A culture of silence remains about medical errors, but things are slowly improving, physician-activist says

There has been a culture of silence when it comes to talking about medical errors, but things are slowly changing, writes Dr. Kevin Kavanagh, right, in an op-ed piece in the Lexington Herald-Leader.

Kavanagh, who is chairman of Health Watch USA, recalls an incident in which a patient came to be treated for a severe sinus infection. Upon being rushed to surgery, Kavanagh discovered "an old smelly gauze pack" had been left in the sinus from a previous operation. When an assistant asked Kavanagh what he should tell the patient, "I answered, 'The truth'," for which he was disciplined by a senior surgeon.

"Years have passed, and things are starting to change in medicine," Kavanagh writes. "Telling patients that something went wrong is slowly being accepted — a revolutionary idea to medicine."

Studies have shown that hospitals with full-disclosure policies actually have lower patient death rates, which Kavanagh just called "common sense." "If preventable patient harm occurs on a ward and the patient is not told, almost all of the employees on the ward will know about the cover-up," he writes. "How then will the administration garner the respect to effectively oversee the functioning of personnel? If hospital staff are not performing adequately, how do you discharge them when there are skeletons in the closet?"

Full disclosure also lowers malpractice expenses, Kavanagh contends. Stanford University hospitals had a 36 percent drop in malpractice claims and has saved $3.2 million since it adopted a full-disclosure policy in 2007. University of Michigan had a 40 percent drop in new claims and saves $2 million each year.

But full disclosure is not common in Kentucky, despite the Veterans Affairs hospitals in Lexington being the first to implement full disclosure in the country. "Instead of this practice spreading throughout Kentucky, the next health-care system to implement it was the University of Michigan," Kavanagh writes.

Things need to change, especially in the face of superbugs like MRSA. As he looked back at the incident involving the botched sinus surgery, "I am most bothered that I apologized for my actions," Kavanagh writes. "Now I would reserve the words, 'I'm sorry' for the patients who have been harmed." (Read more)

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Louisville vascular surgeon provides 'hands on' support for troops

Dr. Andrea Yancey, a vascular surgeon from Louisville, has completed two weeks of volunteer service treating wounded American soldiers transported from Afghanistan and Iraq to the U.S. Army’s Landstuhl Regional Medical Center in Germany.

“I now have a better understanding and enhanced respect and appreciation for our military,” Yancey said in a press release from the Society for Vascular Surgery, which has provided continuous two-week rotations of vascular surgeons at LRMC for the past four years, the release said.

“The soldiers were young, polite, and grateful,” Yancey said. “Their mental and physical toughness and capacity for resilience were hard to comprehend. In spite of their injuries, they never complained or asked for pain medicine. They did not want to inconvenience anyone.”

Yancey is an assistant professor of surgery at the University of Louisville and a surgeon at the Robley Rex Veterans Affairs Medical Center in Louisville.

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Weight gain after gastric bypass is common; study will see if post-operative supervision helps keep it off

Though 200,000 people undergo gastric bypass surgery to lose weight each year, more than half of patients put back on at least 20 percent of the weight they lost, research-reporting service Newswise reports. A new study will test whether supervising patients' exercise and food intake post surgery will help the pounds from creeping back on. This should be of more than passing interest in Kentucky, given our high nrate of obesity.

"You wouldn't invest $25,000 to remodel your home and not maintain it. Shocking as it may seem, follow-up on diet and exercise just isn't the norm with gastric bypass," said Gary D. Miller, who will head the study at Wake Forest University in North Carolina. "With so many people seeking gastric bypass each year, we can improve the long-term outcome of gastric bypass by keeping up with patients as they figure out their new lifestyle."

In the sixth-month study, one group of patients who recently underwent gastric bypass surgery will receive aerobic training, such as walking or cycling, and resistance training three days a week. They will also be supervised by an exercise psychologist and will be asked to document what they eat in a food diary, which will later be analyzed. They will additionally be encouraged to exercise at least two more days a week.

A second group will receive post-surgery care that is standard to gastric bypass patients. Generally, these patients receive guidance about diet and exercise, but their fitness levels and eating habits are not supervised. "This could show that surgery plus supervised exercise and diet might be the best, most efficient option for weight loss in obese and morbidly obese people," Miller said. (Read more)

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