MEDICAL POLITICS

A letter from a reader on the unwisdom of battles against bureaucracy such as that undertaken by Dr. Szabo in California -- a case referred to here yesterday:

"While I was an anesthesiologist at a major teaching hospital, the hospital administration hired a surgical specialist. The hospital paid good money to a search firm to find this doctor. But he had been at his last job less than a year.

Things went very wrong with this man from the start. He threw bags of IV fluids at anesthesiologists. He did a number of strange things, and behaved in a bizarre manner. A colleague found out all he needed to know with a few phone calls to those who had worked with him. Others discovered that he had been the same since his training. One by one, the anesthesia staff formally refused to work with this surgeon. Only I and two others (including the Chairman) would work with him after a few months.

On the day after I wrote a letter to the Chairman saying that I would no longer work with this man, the Chairman gave me a letter saying he would not renew my contract. He backed down when I said I would work with this surgeon. If I knew what I know now, I wouldn't have done so.

A few years passed, and I was again given a letter of non-renewal. I filed an appeal with the Medical School, with hearings and an attorney, etc. But, predictably, I was turned down by the Dean. [Of course, knowing what I know now, the Dean has only 2 options - fire me or the Chairman. Firing me was much less costly to him]

Fortunately, my attorney convinced me NOT to pursue this further. The case was much too complex for a jury. On the other hand, if I had filed an appeal immediately after the letter that I received one day after refusing to work with this incompetent surgeon (who was eventually removed from the staff -- in under a year. He had 7 lawsuits against him by this time), this would have been a "smoking gun" and would have been much easier to litigate. In addition, my attorney convinced me that, if I filed a lawsuit, I would be a "marked man' and likely unable to get a good job in medical schools.

And why, I asked myself, should I make life miserable for myself and others by forcing those who didn't want me to keep me on their staff? I took his advice, and got a better job. And no one has tried to fire me for the last 14 years".






DANGEROUSLY INSANE IRISH REGULATIONS

And there's no move to change anything, either

The life of a Newbridge baby was put at risk recently because of a restrictor device that limits an army ambulance to speeds of just 55 miles per hour. The 14-month-old baby had reportedly slipped into unconsciousness following a seizure, but when the anguished parents called 999 it transpired that all the ambulances at Naas General Hospital were out on call.

The emergency protocol then kicked in and the Eastern Health Board Regional Area (EHRA) called for backup from the Defence Forces at the Curragh Camp. In February, the army had bought a new 250,000 Euro state-of-theart Emergency Rescue vehicle as a back-up resource for the county. As this new ambulance was on stand-by in the army barracks on the Curragh, it was closer to Newbridge than any other ambulance that could be dispatched from Naas.

The parents, who were relieved that the medical experts were on hand to deal with their little boy, were unaware that the paramedics were secretly panicking. On the way to the hospital, the condition of the baby worsened, but instead of racing even faster the ambulance crew made a decision that baffled everyone. They pulled over and called Naas General Hospital to dispatch a different ambulance to collect the child.

The reason was that they didn't trust their own vehicle to save the child's life as a restrictor had been put on the engine. This meant that the highest speed the ambulance could reach was 90kmh (around 55mph); the speed limit on the motorway to Tallaght hospital is 120kmh.

Emergency response vehicles regularly break the speed limits to save lives, but if this ambulance had tried to rush the child to hospital the journey would have taken three times as long as it should. Since the incident, Naas General Hospital has not called on the services of the Curragh ambulance as emergency back up. The restrictor remains in place on that vehicle.

Over a typical weekend, the previous Military Medical Facility, which is no longer considered reliable or roadworthy, would have responded to up to 25 calls, but now people have to rely on back-up from Athy, which is at least 20 minutes away from Newbridge.

A spokesperson for the army said that the restrictor was a manufacturing design. He said: "It is a legal requirement to do with the weight of the vehicle, and is actually set higher than the legal speed limit for army vehicles." He was keen to point out that the ambulance was for military use only and was only a back-up service for the EHRA.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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