Second, Dr Makary works for a major teaching institution. In other words, a teaching hospital. Using his arguments, we should ban all teaching facilities. Teaching hospital allow residents (physicians who are being trained) and nursing students to actually treat patients. These residents actually operate on patients. It does not matter how much supervision he or she may have. Using a scalpel or cutting near the aorta has risks. By Dr Makary’s argument, this should not be allowed. Let me go further. Teaching institutions will have complications, I can guarantee that almost any surgery will be safer in the hands of a board certified surgeon than a 1st year resident. If we follow Dr Makary, there will never be any well trained surgeon. Ever hear the old adage, never go to a teaching hospital in July. That’s because all the new interns start July 1st!
OK, lets go a little deeper. Most hospitals now have extensive precautions to minimize any of those horrible complications he sites. St. John’s Health Center and Cedars Sinai here in Los Angeles, and all other good hospitals, institute double and triple check systems before any surgery. We have what we call time outs, where everyone in the operating room must stop what they are doing and either the surgeon or the nurse will do a sort of pre-flight check. ALL must be in order.
The first paragraph of the WSJ article claims that American medicine is more deadly than the airline industry. I love a smart guy who can mix and match whatever he likes. Reminds me of the silly joke that went around when I was a kid, but makes sense now: “Do you walk to school, or carry a lunch?” One has nothing to do with the other. Except if you believe in yellow journalism.
His solutions are interesting and I’m not opposed to them in principle, but I reject his claim that this will remove all medical errors. He is trying to quantify what he considers being a good doctor. Dr Makary, that can not be done. That’s like trying to quantify and qualify what makes a good person. It’s a bell shaped curve.We can give general guidelines, but that’s about it. Government intervention can not make a good doctor, nor can it prevent a bad one. Just like voting for a President doesn’t make him a good one, no matter how much hope is promised.
His first solutions: