Maggie's Farm

RE EBOLA

The story says that Duncan "told the DOCTORS" he had recently traveled from Africa. According to the news reports, that's FALSE. Duncan apparently told the ER nurse, who recorded that in her notes, but he didn't tell the doctor - and (it appears) neither did the nurse.

The hospital was quick to point out that the nurse recorded Duncan's visit to Africa in her notes which were "available" to the other health care providers. However, the hospital never says that either the nurse or Duncan directly informed the doctor of his travel.

How could this happen?

First, so called quality assurance guidelines and rules have been mandated by the federal government to make us think we are getting quality care. The problem is that these rules - which hospitals and doctors must follow or suffer financial punishments - mandate that health care providers record volumes of information that is not pertinent. Doctors simply don't have enough time to peruse the nursing notes and in an ER situation either rely on their own discussion with the patient or on the nurse to verbally relay pertinent and significant data.

Second, as Obama boasted, his health care vision was to reduce costs by "cutting out a lot of the fat" in health care. The problem is that a lot of the so called "fat" is spending enough time chatting with the patient so that one can get a feel for things other than raw data and facts, to give the patient a chance to mention things that one would not typically ask about, and to explore answers in more detail.

It's my bet that having told the nurse about his African travel, Duncan felt no need to tell the doctor. The nurse may not have told the doctor either because she didn't recognize the significance or simply didn't have the time - the federal government lets us know that they are only concerned about what she writes in the chart, not what she tells the doctor. Based on past experience, the doctor views reading pages of nurses notes about information not pertinent to the case (like does the patient have a health care power of attorney, does anyone abuse him at home, has he had a tetanus shot, is he an organ donor, etc.) as a waste of valuable time.

It's my assertion that it's our federal government's policies that attempt to give the perception of quality while actually reducing quality that led to this oversight. If we truly want quality medical care, we must insist that the federal government stop meddling with quality issues, cost issues and access issues - all of which are made worse when Washington tries to make us think they are solving the problems that they, in reality, have created.