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Sunday's letters: How modern medicine should learn from its mistakes

 
Published Dec. 14, 2018

There is nothing more heartbreaking than watching your child suffer. "Heartbroken," detailing the recent troubles of Johns Hopkins All Children's Hospital Heart Institute, is absolutely heartbreaking and infuriating. But unfortunately, not surprising. The truth is that this could happen at any hospital. I currently care for pregnant moms as a resident in OB-GYN in Washington, but I trained for a few weeks at this hospital during my pediatric rotation while attending medical school at the University of South Florida in Tampa, my hometown.

The gigantic machine that medicine has become makes it all the more important to emphasize honest, vigorous focus on pragmatic patient safety and quality improvement, not just lip service to an abstract ideal.

In this case it's clear that efforts were made to improve, and many people made good-faith efforts to recognize problems and attempt change, even when it meant putting their careers on the line to speak truth to power. It wasn't enough, and it wasn't in time for these kids. We must learn from this. Transparency is a great first step but as anyone familiar with statistics will tell you, outcome measurement out of context can be misleading. Complicated patients often have more complications. Here are steps that should be taken:

• Be open and honest about mistakes and complications, and we need fair tort reform to do this.

• Emphasize patient safety in medical education and residency.

• More top-down emphasis on encouraging anyone and everyone to speak up and "stop the line" and less emphasis on ridicule and anger.

• Use morbidity and mortality conferences for doctors to review less than ideal outcomes among peers.

• Enact comprehensive healthcare reform to help remove the financial component from medical decision making.

• Patients and family members should ask questions, push to have face-to-face conversations with their doctors and refuse to be brushed off.

Medicine needs to continue to be held accountable.

Elise Diamond, Fairfax, Va.

Let them vote | Editorial, Dec. 7

Follow the will of the people

Apparently our governor-elect thinks that felons shouldn't be able to vote until the Legislature enacts the rules to facilitate the constitutional amendment. Don't be shocked. Since 1995, our governors and the legislatures have ignored another constitutional amendment passed by the people. Then, the Florida Constitution was amended to require all polluters of Florida's Everglades to pay for their damage. No legislation has ever been enacted to implement that amendment, and the full pollution cost fell on the state. Might there be big political funders who don't want to make either of these amendments effective?

Gregory Matthews, St. Petersburg

We're still texting while driving? | Letter, Dec. 13

My bill to make roads safer

I have filed a bill for the 2019 legislative session that would prohibit the use of all hand-held wireless communication devices while driving. The "Hands-Free Florida Bill" (HB 45) would ban the holding or touching of any wireless communications device while driving.

Opponents believe the bill will lead to invasion of privacy and racial profiling. But this bill was specifically drafted with these concerns in mind. On privacy: Only in the event of a crash resulting in death or personal injury would a driver's wireless communications be admissible to determine if a device was in use. To prevent racial profiling: When a driver receives a citation, the officer must record the driver's race. This information will be in a database for an annual report.

In 2016, distracted driving caused 50,000 vehicle accidents in Florida; 3,500 people were seriously hurt, and 241 died. In that same year, 3,450 fatalities were attributed to distracted driving across the United States. A University of Utah study showed that drivers using a wireless device displayed greater impairment than legally intoxicated drivers.

These aren't just statistics, these are real tragedies that affect real people, every day. Each of these tragedies brings me back in memory to the day in 1996 when I lost my twin sister, Dori, in a car crash. I live with this tragedy every day. In honor of my sister Dori, public safety is my No. 1 priority.

Emily Slosberg, Delray Beach

The writer represents District 91 in the Florida House of Representatives.

Pathogens by the plateful | Dec. 7

How to stem food poisoning

Although most people recover from a bout of food poisoning in a few days, the Centers for Disease Control estimates that 3,000 Americans die each year from food poisoning. Many others contract long-term illnesses such as Guillain-Barre syndrome, hemolytic uremic syndrome and irritable bowel syndrome. Some even suffer permanent spinal injuries from forceful vomiting. Since the treatment regimen is the same for most stomach ailments including food poisoning, hospitals routinely categorize them with the catch-all diagnosis of gastroenteritis. Therefore, many cases of food poisoning are undetected, and others may become ill from eating the same food. Obtaining a stool sample test and reporting positive results to the health department could prevent many illnesses and possibly save lives.

Dan Kasaris, Madeira Beach

6M acres of Florida wetlands face risk | Dec. 13

Keep our water clean

We may have to get used to Red Tide, green algae slime and its smell, brown water and dead sea life if President Donald Trump's rollback of regulations regarding the pollution of wetlands and tributaries takes effect. This will mean more fertilizers, phosphates and industrial waste flowing in our waterways and into the ocean. Don't let this happen.

R. Estabrook, Riverview