Regulations Are Killing Me

The title is a bit of an exaggeration. Regulations are not killing me but they certainly are driving me, along with many other providers, right out of medicine.

Yesterday, I had to sit through another one of these interminable meetings-from-hell. So did the whole rest of my Division: doctors, nurses, admin staff, social workers, and technicians. The meeting cost over $1000 and all we got out of it was frustration.

The meeting was about National Patient Safety Standards. Regulators in Washington thought up what they believed were important safety issues and then created rules. These were not based on evidence; there were no calculations of cost or impact; the standards were applied to everyone; and there was no system for feedback of effects.

Apparently, our Division was not meeting the National Standards because we did not ask our patients about smoking habits or suicidal thinking. Our Division cares for babies and infants with heart problems. Can you just see me asking a three month old with a hole in her heart how much she smokes? Imagine a nurse asking a post-operative six month old if he is thinking of killing himself. Ludicrous. However, by not doing these things, we were “out of compliance” and the whole hospital could be fined or even closed.

What if you went to the doctor with a headache and she proceeded to operate on your ankle? What has your ankle got to do with your head? Answer: about as much as smoking cessation and suicide prevention have to do with eliminating patient injuries – Nothing.

The regulators went directly from noticing a problem to solving it. What happened to?

  • Problem delineation;
  • Data gathering;
  • Outcomes measurements;
  • Testing for effects;
  • Evidence analysis;
  • Alternative solutions;
  • Evaluation; and
  • Feedback.

No wonder regulations do nothing but frustrate patients as well as healthcare people!

The SystemMD

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