd standardise that or something...
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Flion



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PostPosted: Thu Oct 05, 2006 12:37 am    Post subject: Reply with quote

Yeah, like language. Or metric measurement. Or ... well, I'll stop; it's just necrobestialsadism. Any phrase with 'you'd think ...' is automatically suspect. 'They' have not been proven to have any common sense whatsoever. Razz
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sporko



Joined: 09 Jul 2006
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PostPosted: Thu Oct 05, 2006 12:44 am    Post subject: Reply with quote

Flion wrote:
Yeah, like language. Or metric measurement. Or ... well, I'll stop; it's just necrobestialsadism. Any phrase with 'you'd think ...' is automatically suspect. 'They' have not been proven to have any common sense whatsoever. Razz


uh, yeahh....not really comparable, there, buddy, but nice try.

also, language and metric measurement are generally standardised. that's what "grammar" and "spelling" and "1000cc = 1 L" are for.
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Darqcyde



Joined: 11 Jul 2006
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Location: A false vacuum abiding in ignorance.

PostPosted: Thu Oct 05, 2006 3:27 am    Post subject: Reply with quote

Halen wrote:
I was in an interesting course on Tuesday. The guy was friends with a consultant who worked at two hospitals. He was a cutter - did amputations. One of the hospitals put an X on the leg he was supposed to cut off. The other hospital put it on the leg he was supposed to NOT cut off...


Joke time:

A guy walks into a doctor's office and demands to see the doctor as soon as possible. WHen he finally sees the doctor he tells him "Doc, I want to be castrated. How soon can you do it?"

The doctor looks the man up and down and then says to him "Are you sure you want to be castrated?"

"Yes, I want to be castrated, how soon can I get it done?"

"Well, you'll need some recovery time soo...I can schedule a surgery two weeks from now."

"Good enough, I'll see you then."

Two weeks go by, the man has the surgery, everything goes fine and he's wheeled into his hospital room. He comes to and decides to watch some TV. A little while later another patient is wheeled into the bed next to him. After the second patient comes to the man decides to chat him up.

"So what kind of surgery were you in for?"

"Circumcision."

"DAMINT! That's the word I was thinking of!"
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Flion



Joined: 09 Jul 2006
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PostPosted: Thu Oct 05, 2006 6:20 am    Post subject: Reply with quote

sporko wrote:
Flion wrote:
Yeah, like language. Or metric measurement. Or ... well, I'll stop; it's just necrobestialsadism. Any phrase with 'you'd think ...' is automatically suspect. 'They' have not been proven to have any common sense whatsoever. Razz


uh, yeahh....not really comparable, there, buddy, but nice try.

also, language and metric measurement are generally standardised. that's what "grammar" and "spelling" and "1000cc = 1 L" are for.


Well, ok, if you're gonna take that comment seriously (which it wasn't) measurement is not standardized from location to location, nor is language. Not even a single language. So my joke was that one hospital's standard is another's malpractice. And you might get the hospitals in some areas to standardize, but probably not universally. You should see how different, for instance, Japanese medicine is to American medicine. So, in that context, very comparable. But meant lightly.

You might think they'd standardize, but I know that first there'll be a long-drawn-out pissing match over who's standard is better. Kinda like why America hasn't really adopted metric, even though it would be sensible. What's sense got to do with it. In that sense, I agree with you: they should standardize. I'm just cynical enough to realize that they won't, except under duress.
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Halen



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PostPosted: Thu Oct 05, 2006 7:16 pm    Post subject: Reply with quote

Ok, I found the stats from my course. You'll like this. Doctors tell you they practice "evidence based medicine", right? So the drugs you are prescribed are supposed to be based on evidence - drug trials.

Actually, what you find most hospitals practice "economics based medicine". Because drugs are expensive, thanks to pharmacutical companies. That's a huge market, and very expensive (we've had threads on this). Drug trials are largely run on a 6-month basis, on young people. But a huge proportion of drugs are actually intended for older people, and what you find is that many drugs have side effects that only manifest after a year or so.

From the British Medical Journal Clinical Evidence COncise 2005- a survey of all the drugs currently used in the British medical industry based on the trials that have been done on their efficacy (www.clinicalevidence.com):

Drugs proven to be beneficial: 15%
Drugs likely to be beneficial: 23%
Trade off between benefits and harms: 7%
Unlikely to be beneficial: 5%
Likely to be ineffective or harmful: 4%
Unknown effectiveness: 46%

Nearly HALF of all drugs have had such ineffective trials, their effectiveness is not even known.

Here's some more medical data. An economist called Wennberg did a comparison of Medicare beneficiaries in Boston and New Haven, where the demographic characteristics of the populations are similar. Expenditure in Boston was nearly double that of New Haven. Adjusted rates of discharge, readmission, length of stay and reimbursement varied by 47%, 29%, 15% and 79%. Those are large differences, caused by the large change in investment. But mortality rates in the two areas were IDENTICAL. The vast amount of money that is pumped into healthcare, that dramatically affects the care you recieve (60% more care in boston) has absolute zero effect on your length of life. (New England Journal of Medicine 1989, Lancet 1987)

There's more stuff on the way doctors, hospitals, and consultants are paid, but it was a whole day's course and I can't be arsed.
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mouse



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PostPosted: Thu Oct 05, 2006 8:44 pm    Post subject: Reply with quote

a statistician i used to work with told me there was a study done on where doctors get most of their advice on new drugs from. the winner: their golfing buddies.

Halen wrote:
He was a cutter - did amputations. One of the hospitals put an X on the leg he was supposed to cut off. The other hospital put it on the leg he was supposed to NOT cut off...


in the (i hope wildly unlikely) event i ever need one of a paired organ amputated, i am going to demand a big black sharpie and write "NOT THIS ONE! DO NOT CUT HERE! NONONONONO!" all over the healthy one before i let them wheel me in to surgery.
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Major Tom



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PostPosted: Thu Oct 05, 2006 8:57 pm    Post subject: Reply with quote

did the statistician ask how often the docs golfed with pharmco sales reps?

cuz, y'know, i wouldn't be suprised if there were a linking indicator in there somewhere
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Darqcyde



Joined: 11 Jul 2006
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PostPosted: Thu Oct 05, 2006 9:05 pm    Post subject: Reply with quote

Major Tom wrote:
did the statistician ask how often the docs golfed with pharmco sales reps?

cuz, y'know, i wouldn't be suprised if there were a linking indicator in there somewhere


"Yeah, sure Bob, I could get you into the country club somehow." *wink wink nudge nudge*
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MsFrisby



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PostPosted: Thu Oct 05, 2006 11:57 pm    Post subject: Reply with quote

Last year, I was temping at the hospital in Cheyenne. Part of my job was to help prepare for the JCAHO evaluation. They have huge books of material on what hospitals should and shouldn't do and how they can rate themselves and they come and inspect the hospital. They look for "sentinel events." A euphemism for "accidents that are the hospitals/doctor's fault."
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Major Tom



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PostPosted: Fri Oct 06, 2006 12:37 am    Post subject: Reply with quote

but do they treat the "big book" as a study-guide of best-practice, or an appendix of referendum, is the question.
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Sam



Joined: 09 Jul 2006
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PostPosted: Fri Oct 06, 2006 1:43 am    Post subject: not well you say. bummmmer city Reply with quote

hey america how's that privatized medical system working fer ya
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Darqcyde



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PostPosted: Fri Oct 06, 2006 2:24 am    Post subject: Re: not well you say. bummmmer city Reply with quote

Sam wrote:
hey america how's that privatized medical system working fer ya


"...and #1 on tonight's 'Top Ten Reasons to Move to Canada' : What if my wife gets cancer?"
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Halen



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PostPosted: Fri Oct 06, 2006 6:49 am    Post subject: Re: not well you say. bummmmer city Reply with quote

Sam wrote:
hey america how's that privatized medical system working fer ya


Oh, there was a stat that said that 55% of americans don't receive the medical care they need. Sorry, I put the papers away, but I'll get a reference if anyone really cares :p
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