Thursday, June 14, 2007

Our Medical System Is Dying: Can Anyone Really Save It?

So what do we do? Our medical care system is in trouble. Funding is at an all-time low. There is a lack of nurses, doctors and support staff. Waits in Emergency Rooms can be up to 24 hours here in Los Angeles. I hear all the crap about reform, reform, reform. But there are no valid solutions. People say to get rid of all the illegal aliens and that will fix the problem. I don't think so. Recently, one of our level-1 trauma centers had an incident in which a lady (and yes she's Hispanic and had a warrant, but that's irrelavent) writhed on the floor in pain and eventually died. This story is a moral and human breakdown and it's all caught on tape. Check this out...

At 1:43 a.m. May 9, Edith Rodriquez, 43, a mother of three had her boyfriend, Jose Prado, place a call to 911 from a pay phone just outside the emergency room at Los Angeles' Martin Luther King Jr.-Harbor Hospital. She is throwing up blood. Family members say hospital workers ignored their pleas for help, so they called 911 from the hospital frantically seeking help. A half an hour later, Rodriquez was dead, leaving the family reeling.

911 Operator: "What's wrong with her?," the 911 operator asked.

Prado: "She's vomiting blood."

The operator then questions why hospital officials are not helping Rodriguez.

Prado: "They're watching her and they're not doing anything. Just watching her."

Now the story behind the story. Rodriguez had been to the emergency room on three separate occasions. Each time she was released after being given prescriptions for pain. This time, she lay on the floor of the emergency room for 45 minutes. A security video shows staffers and other patients standing by as a janitor cleaned the floor around her. Eight minutes after the first call, another call to 911 apparently comes from another person not related to Rodriquez. "There's a woman on the ground of the emergency room at Martin Luther King and they're overlooking her," the female caller says, "and they're ignoring her." The operator asks the caller what she wants him to do and informs the woman to contact hospital personnel. The conversation then becomes tense as the operator lets the caller know he cannot send an ambulance to the hospital.

King-Harbor, formerly King-Drew, in Willowbrook, south of Watts, could still lose its federal certification for failing to meet the terms of a March agreement with the U.S. Centers for Medicare and Medicaid Services, even if the problems were resolved. Last week, federal inspectors declared that patients at King-Harbor were in "immediate jeopardy" of harm or death and gave the hospital 23 days to correct procedures or lose certification. It was the fourth time in less than four years that the hospital had received the warning, according to The Los Angeles Times. Federal health officials gave Martin Luther King Jr.-Harbor Hospital 23 days (are you freaking kidding me?) to fix emergency room problems or lose federal funding once and for all.

This troubled hospital seems to be a product of its environment. Very sad that it should come to this; obviously the hospital is severely underfunded, understaffed, and what staff is employed is undertrained and under qualified to care for others. There are some important missing details here but even if they were provided, for this to happen is pretty shocking. The 911 operator seemed equally unqualified for the job. The problem is, how would closing the hospital help anything? Surrounding hospitals would just be inundated with more patients than they could possibly handle too. We're losing trauma centers every day due to underfunding. Reform of the system isn't going to do jack if there's no system to reform.

Opened in 1972 after the Watts riots, King-Drew was intended as a beacon of competence and modernity. Instead, long before the Los Angeles Times published its devastating 2004 investigative series on the place, King-Drew was known as “Killer King,” one of the worst hospitals in America. But, for all its scandals, it remained crucial to the county health care system — and especially to South Los Angeles. For the past several years, the five-member, elected Los Angeles County Board of Supervisors has been downscaling the facility in an effort to keep it functioning.My gastric bypass surgeon practices there and she specializes in multiple-gunshot trauma. It's one of the few hospitals that can hand this type of injury. We need this hospital. It's essential to our LA system.

This tragic event and the countless others indicate the need for medical reform in the US, but particular systems that provide 100% coverage (social medicine) like those found in Sweden, the UK or other European countries are not the answer. Americans would never settle for the quality of social medical service provided in other countries. Six months ago, a guy in a Swedish ER with acute abdominal pain and intestinal bleeding while waiting six hours to see a doctor. When the bleeding intensified, they could not find any staff of any kind for 20 minutes. If there would have been a private option, the patient would have gladly paid for it out of my pocket. During the four day stay in the hospital, he considered leaving the hospital and flying to the US for treatment. Coincidentlly, one of the fastest growing service industries in Sweden at the moment is private medicine! Reform the system, but do not replace it...medical reforms must preserve service flexibility, quality, and provide for the research and development that leads to improved medical technology.

So is this a race issue? Nope. In 1990, 71.6% of the employees were Black, 11.8% were Hispanic, 8.4% were Asian, 5.2% were White, and 3.1% were Filipino. After complaints about King/Drew’s hiring and promotional policy, the Equal Employment Opportunity Commission (EEOC) investigated and found that King/Drew did not recruit, hire or promote Hispanics, a group that comprises 60% of the hospital’s patients. There have been 35 race-based discrimination cases filed against King/Drew since 1991, and three have been filed within the past year. Today, 60.8% are Black, 18.5% are Hispanic, 9.6% are Asian, 5.4% are Filipino, 5.6% are White and 0.1% are American Indian. There is a lack of hospital personnel in the US. Many nurses work 12 hour shifts and rarely have time to pee or eat lunch or dinner. When I go home at night, my feet and legs hurt so bad I can not sleep. Hospitals are understaffed and nurses have been and are lobbying for better staffing ratio's.

IT IS TIME FOR EVERYONE, AND NOT JUST THE MEDICAL PROFESSION, TO GET OFF THEIR BEHINDS AND DEMAND SOMETHING BE DONE. As far as insurance reform, find out what you are talking about. Obviously you don't have a clue about insurance reform. It has more to do with providing equal care for everyone then paying Drs.As far as staff standing around and watching this woman die, I think it would be good to actually "watch" the video and find out what kind of staff they were. Everyone that wears a uniform in a hospital is not always a doctor or a nurse.....Yes, I agree that it is horrible that this happened. But waiting in ER for 45 min. is not unusual at all. Emergency rooms are often over crowded and ER staff work as fast as they can to get to them. Lots of people use ER's as their Dr. and take kids and family members for conditions that could and should be treated in a Drs. office. They do not have insurance so they DO bring them to the ER because and ER CAN NOT refuse to see them. This travesty is our fault not just the medical and insurance profession. I don't have the answers and I think we've got to take a hard look at the problem and make it fair and equitable to everyone. Do you like to work 12 hours? Do you want to make more money? Sure, that's human nature. Why is it that we blame hospitals, doctors, nurses and the insurance system?

We need to do something about this other than blaming everyone else. Of course, that's just my opinion, I could be wrong!