Increasing the Speed of Medical Patient Safety Advances in the USA

Jason Maude Jason.Maude at ISABELHEALTHCARE.COM
Thu Nov 13 18:14:17 UTC 2014

As somebody from outside medicine who has being trying to introduce a ‘medical advance’ over the last 14 years, I wonder continuously about this issue and ask myself why does it have to take so long?

I remember watching a speech by Barry Marshall and his answer to the question was that the key barrier was the 'illusion of knowledge’ quoting Daniel Boorstein, Librarian for the US Congress who said:  “The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge.” His point was that if somebody thought they already knew the answer then they would be reluctant to listen to the new message. I think that this is a good partial explanation.

If you haven’t read Atul Gawande’s article comparing the adoption of anaesthesia versus antiseptics then it is a must read for the understanding of this issue

The speed of adoption of anaesthesia was truly remarkable—just a few weeks! The motives behind this and the slow adoption of antiseptics are less remarkable.

In the end most industries where major change needs to happen either need to be told (regulation) or shamed into action (public pressure).

Public pressure is coming via a better informed patient. I wonder if the treatment of ulcers with antibiotics would have taken so long today if patients had read about this and challenged their doctor more vigorously?

I think a national symposium on this topic would be very interesting, probably rather depressing as we learnt about many other good things had taken a long time to be adopted but may not achieve much real change.


Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890<>

From: robert bell <rmsbell at ESEDONA.NET<mailto:rmsbell at ESEDONA.NET>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, robert bell <rmsbell at ESEDONA.NET<mailto:rmsbell at ESEDONA.NET>>
Date: Wednesday, 12 November 2014 05:24
Subject: [IMPROVEDX] Increasing the Speed of Medical Patient Safety Advances in the USA

Increasing the Speed of Medical Safety Advances in the USA
Medical advances are sometimes quick and sometimes painfully slow. There is an estimate now that 440,000 patients are dying of error (including diagnostic) every year in the USA with more being injured. This figure if true has risen from the IOM estimate 15 years ago of an upper limit of 99,000 deaths. And presumably with the Affordable Care Act and more people coming into the system there will be even more deaths occurring.
About 167 years ago Ignaz Semmelweis suggested we wash our hands before seeing patients – it has been said that only 2/3rds of physicians do this today when going from patient to patient in hospitals. The importance of Helicobacter pylori in peptic ulcers and its treatment with antibiotics discovered by Nobel Prize winners Barry Marshall and Robin Warren of Australia took some 15 years to be fully accepted in the US. Also, the length of time it takes to get a new pharmaceutical drug on the market (about 10 - 15 years).  Are such times acceptable when patients are dying?
Here on this list we talk about ways to handle a particular problem. Some will be excellent and life saving advances, but whether they are introduced into hospitals will depend on the enthusiasm of a few and the culture in the hospital in question. And then with normal good idea spread one could expect that idea to take 20 – 30 years to be adopted in all 5,723 hospitals in the US.
So if we want to prevent more deaths we need to introduce ideas that are effective far, far more quickly.
How to do this well is the challenge? The quickest way would seem to be through legislation, but in our gridlocked Washington DC environment, is this possible?
It would seem that numbers are more powerful and that greater co-operation and coalition formation between the Medical Safety Societies would be worth exploring further to see if such an approach would move things along much faster.
It also seems that all or most communications to the list should more often focus on solutions and how to achieve widespread use of something that works. This so that posts are more action oriented.
Further, I would suggest that contributors copy others to help move things along. Ideas can be like seeds in the desert waiting for the right conditions to germinate. Perhaps even establish a good idea website by category. I do not know what the whole solution is in this complicated field but it seems that we need to be experimenting more, communicating more, and doing more, if we want to significantly impact the death and injury toll.
I would also propose that a National Symposium be held to discuss, How to Increase the Speed of Medical Patient Safety Advances.
Would welcome comments.
Robert M. Bell, M.D.



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