Drudge Retort: The Other Side of the News
Wednesday, August 07, 2019

It is true that health care has become corporatized to an almost unrecognizable degree. But it is also true that most clinicians remain committed to the ethics that brought them into the field in the first place. This makes the hospital an inspiring place to work.

Increasingly, though, I've come to the uncomfortable realization that this ethic that I hold so dear is being cynically manipulated.

By now, corporate medicine has milked just about all the "efficiency" it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go.

But one resource that seems endless -- and free -- is the professional ethic of medical staff members.

This ethic holds the entire enterprise together.

If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don't shirk. The system knows it, too, and takes advantage.

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Some of you here that post your ridiculous political worldview would not make it thru one 8-hour day working in any American hospital or clinic.

#1 | Posted by PinchALoaf at 2019-08-07 08:49 AM | Reply

Hospitals squeeze the nursing staff to the point where they are so over worked and stressed they make careless mistakes. A family friend is a nurse who is supposed to work 30 hours per week because of her kids. 50 hour weeks were common. Despite her working that much, they still treated her benefits as if she were 30 hours until she threatened to go the DOL. Amazingly they cut her hours to 30 and pushed the 20 hours onto the other nurses in her department.

#2 | Posted by Nixon at 2019-08-07 09:06 AM | Reply

And, under a capitalist system to whom do the CEO and other execs owe their allegiance? To patients? To doctors and nurses? No, to the share holders. This is a perfect argument for socialized medicine, healthcare should not be a profit center.

#3 | Posted by danni at 2019-08-07 09:08 AM | Reply

How does this make them any different than any other employee?
Thanks Capitalism!

#4 | Posted by TFDNihilist at 2019-08-07 09:30 AM | Reply | Newsworthy 1


Our healthcare system is driven to maximum corporate profits, in spite of what is said to the contrary by those in the healthcare system.

Have you noticed that the profits (and stock values) of healthcare corporations is increasing, even though the life expectancy of Americans has been dropping for years?

Why is the value of the healthcare stocks tied to corporate profits and not the health of Americans?

#5 | Posted by LampLighter at 2019-08-07 09:49 AM | Reply | Newsworthy 1

@#5 ... in spite of what is said to the contrary by those in the healthcare system. ...

I could have worded what I meant a little more clearly:

... in spite of what is said to the contrary by those running the healthcare system.

By those running the healthcare system, I mean the corporate types, not the front-line medical professionals.

#6 | Posted by LampLighter at 2019-08-07 09:58 AM | Reply

Have you noticed that the profits (and stock values) of healthcare corporations is increasing,

That's the American way.

Number of insured is dropping like a rock too thanks to Fat Nixon.

#7 | Posted by Nixon at 2019-08-07 10:56 AM | Reply

If you work for a hospital your patient interactions are heavily micromanaged. In the clinics you're given 20 minutes per patient and you're often double booked. Doesn't matter if this is the first time you're seeing a patient or what the severity of the reason the person has sought medical attention is. It's very much managed like an assembly line. My wife's average patient times tend to lag behind others, and it's been noted on more than one occasion that it affects her productivity rating, but she makes up for it by writing meticulous notes, which results in higher billing potential. This buys her a little leeway when it comes to evaluating her performance but not much. Doctors and nurses she works with have been quitting left and right the last couple years to the point where it's part of our weekly conversation.

#8 | Posted by Hagbard_Celine at 2019-08-07 01:13 PM | Reply | Newsworthy 1

Per the article ...

By far the biggest culprit of the mushrooming workload is the electronic medical record, or E.M.R. It has burrowed its tentacles into every aspect of the health care system.

There are many salutary aspects of the E.M.R., and no one wants to go back to the old days of chasing down lost charts and deciphering inscrutable handwriting.

But the data entry is mind-numbing and voluminous.

Primary-care doctors spend nearly two hours typing into the E.M.R. for every one hour of direct patient care. Most of us are now putting in hours of additional time each day for the same number of patients.

In a factory, if 30 percent more items were suddenly dropped onto an assembly line, the process would grind to a halt. Imagine a plumber or a lawyer doing 30 percent more work without billing for it. But in health care there is a wondrous elasticity -- you can keep adding work and magically it all somehow gets done. The nurse won't take a lunch break if the ward is short of staff members. The doctor will "squeeze in" the extra patients.

The E.M.R. is now "conveniently available" to log into from home. Many of my colleagues devote their weekends and evenings to the spillover work. They feel they can't sign off until they've documented all the critical details of their patients' complex medical histories, followed up on all the test results, sorted out all the medication inconsistencies, and responded to all the calls and messages from patients.

For most doctors and nurses, it is unthinkable to walk away without completing your work because dropping the ball could endanger your patients.

The health care system needs to be restructured to reflect the realities of patient care.

From 1975 to 2010, the number of health care administrators increased 3,200 percent.

There are now roughly 10 administrators for every doctor. If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork.


Medical error is the 3rd leading cause of death in America ...

So when people complain about the EMRs (electronic medical record), whether it's patients or clinicians, it has to be said that we're not ever going back to paper records and just the idea of that is a ridiculous -- medical error was ubiquitous before EMRs but was more hidden, and now at least there's a tool (with the EMR) at the center of patient care for care coordination and simply for knowing what's been done for the patient.

All that said, as the article points out, all the extra administrators and clerks have not made things easier and reports keep coming in that quality and safety are not improving ...

Patient Safety Movement: Human Factors Engineering with Rollin "Terry" Fairbanks, MD
www.youtube.com
[7:23]

#9 | Posted by PinchALoaf at 2019-08-08 08:33 AM | Reply

And speaking of electronic medical records ... the mistake of each hospital using a propriety IT for that individual hospital, makes it that much harder for regional networks of hospitals to coordinate complex medical conditions with patients who think that going to specialist after specialist is better for their medical problems.

You know who can cut thru all this? Congress.

But healthcare lobbyists spend FOUR TIMES more than their Military-Industrial-Complex peers lobbying to get their way ... and there's money to be made to keep patient care coordination fragmented and difficult to manage.

#10 | Posted by PinchALoaf at 2019-08-08 08:47 AM | Reply

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