Two studies published in the Journal of the American Medical Association may surprise people in Massachusetts and around the country. These studies indicate that when resident physicians are working the shorter shifts that have been recommended by oversight boards, they tend to make more errors. These shifts are a movement from the traditional 30 hours to 16 hours. These studies also show that shorter hours do not improve residents' depression rates and that they are getting more sleep.The working hours of medical residents are not federally regulated but are set by the Accreditation Council for Graduate Medical Education. This group has been working on adjusting residents' work hours since 2003. Certainly some of the medical errors that the Council was trying to avoid were those of misdiagnosis. However, one expert states that the cause for the increase in errors is that the patient is being "handed off" more frequently between different professionals. It was also pointed out that the teaching hospitals are not increasing staff, thereby forcing the doctors to do more work in fewer hours, which is a stressor.
Doctors in poverty-stricken areas have a new option for reducing the risk of brain damage in oxygen-deprived children. The condition is referred to as hypoxic ischemic encephalopathy. Though placental problems and umbilical knotting can happen during any child delivery, the risks of birth injury and brain damage are compounded in developing areas by malnutrition, anemia and lack of trained delivery personnel. Risks are also greater in developing regions of the world due to lack of expensive medical devices commonly found in Massachusetts and other developed world hospitals.To get around this problem, undergraduate students with the Center for Bioengineering Innovation and Design at Johns Hopkins designed a $40 instrument capable of performing similarly to $12,000 hospital cooling units. The treatment involves reduction of the newborn's temperature by six degrees over three days. Research shows that, if done quickly following birth, brain injury may be prevented.
Officially called "retained surgical items," sponges and instruments accidentally left inside patients' bodies during surgeries and sealed inside are a potentially fatal form of surgeon malpractice. Massachusetts residents may have heard about the Alabama woman who had a caesarian section in 2010. A surgical sponge that was used during the procedure was left inside her abdomen, and it caused her stomach to swell and caused her bowels to shut down. Six weeks after the caesarian section, she had to undergo a six-hour emergency surgery to remove the sponge and then six weeks of hospitalization. In other cases of retained surgical items, patients go months or even years with severe or debilitating pains before it is determined that the causes are errors that were made on the operating tables. It is often the case that an infection will have developed by the time the lost item is discovered and removed, and in some cases, the patients suffer lifelong complications or die as a direct result of the foreign objects inside them.
Massachusetts residents who have suffered a brain injury may be interested in recent studies that shine a new light on the subject. According to recent research by the Cleveland Clinic and the University of Rochester Medical Center, degeneration of the brain may be caused by a significant auto-immune response that occurs after repeated brain trauma. This is an effect that may be similar to what occurs in multiple sclerosis patients. Such repeated head trauma is common in soldiers as well as football players. According to the article, the identification of this over-active immune response is important because it may lead to the advancement of improved treatment options for head injury trauma patients. This research was based on a study conducted by URMC that involved almost 70 college football players. The study showed that a protein biomarker that was associated with those who had experienced traumatic brain injury was present in the blood samples of all of those football players who participated in the research project after the game. This suggests that varying degrees of impact may affect the brain.
A study recently published in the Journal of the American Medical Informatics Association found that implementation of a single information-technology tool in clinical settings could have a profound effect on the quality of patient care in Massachusetts and across the country. Computerized provider order entry, or CPOE, has been in use for years, but according to researchers, the rate of adoption remains "modest" despite a financial incentive included in the HITECH Act.The meta-analysis found that exclusive use of CPOE in a clinical setting could reduce medication errors by as much as 48 percent. Researchers went further by calculating the total benefit in decreased errors that could be attributed to CPOE use in 2008. They found that CPOE use eliminated what would have otherwise been an additional 17.4 million medication errors that year. Prior research by the Institute of Medicine uncovered an average rate of one medication error per day per patient.
A Massachusetts state law enacted in 2012 requires physicians to make their medical errors available to the public; this law also permits physicians who make mistakes to apologize without having to face medical malpractice lawsuits. Physicians, hospital directors, insurance agents and patients alike can visit a recently launched website that seeks to clarify some of the issues found in the newly approved law. The complexity of medical liability claims in the face of the 2012 law may have necessitated www.macrmi.info, created by the Massachusetts Alliance for Communication and Resolution.When a surgeon makes serious surgical errors during a surgical procedure, the patient has a legal right to file a medical malpractice lawsuit against the doctor. The new website and law are part of an integrated system called CARE that is being adopted by facilities statewide in a seeming attempt to cut down on malpractice suits by addressing errors and adverse effects internally. Patients are still permitted to file a claim, however, and the website encourages legal representation in the event that a claim is made through the CARE system or outside of it.
While it is essential that there is a system in place for people to file suit against inattentive or negligent doctors who have harmed them due to medical malpractice, the current system has some major issues. According to a study done by the RAND Corporation, the average physician will spend four years of a 40-year career fighting claims of malpractice. The problem is not only do some of these claims have no merit but that many of them take an enormous amount of time to be settled. This causes problems for both doctors and patients. Doctors will have less time to spend with their patients, and they will also often begin to practice defensive medicine. This drives up the costs of health care, and it can lead to patients having to undergo unnecessary tests and procedures to ensure there is no missed diagnosis. Further, patients who file claims may have to wait years to have their cases completed.
A report recently issued by the Wisconsin State Journal condemns the state for its low physician discipline rate and ranks it with four other "low discipline" states, among which is Massachusetts. The implications of these findings in terms of the incident rate of misdiagnosis, delayed treatment and physician negligence are potentially far-reaching for both patients and medical staff in these states. Wisconsin's rate of disciplinary actions taken against physicians is only 1.9 per 1,000 physicians; a watchdog group noted that while this low rate could be attributed to exceptional care on behalf of the doctors, it is more probable that discipline isn't being conducted as often as it should. The report indicates that only 50 percent of doctors who actually were disciplined between 2010 and 2012 received more than a reprimand, and another group criticizes the medical board's insufficient monitoring of physicians, which enables incompetent ones to act with impunity in many cases. The ineffectiveness of the state's medical board has been pinned partially on diminished state funds.
It is very important for medical professionals to not commit negligence when it comes to the surgical care of patients. No patient should have to be subjected to surgical negligence. Such negligence can be very harmful to patients.
It is very important for medical professionals and medical facilities to not act negligently when it comes to the examining, testing and diagnosing of patients. Such negligence can be very harmful to patients. Such negligence can sometimes even lead to a patient's death.