Tuesday, December 08, 2009
  Doctors Are Human Too

Unless you're injured and think you need an X-ray or patching up having suffered an injury, you are only likely to visit a doctor if you are suffering from unexplainable symptoms, unless, of course, you're a hypochondriac. Generally, though, visiting a doctor is a matter of trust. Willing or unwilling, you place your life in another's hands.

Given that practitioners of western medicine have to undergo many years of training, with regular ongoing training as the accoutrements of their discipline 'advance', it would seem reasonable to expect a level of expertise, competence even, from the medical profession beyond that required from other professions which do not have the everyday power to affect your physical well-being.

It's also a given right to seek second opinions or, as happened to me some years ago, a third.

That was when I broke both elbows in a fall - the circumstances are not that important, merely embarrassing. I ended up with with my arms in slings (which made visits to the toilet a matrimonial matter). The first doctor advised me to not move them. The second doctor advised me to move them as much as possible (which pushed me through the pain barrier).

The third doctor advised me to do what I had already decided to do - to move them upto but not beyond what was bearable.

I'm not going to name the hospital because it doesn't really matter now. Besides, I have never really trusted the medical profession. I knew about staff shortages, the high incidence of patients suffering botched operations and wrong diagnoses, or contracting infections - because they were in hospital.

More recently, a study (.pdf) finds that about 1.24 million patient safety incidents occurred in the USA between 2002 and 2004, compared with 1.14 million between 2000 and 2002, at a cost of $9.3 billion.

In the UK, National Health Service (NHS) records show that 3,645 people died as a result of "patient safety incidents" - including botched operations and the outbreak of infections - between April 2007 and March 2008. The figure was 1,370 higher than two years earlier.

Patient groups have warned that the true toll is likely to be higher because some hospitals do not record all incidents.

From April 2010, all 400 NHS trusts in England – hospitals, primary care trusts, mental health services and ambulance services – will have to log every time a patient is harmed or dies while receiving treatment. Ministers have decided to impose a legally binding duty of openness on the NHS across England in an attempt to improve patient safety. NHS organisations will have to detail every mistake, accident and incident that has led to a patient suffering pain, trauma, injury or death.

They will have to report to the National Patient Safety Agency (NPSA) "without delay" all incidents in which a patient has suffered an injury that has impaired their sensory, motor or intellectual functions; changed the structure of their body; involved prolonged pain or psychological harm; reduced their life expectancy; or caused their death. Penalties for failure to comply will range from warning notices and instant £4,000 fines to the risk of prosecution.

It's that "legally binding duty of openness" which is needed here. If it existed, then the immense mental trauma which Prita Mulyasari is currently going through could have been avoided.

That the Omni Hospital couldn't correctly diagnose that she had mumps rather than dengue fever, an infectious disease transmitted by mosquitoes, is regrettable, and possibly inexcusable given that both are common here. Having had the wrong treatment for six days, her condition kept getting worse: her neck, left hand and left eye swelled and she had trouble breathing. So she transferred herself to another hospital and quickly recovered her health.

Her problems began when she circulated an email to friends detailing her recent troubles, including the fact that Omni Hospital refused to hand her copies of the results of the blood tests she had been given which resulted in the wrong diagnosis and that they were generally uncommunicative with her.

That her missive was passed on has resulted in two cases being brought - one a civil case by Omni Hospital alleging defamation (and a criminal case with a maximum penalty of four years imprisonment which has been dropped) and the other a criminal case brought under the recently enacted Information and Electronic Transaction Law, which opponents fear is being used by the state to clamp down on free expression.

Interestingly, her email was circulated by Juniwati Gunawan, the director of Bintaro International Hospital (RSIB) where she was successfully treated.

Juniwati told the court, “There are 30 supervisors at RSIB. I hope that after reading Prita’s complaints about Omni they will improve their service and pay more attention to patients.”

On Wednesday, Prita was found guilty of defamation in the Banten High Court and fined Rp.204 million (US$ 21,640) in damages. She said she will take her appeal to the Supreme Court.

She said, "I do not agree with the court ruling, but it happened anyway. We will just continue our fight."

The good news is that an appeal has been launched to raise the money, although I do feel this is premature. After all, if I won, so can she. What is more, her lawyers say they have new evidence, pictures of her deterioration during her stay in Omni hospital (stroke hotel/ mall/ fitness centre), which they will submit to the appeal court along with a claim for compensation of Rp.113 million for the losses incurred during that time and another Rp.1 trillion in damages.

But I am puzzled as to how a civil case can be settled before a criminal case related to the same issues. I hope Rob Baiton who has been following the various legal aspects of her case can further enlighten us.

Omni Hospital say that they would not push for the 'compensation' if Prita gives them a written apology. However, she and her many thousands of supporters (including this writer) feel that it is Omni who owe her one. And the rest of us.

As I said, with a couple of edits, about Adam Air a year before one of their planes disappeared off the radar screens, if [Omni] couldn't give a sh*t about a simple thing like proofreading, then what are the odds that they cut corners on [patient] maintenance?

A cursory read of Omni's 'Contact Us' page certainly does not inspire confidence.

For Corporate Social Responsible activities, Omni International Hospital-Alam Sutera is always active participate in any kind of public healthcare service, like conducting charity event by giving free consultation and 1000 fake legs for poor people cooperation with MetroTV (Indonesian News TV). For Public Health Education, Omni International Hospital-Alam Sutera affiliated with Media Indonesia (Indonesian Newspaper) organize social education about the danger of Drugs and other social activities.

The medical profession should still be deserving of our respect and trust but I do feel that one day it will be necessary, and a great shame, for Indonesia to introduce its own National Patient Safety Agency.

Still, just as long as the Indonesian acronym isn't OMNI ......
The legal cases against Prita are explained well on Eye On Ethics.
Background to the ownership of Omni hospital is here.


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