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The Recovery Room 003: Patient Safety, Patient Responsibility

Back in Fall of 1999, the Institute of Medicine published the landmark article "To Err Is Human: Building a Safer Health System." Its most startling finding was that an estimated 44,000 - and maybe as many as 98,000 patients - were dying every year due to medical error. The equivalent of a jumbo jet crash every day for a year. In its wake, the modern patient safety movement took off, insisting on more accountability, more transparency, and changes to the systems that allowed fatal mistakes to take place.  So ten years after To Err Is Human ... what's changed?
Segment 1
Dr. Paul Schyve: Patient Safety, Part I
Dr. Paul Schyve is a senior vice president at the Joint Commission. The joint commission accredits and certifies more than 17,000 private hospitals, health care organizations and programs in the US.
A recent paper published in Health Affairs gave the health care industry a "B minus" on its safety efforts since 2004 which was obviously the five year anniversary of the landmark Institute of Medicine paper To Err Is Human. Among the things the author notes as an area that requires great improvement is the industry's limited ability to measure progress is safety. Is there a movement toward greater disclosure and transparency in the industry?
Segment 2
Dr. Thomas Russell: Patient Safety, Part II
It's the 10th anniversary of an Institute of Medicine paper that served as a major wake up call for American hospitals and physicians and acted as the catalyst for the modern patient safety movement. The paper, To Err Is Human: Building a Safer Health System" estimated that tens of thousands of patients were dying every year due to medical error.
Dr. Tom Russell is the former executive director of the American College of Surgeons, the world's largest organization of surgeons.  Russell is also the author of the recent book "I Need A Operation ... Now What?"
Segment 3
Dr. Thomas Russell: Patient Responsibility
It's important, obviously, to choose a surgeon who has the expertise for your operation, but what is the right and responsibility of a patient to know about the experience of the surgeon. What should the surgeon disclose, what should the patient ask? Is this important?

The Recovery Room 002: Alternative Medicine Gets Integrated

The number of physicians who support the integration of alternative and conventional medicine is still small, but it’s growing. Part of the problem say supporters is not a lack of evidence, but a lack of emphasis. Two doctors trained in both conventional and alternative medicine make the case for integrated medicine. Also on the show: hospital chaplains and their own battle for relevancy in 21st century medicine.
Alternative, complementary, integrative. Non-conventional medicine goes by many names and covers a broad array of treatments and procudures. A third of the country uses some form of it, but lots of doctors are still uninformed and skeptical of it. And insurance convereage of alternative medicine is spotty at best.

Segment 1
Dr. Russell Greenfield: Making the case for Integrative Medicine, Part I

Dr. Russell Greenfield was trained in Emergency Medicine at Harbor/UCLA medical center and at the Fellowship in Integrative Medicine at the University of Arizona College of Medicine under the tutelage of holistic health guru Andrew Weil. He has consulted in the development of national model guidelines for the use of complementary and alternative therapies.

Segment 2
Dr. Thomas Lobe: Making the case for Integrative Medicine, Part II

While the benefits of complementary-alternative medicine continue to be debated, pediatric surgeon Dr. Thomas Lobe uses alternative therapies like clinical hypnosis and acupuncture to help children recover from surgery, as he’s been doing for over 30 years.
Segment 3
Debra Jarvis: The life of a hospital chaplain


As practitioners of alternative medicine continue to struggle for acceptance in a health care system that rightly or wrongly demands results-driven proof for the treatments they provide, hospital chaplains face a similar battle in their own effort to update their image as a legitimate and valuable member of today’s health care team.

The fact is, if you’ve spent any time in a hospital recently, you probably didn’t meet the hospital chaplain. If you did, you or a loved one were likely on the receiving end of a terminal diagnosis. Offering spiritual comfort in often the most trying situations, hospital chaplains play an invaluable role in the care of patients who have run out of medical alternatives.  But as modern health care becomes increasingly complex and medical staffs have less time to spend with patients, chaplains can play an important humanizing role, whether patients require end of life care or a simple, routine surgery.  In fact, a recent study has shown that patients who spend time with a chaplain have a better overall perception of their hospital experience.

But hospitals are unlikely to expand the role of their chaplains any time soon for a several reasons, among them, a dispute among chaplains themselves about the best way to prove their effectiveness.

Debra Jarvis has been working as a spiritual counselor for over two decades. She’s currently a general oncology chaplain at the Seattle Cancer Care Alliance and just published a book about her own recovery from Stage II Breast Cancer called “It’s Not About The Hair: And Other Certainties of Life and Cancer.” Like some of her colleagues, she’s concerned about what it means to be a professional chaplain in an increasingly results-driven era.

Segment 4
Wendy Cadge: Hospital chaplains and 21st century medicine


Wendy Cadge has been studying the role of hospital chaplains as part of her research as an associate professor of sociology at Brandeis University. Her forthcoming book is “Paging God: Religion in the Halls of Medicine.”

The Recovery Room 001: The Physician Shortage

2025 isn’t so far away. And if the Association of American Medical Colleges is correct, we’ll be facing a shortage of at least 124 thousand physicians in 15 short years. Docs who provide the most basic medical needs – primary care physicians and general surgeons – are already in the shortest supply.
Two big factors are contributing to the shortage: there simply aren’t enough doctors in the pipeline to meet the needs of a growing population and doctors in training are overwhelmingly choosing specialties and sub-specialties over those areas of medicine that are in the greatest demand – primary care and general surgery. Unfortunately, it’s no easy fix. And with the country getting bigger and the pool of doctors getting smaller, it’s a crisis in the making.
Dr. Rick Greene talks about the looming crisis with Dr. Tom Ricketts of UNC Chapel Hill's Cecil G. Sheps Center of Health Services Research and former editor of the Annals of Internal Medicine, Dr. Harold Sox. And later in the show, a conversation with rural surgeon Dr. Henry Fleishmann of Eden, NC. A rural surgeon for over 30 years, Fleishmann explains why the rural surgeon is an endanged species.
0:00 - 1:00 | Billboard
1:02 - 12:44 | Dr. Tom Ricketts, Professor of Health Policy and Management at UNC Chapel Hill and Deputy Director of UNC's Cecil G. Sheps Center for Health Services Research
12:44 - 20:15 | Dr. Harold Sox, Professor emeritus of medicine at The Dartmouth Institute in Hanover, NH, and former editor of The Annals of Internal Medicine and former president of the American College of Physicians
20:15 - 27:52 | Dr. Henry Fleishmann, surgeon, Eden, NC
27:52 - 29:00 | Credits