"Adapt...Adapt...Adapt..." Dr. Ram Raju of NYC Health + Hospitals Tells Grads
New York, N.Y. - June 8, 2016 - At a festive gathering at Harlem's famed Apollo Theater last week, the Touro College of Osteopathic Medicine graduated its sixth class, conferring diplomas upon 123 candidates for the doctor of osteopathic medicine (DO) degree. The hall was packed with the graduates' families and friends for the jubilant ceremony, at which the new doctors were reminded by their keynote speaker that medicine is changing rapidly and they must "adapt...adapt...adapt..."
"If you are adaptable, if you are flexible, if you remain open to learning new skills, new methods, new approaches to the practice of medicine, then you will succeed," Ramanathan Raju, M.D., president and CEO of NYC Health+ Hospitals told the graduates. "Because medicine is in a constant state of creative flux."
Dr. Raju said the healthcare landscape the graduates will be practicing in will shift from one that is "hospital-centric" to one that is characterized by chronic disease management, preventive health, and ambulatory care.
"You'll experience more standardization and less autonomy..and the need to follow best practice guidelines," he said. "The empowered patient safety movement is forcing health care to be more accountable and safer than ever before....increasingly, outcomes will be the source of reimbursement rather than volume. Our results will be closely scrutinized and publicized as never before."
Dr. Raju cautioned, "We can get out in front of these changes or we can be dragged along kicking and screaming. We can be change agents or we can be vilified in public opinion" for refusing to embrace change, advising the graduates he was sure they would "make the right [choice] because helping patients and embracing changes that will improve their health is the reason we went into medicine."
Most of the graduates will be heading to residencies at selective hospitals renowned for their excellent training, and indeed half of the class chose primary care. Slightly over half are staying in the New York metropolitan area with a majority working in medically underserved communities.
Executive Dean Robert Goldberg expressed his optimism about the Class of 2016, and congratulated them on their success. He reminded them of the competition they faced for their seats - only one out of 60 applicants were chosen. He described the interview process as a key element, during which the school was looking for "the secret sauce," as he explained it. "We asked ourselves, 'When we blend this together can we produce something that's going to work for the future?' Looking at you today we know that we did a good job."
Congratulating the new doctors on behalf of Touro President Dr. Alan Kadish, Provost Patricia Salkin also touched on the theme of change, noting that the future doctors' patients will be confronted with health challenges that today may not even be known, but that the graduates have committed themselves to a lifetime of education and self-directed learning.
"We are proud to be associated with you because you have committed yourselves to a career in the service to others. They will look to you for hope...for relief...to raise their spirits. Now it is your turn...to make a difference one person at a time," she said.
Numerous awards were presented. Marta Wronska received the Dean's Award for the highest academic standing, as well as the Excellence in the Preclinical Years Award; Aldo Manresa received the Excellence in the Clinical Years Award; and Gabrielle Rozenberg received the DO Student of the Year Award.
Founding Dean and Dean Emeritus Martin Diamond, DO, received the Sheldon Sirota Medal, established in recognition of Sheldon Sirota, DO, for his tireless efforts in establishing four colleges of osteopathic medicine and other programs.
Two graduates, Jemima Akinsanya and Jean Shiraki, won the Medical Society of the State of New York (MSSNY) Community Service Award. Dr. Akinsanya focused on helping underrepresented minorities gain a foothold in medicine and mentoring youth in Harlem who might one day want to pursue a career in health or science. Dr. Shiraki donated her time helping students learn the policy process as well as service. She took on leading roles in the American Medical Association and MSSNY, where she directed programs and advocated on issues affecting minority communities.
About the Touro College and University System
Touro is a system of non-profit institutions of higher and professional education. Touro College was chartered in 1970 primarily to enrich the Jewish heritage, and to serve the larger American and global community. Approximately 18,000 students are currently enrolled in its various schools and divisions. Touro College has 29 branch campuses, locations and instructional sites in the New York area, as well as branch campuses and programs in Berlin, Jerusalem and Moscow. New York Medical College, Touro University California and its Nevada branch campus, as well as Touro University Worldwide and its Touro College Los Angeles division are separately accredited institutions within the Touro College and University System. For further information on Touro College, please go to: http://www.touro.edu/news/
Diverse Technologies for Diverse Minds
Friday, September 30, 2016
Keynote by Dr. Jan Plass, Chair in Digital Media and Learning Sciences at NYU
"Adaptivity and Personalization for Learning"
Adaptivity and Personalization for learning are highly popular notions, for academics and ed tech vendors alike, yet the concepts themselves are poorly defined, and the science of learning behind them is often under-defined or completely lacking. In this talk I will first distinguish among customization, personalization, and adaptivity. I will then propose a taxonomy for adaptivity that will allow for a more systematic discourse about this important topic and more effective evaluation of educational environments that claim to be adaptive. I will illustrate the use of this taxonomy on examples involving adaptivity based on cognitive, emotional, motivational, and socio-cultural variables.
Special Guest Presentation by Dr. Roger Tucker, Founder, Sonocent Software
"Harnessing the Power of Spoken Language for UDL using Sonocent Software"
Written text can be a huge barrier to learning for so many students, but it is not a necessary one. Sonocent makes software that enables students to effectively learn and express themselves using spoken language. From note taking to writing assignments, Sonocent software breaks complex writing tasks into manageable steps, scaffolding many study processes and removing the need for writing entirely for some people. The software enables users to work with images, text and audio in a simple interface, enabling students to combine information from almost all sources in one place. It is currently being used by over 100,000 students across hundreds of institutions, some of whom see their average GPAs rise by as many as 3 points when using the software.This presentation will explain why and how we should be harnessing the power of spoken language to help students study independently and reach their potential, demonstrating how students use Sonocent for note taking and other study skills.
Special Guest Presentation by Dr. Matthew Schneps
Director, Laboratory for Visual Learning
"Rethinking the Technologies We Use for Reading"
Whether we read using a computer, a cell phone, or on a sheet of parchment penned by a quill, reading necessarily invokes use of a technology. While people differ in their abilities to read, how much of this is simply a consequence of the technology itself? New research suggests that reading is fundamentally limited by some basic design choices made in formulating the technology of reading, and that through judicious reconceptualization of such technology people --including those regarded as reading impaired-- can substantially improve their capacity for reading. In this session we will review the emerging literature in this field and consider new perspectives on reading disability implied by these links to technology. The session will offer practical suggestions practitioners can immediately take away and apply to make reading more efficient and inclusive.
We will use an Apple/Android smartphone app called Voice Dream Reader to illustrate some of the ideas presented, and participants may enjoy having this on their device during the presentation to follow along more closely.
Also featuring our Technology Playground
The Tech Playground is an interactive, audience participation segment of the LD Symposium. It is set up like a technology fair, with individual presenters at tables demonstrating technology or apps they use. Our focus is on technology that supports personal or professional productivity. In the past we've highlighted wellness apps, apps for facilitating conversations for individuals on the autism spectrum, note-taking tools, and many others.
Registration and pricing information
Click the link to take you to the registration page.
Standard (9/10 - 9/30)
Dual PVD attendee
*for Landmark College alumni,
including Certificate Program
By Jacob M. Appel MD
"I've never been a big activist from the outside, but from the inside," says Dr. Jo Ivey Boufford, President of the New York Academy of Medicine. "I liked clinical practice a lot and I really enjoyed working with the patients," she explains, noting that she practiced pediatrics for fifteen years, "but I felt I would have more impact entering the policy arena or the management arena, working on institutional change or policy change." Her groundbreaking career witnessed her becoming the first woman to run New York City's Health and Hospitals Corporation in 1985; later, she served as Deputy Assistant Secretary for Health in the Department of Health and Human Services under President Clinton and as dean of NYU's Robert F. Wagner Graduate School of Public Service. Since 2007, at the helm of the 169-year-old Academy, one of the nation's leading healthcare advocacy organizations, she has brought this experience to bear on systemic factors affecting the wellbeing of New Yorkers.
In the nineteenth century, the organization addressed many of the urban public health crises that we now associate with the developing world: sewage disposal, nutritional deficiencies of childhood, infectious disease prevention. More recently, and especially under Boufford's leadership, the Academy has expanded its approach. "We're working very far upstream in terms of realizing that the way in which people can prevent illness is by changing communities....It's fine and dandy to say eat well, to say exercise...but if you live in a community that doesn't have those resources available, we end up with 'victim blaming'" which is precisely what advocates strive to avoid. While many other healthcare nonprofits focus on more traditional notions of medicine such as clinical care and access, the Academy has been tackling broader determinants of health--education, housing, transportation.
Two major initiatives currently underway at the Academy focus on healthy aging and healthcare disparities. The former began as a pilot program in East Harlem, with the Academy asking elderly community members what they saw as challenges. Among those items at the top of the list was an opportunity to swim at public pools, which led to the establishment of senior swimming hours--first in Harlem and later throughout the city. A similar initiative on the Upper West Side resulted in earlier hours at the Apple Store, so seniors could learn how to use computers, and shopping assistance at Fairway Market. The goal is to make New York an "aging friendly" city. And while the Academy's work is focused on New York, Boufford observes that the city's size and prominence mean that the world is often watching, and initiatives spearheaded in New York have the potential to spread well beyond its borders.
Boufford is herself a product of the South. She was born in North Carolina and lived in Atlanta, Georgia, until age twelve, when her family relocated to New York City, then later moved again to Michigan. As a result, she attended large public schools, but also spent a year at the Chapin School in Manhattan, which gave her "a taste for women's education." That led her to Wellesley, then the University of Michigan, from which she earned both a BA in psychology and a medical degree. She was one of 25 female students in a class of 220. As a female student, she did not feel she faced overt discrimination, but rather "there wasn't a differentiation to recognize your presence"; for instance, at convocation, the dean welcomed the students as "gentlemen." Over time, especially during her early policy career, she grew used "to being the only woman in the room." Among her most significant mentors and roll models were two non-physicians: Ruby Hearn, a senior vice president at the Robert Wood Johnson Foundation, and Margaret Mahoney, a former president of the Commonwealth Foundation, who was "one of the first women in national philanthropy" and "someone who was clearly positive about women being engaged." She also admired former Montefiore President Martin Cherkasky, an early employer, who was among the first hospital administrators to "put his head above the parapet of his own institution" to emphasis the overall health of the city's residents.
Although Boufford's path has been anything but traditional, she urges those interested in healthcare policy or management to earn their medical degrees. "Medicine is a fabulous field to go into because it offers you a tremendous amount of flexibility," she says "You have your tickets in term of whatever you want to do." #
The New York Academy of Medicine is proud to announce the recipients of its prestigious annual awards for distinguished contributions by individuals in health policy, public health, clinical practice, biomedical research and an individual who has made significant contributions to the Academy. The awards will be presented at the Academy's 169th Anniversary Discourse & Awards on Thursday, November 3, 2016 at 6:00 p.m. at the Academy which is free and open to the public with registration. If not already a Fellow of the Academy, each awardee will also be recognized at the event as an honorary Fellow.
"The individuals recognized this year have each made significant contributions to the health of the public through innovative research, practice, policy, or programs that address the complex determinants of health," said Jo Ivey Boufford, MD, Academy President. "The New York Academy of Medicine is proud to honor each of these leaders for their outstanding accomplishments."
Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, will receive The New York Academy of Medicine's Award for Exceptional Service to the Academy for her distinguished service on the Academy's Board of Trustees, including as Vice-Chair, and her active engagement in the policy work of the Academy, especially its Age-friendly NYC initiative. #
Office of the President | September 13, 2016
Dear Friends of The Rockefeller University,
I'm delighted that my first communication with you as Rockefeller's new president is to share some splendid news. The Albert and Mary Lasker Foundation announced this morning that Charles M. Rice, the University's Maurice R. and Corinne P. Greenberg Professor in Virology and Head of our Laboratory of Virology and Infectious Disease, has been named a recipient of the 2016 Lasker-DeBakey Clinical Medical Research Award. Dr. Rice will share this award with Ralf F. W. Bartenschlager of Heidelberg University and Michael J. Sofia of Arbutus Biopharma. The award recognizes their critical contributions to the development of a cure for Hepatitis C, a chronic viral infection of the liver that affects 170 million people worldwide and until now has resulted in 350,000 deaths annually.
Dr. Rice's seminal work defined the elements necessary for robust replication of the Hepatitis C virus in cell culture, a discovery that allowed rapid cell-based screening and led to the development of potent drugs that directly inhibit viral replication. Treatment with a combination of two of these drugs now cures virtually all affected individuals with negligible side effects--an extraordinary advance destined to save millions of lives.
Charles Rice was recruited to Rockefeller in 2000 thanks to the visionary philanthropy of University Trustee Emeritus Maurice R. Greenberg and his wife, Corinne. Over the years, Dr. Rice's work has received substantial support from the Greenberg Medical Research Institute, Inc. (funded by the Greenbergs and The Starr Foundation). As a result, Dr. Rice and his research team had the resources, time, and encouragement needed to tackle Hep C. The resulting impact on human health is enormous.
With Dr. Rice's selection, 22 Rockefeller scientists have now received Lasker Awards, including eight who are on our faculty today. It's an astonishing record.
Charlie Rice's remarkable work is the embodiment of the Rockefeller credo, "Science for the benefit of humanity." I know that you share our pride in his well-deserved recognition!
With best wishes,
Richard P. Lifton, M.D., Ph.D.
The Rockefeller University
NEW YORK - Schools Chancellor Carmen Fariña joined students, community members, staff and local officials today to celebrate the opening of The Dock Street School for STEAM Studies, providing 330 new middle school seats for District 13 families. The brand new space will feature state-of-the-art facilities including a science lab, science demo room, a gymatorium, and a music suite with classroom space and separate practice rooms.
Students in grades 6 through 8 from across District 13 will engage in hands-on, collaborative projects in STEAM (science, technology, engineering, arts, and math) fields. By integrating art and design into the curriculum, the school will offer an enriched academic experience in which students can find and explore new passions and become better prepared for college, careers and beyond.
"Opening a new school is a remarkable investment in our City's future, and The Dock Street School will provide a high-quality education to students across the community," said Schools Chancellor Carmen Fariña. "STEAM studies provide hands-on opportunities that engage students while integrating art and design into more traditional subjects, so that students can use applied knowledge to develop problem solving and collaboration skills."
Instruction in these subjects will also incorporate programs built in partnership with local institutions, including cultural performances and workshops at St. Ann's Warehouse, and recreational activities at Brooklyn Bridge Park. Located at 19 Dock Street in Dumbo, the uniquely designed school is just one block away from the East River at the foot of the Brooklyn Bridge.
"The District 13 community has been instrumental in the development of this school," said Deputy Chancellor Elizabeth Rose. "Families, teachers and local leaders are deeply invested in creating a supportive and inclusive school community for their children, and The Dock Street School will provide high-quality and much-needed middle school seats for students across the district to engage in STEAM studies."
In partnership with Two Trees Management, the School Construction Authority completed work on the space this summer in time for the start of the 2016-2017 school year. The building also includes a new Pre-K Center, providing 72 new free, full-day, high quality pre-K seats in the district.
"This brand-new facility provides beautiful amenities for students to learn, grow, and thrive. I am proud of the SCA's work on the Dock Street School, which adds much-needed new seats in District 13," said Lorraine Grillo, President and Chief Executive Officer of the New York City School Construction Authority. "The SCA is grateful to Two Trees for their tremendously important partnership on this project, and we thank District 13 elected officials and other stakeholders for their support of this new school."
"The success of the Dock Street School is a model that shows how the City can leverage real estate values to create public benefits like building new schools, creating space for cultural institutions or updating infrastructure," said Two Trees Management Company CEO Jed Walentas."Today represents a victory for good planning and strong leadership that delivered real benefits to the students and parents of District 13 at a bargain price for the City in addition to much needed affordable housing."
The former M.S. 313 Satellite West was re-sited into the space and the newly redesigned school is projected to serve approximately 140 students in 2016-2017. As 6th-grade cohorts expand over the next three years, the school is expected to increase enrollment to serve more than 350 students by the 2018-2019 school year, when the building is expected to be more fully utilized.
"The Dock Street School is a tremendous addition for families in District 13, offering middle school students a unique educational experience grounded in STEAM studies," said District 13 Superintendent Barbara Freeman. "Under the extraordinary leadership of Principal Dr. Melissa Vaughan, the Dock Street School will provide a high-quality education to students in the area."
"In partnership with staff, families and community members, we are proud to be a part of the team that gets to open the doors to this truly remarkable building for students to come in and learn," said Dr. Melissa Vaughan, principal of The Dock Street School for STEAM Studies. "Students joining us this school year will become part of a special community of learners with access to the facilities, partnerships and innovative curriculum needed to succeed and thrive in the classroom and in their daily lives outside of school."
Additional information is available on the school's website: http://dockstreetschool.nyc/
BY SYBIL MAIMIN
Young, enthusiastic fans of children's author Mo Willems are currently flocking to the New York Historical Society where they are rewarded with a delightful, kid-friendly exhibit, "The Art and Whimsy of Mo Willems." Giggles, shrieks of delight, and familiarity greeted the author and illustrator during the exhibit's opening week-end when, before a packed auditorium, he read from two of his books, "I Really Like Slop" and "Knuffle Bunny: A Cautionary Tale." Tall, slim, and dressed in "happy" attire including electric orange sneakers, the author, who has received the Caldecott Honor award three times, shared wisdom about his works with his audience: "Everything is true except the parts I made up," and "When a teacher says, It's writing time, it's lying time. Start with the truth and say, This is a story." On stage, as in his work, Willems seems to understand his young admirers and connects with them viscerally.
Willems studied animation at NYU Tisch School of the Arts in the 1980's and went on to nine very successful seasons with Sesame Street where he won 6 Emmys. Seeking greater artistic freedom, he began writing children's picture books, starting with "Don't Let the Pigeon Drive the Bus" in 2003. He is known for economy of line, visual gags, and illustrations that focus on feelings. "All my characters are thoroughly neurotic and have very deep emotional lives," he explains. Willems has written four children's picture book series. The "Knuffle Bunny" trilogy is about the relationship between Brooklynite Trixie (his daughter's name) and her beloved stuffed animal, a letting-go tale. The "Pigeon" series features a strong-willed unpredictable urban bird. Since his creation, Pigeon has made cameo appearances in all Willem's books. The author explains, "Pigeon hates it when I make a book that is not about him, so he sneaks in." The "Elephant and Piggie" series is about unlikely friends and is especially suited to readers aged 4 to 8. The "Cat the Cat" series, geared to younger readers (ages 2 to 5) features bright colors and simple, engaging themes. Writing early books is especially challenging, Willems notes. A story must be conveyed with about 50 words. "You just don't knock out children's books," he says. "It has to be something that can be read a billion times. It has to be a kid's friend."
The exhibit includes framed illustrations from his works, ten stations designed to resemble bus stops where, through headphones, visitors can hear Willems explain his artistic process and the development of his characters, and comfortable reading areas filled with his books. The New York Historical Society is offering a broad array of family programming to enhance visits to the exhibit including story times, gallery sketching with art materials similar to those used by Willems, movies, birthday parties, and tattoos. Opening weekend offered photo opportunities with Gerald the Elephant and Piggie costumed characters and a book signing with the author. It was an exciting time for all. The exhibit runs through September 25.
BY SYBIL MAIMIN
The venerable, and exciting, National Academy Museum and School will host "Creative Mischief," its Fifth Annual juried show of works by faculty, alumni, and students from May 18 to May 29. The vast, 100 work exhibit will fill the galleries in the beautiful Fifth Avenue Museum as well as in the Academy School on East 89th Street. Academy School Director Maurizio Pellegrin enthusiastically explains that all subjects, techniques, and disciplines will be represented. The pride of a truly international institution with 2,000 students a year coming from 40 countries, the show will reflect diverse histories, sensibilities, and approaches to art. Viewers will see everything from site-specific installations to figurative and abstract paintings, to photography, videos, and animation.
"Creative Mischief" is following a particularly handsome student show, "Black & White Perspectives: Works on Paper," that ran from April 14 to May 8. Director Pellegrin explains he wanted to produce an exhibit that bypassed the "indulgence of color" and focused on weight, mass, volume, and lines. Seemingly imposing limits, the common denominators of black, white, and paper actually stimulated an impressive mix of interpretations. New ways of seeing and doing were found everywhere. There were wall pieces and floor pieces; big, small, and in-between sizes; works of multiple parts or multiple layers; paper that rippled and flowed freely on the wall and floor as well as art contained behind glass and frame. Victoria Borisova, a second-year student from Russia, explained she grew up around clothing with a fashion designer mother. Using paper, wire, and thread, she deconstructed clothing patterns to create a 3-dimensional black and white abstract design, "Dance of the Patterns," that seemed to move rhythmically on its pedestal. Speaking about the school, she said, "There are lots of talented people who think outside the box and inspire me." Joan Lane, a New York native with ties to Vermont, represented a more traditional mode, exhibiting a matted and framed woodcut, "Freedom," that, in heavy, strong, disjointed white lines on a black ground, beautifully caught the strength and pride of a rearing horse. In "Black Coral,"Poramit Thantapalit used interlocking recycled cardboard bathed in acrylic paint and graphite to create a large abstract mass of flowers in shades of black, gray, and white. The viewer was drawn into "This Happy Breed of Man, This Little World" by Micaela Kramer, a very large and evocative collage that incorporated asphalt, gravel, newsprint, and acrylic paint.
The National Academy School, opened in 1826, offers a wide array of classes for all ages and goals. Studio Art Intensive is a 2 or 3-year certificate program based on a minimum of 12 courses a year including a concentration in painting, sculpture, printmaking, drawing, or new media. Traditional, contemporary, and experimental approaches are offered. Practical application and career and portfolio development are a focus. Faculty are professional working artists.
Art camps for youngsters are being offered this summer from June 6 through August 5. The one-week sessions are Art & Drama (ages 5-9), Drawing, Painting, Mixed Media, & Sculpture (ages 10-13), and Drawing, Digital Photography, 3D Modeling & Printing, Mixed Media, Mural Painting, Painting, Sculpture, and Video (ages 13-17). A broad range of styles, techniques, materials, and tools are offered. Materials are included. The summer ends with the Annual Young Artists Exhibition. Registration is open at: 212-996-1908, or learn more at: www.nationalacademy.org.
The National Academy Museum on Fifth Avenue has announced it will close on June 1 and put its building up for sale. The National Academy School will continue to function normally.
An absolute pleasure it was to spend time with her and confirm her participation in mid-August's show "Abstract Women" at the gallery's Jamesport location. Details to follow. Her work is mixed-media layered in acrylics and textiles; each piece holds endless possibilities for interpretation. At one time playful, contemplative, colorful, thought provoking. So much too consider in each painting.
by Allen Frances, M.D.
It seems like someone I know gets sick almost every week. At my age, this is expectable and acceptable. What is completely unexpected and unacceptable is how often doctors and hospitals make serious mistakes.
I have written about this in three previous blogs, each describing or explaining one or another aspect of outrageously incompetent medical care.
"Why Are Medical Mistakes Our Third Leading Cause of Death?"
"High Tech Medicine Can Be Bad for Your Health"
"We Have Too Many Specialists and Too Few General Practitioners"
In this blog, we benefit from the unique perspectives of Donna Helen Crisp- a patient-victim who also happens to be a nurse, lawyer, and author of the important book "Anatomy of Medical Errors: The Patient in Room 2".
Donna Helen writes: "The Center for Disease Control (CDC) compiles data on the leading causes of death. Heart disease and cancer are the top two. This list is important because it influences public health priorities, including research and funding allocation.
Unfortunately, medical errors are not on this list even though they would rank at least third. Precise numbers aren't available, and estimates are controversial, but medical errors probably cause the deaths of between 250,000-440,000 patients a year- astounding and terrifying numbers.
Many more patients, like me, survive their medical errors, to suffer untold complications, sometimes for the rest of their lives.
Why are medical errors nowhere on the CDC's list? Because human or system factors are not considered when doctors, coroners, and funeral directors fill out death certificates. They use only categories of disease, morbid condition, and injury for coding.
I know about this because I experienced horrific medical errors and adverse events after entering a hospital for a simple surgery. Instead of going home the next morning, I ended up in a coma in an ICU for weeks- after my surgeons had unknowingly torn my intestine in two places.
I was slowly dying and no one knew it. Residents were busy writing orders for me to eat breakfast and be discharged. With no one supervising the new doctors or coordinating my care, it took about forty hours before anyone realized how sick I was.
Things got worse in my emergency repair surgery. A student placed a tube incorrectly, causing me to aspirate barium dye into my lungs. In addition to the infection I had from my leaking bowel, I developed new raging infections, including sepsis.
I endured three more surgeries as doctors tried to save my life. After a month, I finally went home, unable to move, with a huge hole in my abdomen, connected to a wound vac draining machine. I had no idea how to put my life back together.
While most people know someone who has suffered with or died from heart disease or cancer, few people realize the risks patients face from injury or death due to medical errors in hospitals. Physicians and hospitals seldom disclose the truth. Patients get worse or die without knowing what went wrong.
It is possible to lower or avoid some risk factors for cancer or heart disease. Alas, there is little a patient can do to prevent medical errors. Patients cannot diagnose themselves, prescribe correct medications, observe their surgery, or coordinate their own care.
It took years for me to learn what went wrong in my specific case. Here are some of what I learned about why things go wrong:
• Corporate profit is often protected at the expense of patient safety.
Health insurance companies are complicit with hospitals, both of which need patients to produce income.
•Training new doctors is often valued more than patient safety. Patients are seldom told the extent to which they will be practiced on by new doctors or fellows. A famous teaching hospital may be the most dangerous place to be a patient.
•When things go wrong in hospitals, silence is the common response. Doctors and surgeons often deny or cover up errors, or pretend they never occurred.
•Patients and families often wrongly believe a tragic outcome is due to bad luck, or fate.
Here are some of my proposed solutions:
•Healthcare systems and insurance companies need to value patient safety more than profit.
•Hospitals and other healthcare facilities need to operate with transparency so errors can be identified, understood, and eliminated.
•Consumers (and providers) of health care need to learn the truth so they can advocate for safety and prevent medical errors and adverse events.
•Hospitals need to provide leadership and training to encourage and support doctors and other staff to be accountable for their actions.
•The public must become aware of the risks they face in medical settings from preventable errors.
•Consumers of health care need to become their own change agents.
Here is what patients can do:
• Ask question about every procedure every step of the way and expect clear answers about risks and benefits.
• Maintain current advance directives - living will and health care power of attorney. Keep originals and provide copies when entering a health system.
• Ask who will participate in your procedure or surgery. Will students, residents, fellows, or observers be present? If so, what will they be doing to your body?
• The "informed consent" you are required to sign is usually minimal and generic. Much of what you are consenting to is not written on the form or discussed with you. You have the right to add or delete certain items before you sign the consent form, even if a doctor or nurse says otherwise.
• Keep a list of your medications and know the purpose, risks, side effects, and interactions. On average, there is one medication error per patient per day in hospitals.
• Have someone act as your advocate and stay with you at all times, or at least during the day and evening. Staffing shortages are common. Once, I sat in a chair for more than two hours waiting for someone to help me back to bed. It was after midnight and my family had gone home.
• Know the chain of command. If there is a problem, speak with your nurse, the nursing supervisor, the unit manager, the doctor, doctor on call, or the doctor's supervisor. Never assume a new nurse or resident is an authority on your problem.
•If no one can help you, dial zero and ask the hospital operator to connect you with the administrator on call. If this fails, consider dialing "911." I know a nurse who worked at a major medical center. One night, when she could not get anyone to help her patient, she called "911" and it worked."
Thanks, Donna Helen. Hospitals are now competing for patients in all the wrong ways- trying to be the fanciest hotel, not the safest and best deliverer of care. Instead of spending fortunes on new lobbies and ritzier rooms, hospitals should be doing much more to perfect quality assurance programs that can prevent errors.
Doctors no longer have time to know their patients and instead are often treating lab tests, not people. We need fewer high tech specialists and many more primary care doctors to organize care and ensure it makes sense and is done well.
Health providers must admit mistakes and learn from them. This actually reduces the risk of malpractice suits and results in fewer future mistakes.
Patients and families can't be passive. You really have to become fully informed and fight for safe care. Unfortunately, your basic assumption must be that things will go wrong unless you take some responsibility for monitoring them.
People should become much less afraid of disease and much more afraid of treatments.
To learn more about medical mistakes, everyone should see one of the best movies ever made, the hilarious
black comedy, 'The Hospital'.