Monday, November 26, 2007

People Vs. OPMC

In late 2000, a group of us visited with the OPMC, Office of Professional Medical Conduct in New York City to discuss the unfairness of the group’s cases of what they felt were medical misconduct. The cases were closed by the OPMC and in our opinion, unfairly so.

I met earlier with the person in charge who invited me to bring members of PULSE to present their case and maybe they would be reopened. I spent many long hours investigating cases, reviewing backgrounds and information given to me that I believed was an obvious oversight, or perhaps purposely left out of the cases that were reviewed by the OPMC. I worked with the patient, and sometimes surviving family members to review the information and draw up the correct information to be presented, this time with the patients’ side of the story.

We met with a fairly large group of OPMC staff and each participant got to share their concerns. We presented information that we felt was important to each case. In one case, a patient found a letter to another doctor in her medical file asking her next doctor to lie were he to be called in as a witness. This was submitted to the OPMC. In another case, I used research by the doctor in question that said no one should use the medication prescribed for this patient. The doctor recommended a series of treatments to the elderly patient that this doctor himself suggested should never be used – ultimately killing the patient.

When we left the meeting, I was told by the people there that the OPMC needs a lot of work. “It’s people like you”, one person in charge told me, “that can get things done”.

We trusted that these cases would be reopened as it was early in my advocacy career and I still had faith in the system. Weeks went by and each participant received a letter that read that the case is still closed. No further investigation was in order.

Months later, I was invited to give testimony about the work of the OPMC. I brought some of these people with me but was most surprised when the first panel gave testimony and one of the legislators said to the OPMC staff “you were pleased with the way you operate. You thought you were doing the state a service and you quoted various indicators that nationally you were recognized as doing a good job.”

The staff person now had an opportunity to suggest changes, but he didn’t. He protected his job while putting patients in harm’s way. “He lied to me” I thought. I later saw him in the hallway and he began to share pleasantries. “You lied to me or you lied under oath” I told him. I was soon to learn how the OPMC ran.

Now today, many years later, Dr. Harvey Finkelstein of Plainview is in the news. The doctor broke some rules, the OPMC investigated and the public is not permitted to know what he did, what the OPMC did, what was found or how it was handled. We have to assume that the state has our best interest in mind - but I think we know better. Actually, the whole thing makes me physically sick.

Posters on Infections

I spent today at a local college helping the graphics design class design posters with the subject of my choosing. Of course, with the recent press about the spreading of infections and MRSA, I was able to talk to them about the importance of hand washing and just knowing about germs, diseases and hospital acquired infections.

They had a choice to design a poster for a school or a hospital or even a doctor’s office. Anyplace that people needed to be reminded to wash their hands. My first visit was to talk about the statistics of hospital acquired infections. I put a face on the numbers and we talked about the obvious things people can do to avoid infections.

Today I went back to review their posters before the final project is due next week. The most impressive thing about this is that these kids, ages 19-20 really “get it”. They can be taught about infections and the importance of hand washing, avoiding germs and proper contact. Some developed super heroes. Others focused on kid stuff like the germs on cell phones and I-Pods. Some did their project with instructions on hand washing. One young man designed a super hero that zapped the germs but wouldn’t use the word “kill” because that would not be kid friendly.

It was fun. The best part of my work is introducing people to patient safety in a friendly and fun manner. I give a 100% to my friend Diane who let’s me do this with her class. She’s a teacher who really cares about substance as well as the art.

To see a news clip of the event visit:

Friday, November 16, 2007

Dirty Needle Doctor

The recent press about Dr. Harvey Finkelstein has really got me in a tailspin. Just when you think we may be making headway, New York proves we are light years behind in protecting patients.

First, how bad must this doctor be if he didn’t know basic infection control procedures? If he didn’t know, he should be closed down immediately - and if he did know but didn’t follow the procedures, he should have been closed down immediately. But instead, our state Department of Health, Office of Professional Medical Conduct kept him open for business while monitoring him allowing him access to more patients and opportunities of spreading more disease and ruining more lives.

Second, what was going on that took the OPMC so long in this investigation? He either didn’t know procedures or he did. (see above) either way, he should have some kind of discipline to make sure he doesn’t think he can get away with not knowing what most medical students (so I have heard a lot about recently) learn in the beginning of their career, basic infection control methods.

This guy is a scapegoat. He’s not the first person to get away with bad behavior in our states disciplining process. He’s one who got caught. With the lack of transparency we have no idea what goes on when a doctor is being investigated – or not. There is no reason we shouldn’t post physicians who are being investigated unless the OPMC investigates unnecessarily. If they don’t investigate for sound reason, let the public know that there is, in fact an investigation going on.

Just look at this guys profile he’s got 10 malpractice payments since 1998 – 5 above average. He only graduated in 1981. Hardly something a patient should ignore. Don’t tell me anesthesiologists get sued regularly. I went to the same website and out of the first 15 anesthesiologists I looked at (in alphabetical order to make it fair), only one had a malpractice payout listed.

Surely someone is not doing their job. After 3 malpractice payouts, shouldn’t someone be looking a little bit deeper at the doctor’s practice?

Its not like patients or surviving family members have too many choices how to proceed if they are not satisfied with their care. They either complain to the facility, go to the state Department of Health or find a lawyer to take their case. In this instance the DOH let the public down by not disciplining the doctor or at least shutting him down immediately, allowing him to control what patients names get shared for the investigation and which names don’t therefore delaying the information getting to the public. The DOH waited until the statute of limitations of 2.5 years ran out. So now what does the public have to count on to protect us?
Thank goodness for the press.

Thursday, November 1, 2007

Is Flying Like Surgery?

I used to hate to fly. I don’t hate it as much any more. I don’t fly that much. Maybe much more than when I worked in the post office, but much less than some of my colleagues in patient safety.

I hated flying because of the lack of control, frustration of being locked in a seat for many hours and just missing being with my family. I don’t “hate” it as much for the same reason. I looked at the clouds this morning on my early morning walk and said aloud “I’ll be there soon”, locked in a seat, leaving troubles behind – but still missing my family. The last time I flew, I realized there is nothing I can do to protect myself. I simply had to trust the airline industry, pilot and everyone else who worked together to keep me, and the other passengers safe. It helped me to think of leaving all my frustrations behind and I was “lifted” above the world of work, frustration and any stressful thoughts.

It’s almost like that with surgery. We are “locked” in our seat. My dad is going for surgery next week. I can’t stand it. He is my hero, my rock. He knows about patient safety, maybe too much and he did his homework. He chose the doctor he liked best for a whole lot of reasons. My dad has to use the hospital his doctor uses. Going for surgery is almost like getting on a plane. It is limiting what you can do to stay safe.

I don’t want my dad to be thinking about telling the staff to wash their hands or to plan on asking them to not kill him with someone else’s medication. He should not have to worry about making sure people know who he is and have the correct procedure. I will be there to do my best. But, now I’m nervous because even some of the best doctors have watched horrible things happen to their family and felt powerless to avoid it.

What scares me about this “partnership”, the term used so freely in healthcare to make patients think they have a role in their safe care, is that this hospital has never shown any interest in partnerships – at least to me, a community member who travels around the country talking about the patients role in patient safety and does community education in this hospitals community.

I have reached out many times to South Nassau Communities Hospital in Oceanside LI but have never received a response, even a generic letter from the staff or CEO who I have contacted to learn about their role in patient safety. Although like many Long Island hospitals, I’m sure they do care about patient safety, especially after the recent news about a dead baby being found in their laundry, but I just can’t seem to find how they include the patient in patient safety. Maybe they hand the patient a Joint Commission Speak Up Brochure in their admissions packet.

When putting the words patient safety into their search engine, I get a picture and bio of the CEO. I was so shocked that I asked others to try in case my computer wasn’t working. Nothing – or at least nothing that I could find about this hospital working with their patients for safe, quality care.

So, I guess I will be on the plane later today and hope for the best, and I will be with my dad for surgery next week at South Nassau Communities Hospital and hope for the best, but if for any reason we are not satisfied…………………….