Tuesday, December 29, 2015

Another Failure for Socialized Medicine

If I had to speculate I would say that a goodly majority of physicians does not thrill when patients do Google searches about their symptoms.

The poet said: “A little learning is a dangerous thing” and it is probably true that googling your symptoms will produce more anxiety than light. Best to consult with a physician before jumping to what is likely to be the wrong conclusion.

Speaking of truthiness, Paul Krugman has assured us that socialized medicine is the best of all possible worlds. You do not think that the Nobel prize-winning polemicist could be skewing the facts, do you? I am referring to Krugman’s often quoted line that all the horror stories about the British National Health Service are false.

In Krugman’s words:

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. 

One should not fail to note that Krugman had also argued, several years earlier, that the Veterans Administration should be the role model for American health care. How did that one work out, Kruggy?

Today, we discover, to everyone’s chagrin, that a young British woman’s Google searches provided better information than her physicians in the National Health Service hospital in Nottingham. And that her physicians ignored the information.

The nineteen-year old was named Bronte Doyne. The London Telegraph reported the story a few months ago:

A teenager who begged doctors to take her health fears seriously in the months before she died from a rare cancer was told by medics to "stop Googling your symptoms".

Bronte Doyne died on March 23, 2013, aged 19 - just 16 months after she first complained of severe stomach pains.

In text messages, tweets and personal diary entries, the student expressed her worries that medics were not acting as her health deteriorated.

Doctors dismissed her concerns, leaving her desperate for someone to take her seriously….

Finally, after pleading to be taken seriously, she was admitted to hospital where she passed away 10 days later.

Now bosses at the Nottingham University Hospitals NHS Trust have admitted they "did not listen with sufficient attention" and that they must embrace the "internet age".

The NHS physicians thought that she was hysterical. They were wrong. They now believe that they need to enhance their listening skills. Their patient died. Apparently, in the NHS no one is held accountable. 

Were there any indications that Doyne might really be very ill? In fact, there were. She was being treated for liver cancer.

The Telegraph writes:

Miss Doyne, of West Bridgford, Nottingham, was first admitted to hospital in September 2011 with suspected appendicitis. But she was eventually told she had fibrolamellar hepatocellular carcinoma, which affects only 200 people globally each year.

The family found information about the cancer on a website endorsed by the US government and discovered it had a high chance of recurrence but, when they raised the issue, doctors told them to stop searching the internet for information.

Now Miss Doyne's mother Lorraine, 50, has criticised "a woeful lack of care and empathy" from doctors.

She said: "Bronte was denied pain relief, referrals were hugely delayed and efforts by her family to gather information and understand Bronte's prognosis were handled in an evasive and aloof manner.

"Her fears that her symptoms over the preceding months before she died were cancer-related were proved right. The messages from Bronte are all her own words and I believe that's more powerful for people to understand what she went through. I want to see changes and action now."

We understand that her cancer was very rare. And we understand that she might have died anyway, even with the best treatment.

Yet, that is not an excuse for ignorance and incompetence. The information was available to anyone who wanted to check on it. One appreciates that the parents are grieving, but we cannot fail to notice that the problem was not a lack of empathy… it was her physicians’ arrogance, cockiness and sloth. And that assumes a certain level of competence. Do you think that a government run health care system attracts the best and the brightest?

The physicians told Bronte and her parents that the cancer was in remission. The American website suggested that their view was overly optimistic.

Mrs Doyne said they were led to believe the surgery would cure the cancer but the online information suggested otherwise.

She added: "We asked after the surgery if they were suspicious the cancer could come back but their response was 'how will that help Bronte?' We were told they will be seeing her over the next 20 years - it made her feel relieved but she still didn't feel quite right.

"We weren't given any information by the hospital about this but we did know it had a really poor outcome, yet they did nothing and just left us to wait and dismissed her concerns."

The Telegraph continues:

She underwent liver resection surgery in December 2011. But 11 months later, after doctors had told her she was fine, she wrote in her diary In November 2012: "Feeling sick for months now. Tired of this feeling crap. Hospital not worried so trying to get on with it."

Six weeks before her death, she was advised by her GP to go to hospital as an emergency case if her symptoms worsened.

But when she got to Nottingham's Queen's Medical Centre, Miss Doyne was told by a doctor that she did not need to be seen.

She wrote: "I got so angry because the doctor was so rude and just shrugged his shoulders. He gave me a sarcastic comment like you can sleep here if you want but they won't do anything. So I just have to wait for another hospital appointment."

One is struck by the insouciance of these physicians. They seemed not to care about a seriously ill patient, whose initial complaint was decidedly not hysteria. After the patient died, the physicians and the bureaucrats still seemed not to care. They thought the problem was communication, not competence.

And they seem radically incapable of doing their jobs. It’s a frightening scenario. If people like Prof. Krugman have their way it will soon be coming to a hospital near you.


Dennis said...

Since I am still dealing with a daughter who was denied an operation on her back by TRICARE which has crated all kinds of problems, both mentally and physically, I am well aware of the disconnect that is created by Socialized/Government healthcare. Because they denied this surgery my daughter is now going to cost the taxpayers of this country a lot more and for a far longer time. Every disc in her spine are slowly eroding. Something that in the beginning was easily fixed. This is not even considering the addiction to pain killers.
Though I have access to VA facilities I stay as far away as is possible. I almost consider the VA as the Veteran's "roach motel." Veterans go in, but don't come out. My first experience was a lasting experience. The place was dirty, people slogged along and I don't remember seeing a caring face or attitude in the place. It fact the attitude towards veterans was much as I experienced in a government Human Resources office when dealing with Vietnam veterans. One that could be considered as pure disregard bordering on hatred. It was as if you were supposed to die and I resent you not dong it. "Rosie the Riveter" did not make the jump to the 60's and thereafter.
I am not sure if it is still like that, but if current headlines are any indicator things have not changed. I am not sure what creates the attitude among people in government that begins to see people as less than human, as a bother or with such disgust. I sometimes wonder if this does not come from a welfare system that breeds contempt for others or the fact that many got jobs because others were expected to do the dying. The more one makes people dependent upon the government the less one cares for people who actually earned the benefits. I guess the closer one stands next to a mud puddle the more one gets soiled by the mud.

sestamibi said...

I suppose it might be a bit too incendiary, even for you Stuart, but I can't help but wonder what the race/ethnicity of the medical personnel involved was.

Sam L. said...

This is brick in the wall of why I have no trust in Paullie The Beard" Krugman (and by extension, the NYT, though there are more reasons) and socialized medicine.

Stuart Schneiderman said...

The report said nothing about the race/ethnicity of the personnel. If it had I would have said something, no matter how incendiary.