The NY Times ran an article yesterday titled “You’re Sick. Now What? Knowledge is Power“. One of the phsycians states
The goal is to find an M.D., not become one.
I am not so sure – I think the goal is too become better informed so you can be a better partner with your physician. The article is right about balance and everyone must determine their information personality. If you like lots of information you can find it, if you don’t it is easy to get overwhelmed. No matter your desires there are many sources and not just limited to Google and the world wide web (although in todays digital age these are the easy choices).
Gather the information, try to distill it and then use it to educate yourself and bring the information with you when you consult your doctor, being careful not to overwhelm him the process with hundred’s of pages of print out that would be impossible for anyone to process in a time limited consultation.
If you are lucky your doctor will have the time to help you process the information and will use it to help guide your care. But even if they don’t being more informed is always better than being uninformed.
There is no rocket science in the ideas behind Peter Pronovost’s concepts for saving live but it’s important to look for in any institution. So he deserves the recognition from the John D and Catherine T MacArthur Foundation as a newly inducted fellow
His work has received criticism and resistance but there is no denying the results:
To address this all-too-common problem, responsible for thousands of
deaths each year, Pronovost culled lengthy guidelines into a simple
checklist of five precautionary steps and tested its efficacy through a
cohort study conducted in ICUs throughout the state of Michigan.
Pronovost’s checklist intervention yielded a significant and sizeable
decrease in rates of infection…
The idea was the subject of an article in the New Yorker titled The Checklist which stated:
If a new drug were as effective at saving lives as Peter Pronovost’s
checklist, there would be a nationwide marketing campaign urging
doctors to use it.
There is reference back to the B-17 bomber test of 1935 that ended in disaster because of “pilot Error” – what they meant was it was “too much airplane for one man to fly”. The soltuion ot the problem – simple checklists to help pilots fly the airplane. Medicine as the article states “has entered the B-17 phase”
Peter Pronovost idea – On a sheet of plain paper, he plotted out the steps to take in order to
avoid infections when putting a line in.
(1) wash their hands with soap
(2) clean the patient’s skin with chlorhexidine antiseptic
(3) put sterile drapes over the entire patient
(4) wear a sterile mask, hat, gown, and gloves,
(5) put a sterile dressing over the catheter site once the line is in
As I said – not rocket science – but armed with the right information to observe even patients can get involved to make sure that they are receiving the best possible care.