Saturday, January 08, 2005

HOW PUBLIC MEDICINE KILLED THE SICK BRITISH BABY

Below is a correspondence I had with a regular reader of my blogs -- a medical specialist who works in an American public hospital -- about the case I reported two days ago -- where a baby ill with meningitis was shuffled from British public hospital to British public hospital and ended up dying:


JR:

If it had been my son he would be alive today. I would have taken him to a top private hospital only a short drive away from me that I use from time to time and I would only have had to raise an eyebrow for tests to be done, drips to be used if indicated and precautionary antibiotics administered. And he would of course have been admitted and kept under observation until his temperature came down.

Under the British NHS I would have no power to ensure any of that and it would not be (and was not) done

Reader:

Ditto: [For non-American readers: "Ditto" is an American way of indicating strong agreement]

I don't in any way approve of the system as it it - I am just being the devil's advocate - many serious and life-threatening diseases - like pneumonia and meningitis - start out as colds. And children with fevers often have seizures - usually not serious. The first few days are not surprising - but the long ambulance ride etc was truly unacceptable.

And of course, when the child is not getting better - most medical people would take another look.

And herein IS the major problem: we call it "polydoctoritis" If there was anything close to good care nearby, the parents would have been counseled that "it's most likely a cold, BUT- here is what to look for" and call us back IF. And the same doctor (or someone else in the same grop) most likely would see the child.

And this IS the most serious problem - when a new doctor sees the patient, he "starts from scratch" - he doesn't really know that the child may be worse than he was just a few hours earlier. In medicine, "watchful waiting" is an important thing - and experienced doctors and nurses can make observations that just can't be made by less experienced people, and people who have seen the child for the first time.

Also, an important part of pediatric practice is evaluation of the parents - parents that appear as nervous wrecks or hypochondriacs may not be taken seriously in a busy practice.

Unfortunately, in the US, many of these types of patients end up in emergency rooms, and waiting many hours to be seen. Having a readily available family doctor is a luxury that is difficult for many to find. Of course, free enterprise would solve this overnight - but Government forces are resisting this.

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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.

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