Thursday, January 10, 2008

Patients Deserve The Best Care

Dr Michael O'Keefe writing an editorial in the February issue of EuroTimes says patients must come first in every situation. These are his comments

There has been huge progress in the last fifty years in ophthalmology through innovations such as microsurgery, intraocular lenses and the new frontiers in macular degeneration, stem cell retinal pigment transplantation and synthetic keratoprosthesis. But at the same time there is a danger that we will create the public expectation that everything can be cured, that surgery does not carry risks any more. Nothing could be further from the truth.
Eighty five per cent of all refractive surgery in Britain is done in commercial clinics. Doctors are no longer masters of what they do. They are employed by business people.
In my practice, out of every ten people I see, probably four should not have any laser done. If I were involved in a commercial clinic, I would be under pressure to reduce that. I think it is a worrying trend.
The other thing that is happening which I think is really alarming is that doctors are appearing more with patients for the first time on the day of surgery. They never see them before, they never see them after and they appear over them on the day to do the surgery. I think that is frightening. I would never allow that to be done to me, I would not allow it to be done to my relations.
We are now becoming technicians. Do you need an MD degree anymore? You could train a technician now to do a lot of the laser work or to do the cataracts.
We are selling ourselves out and that is bad for medicine, it is bad for people. You don’t talk to people before, you don’t talk to them afterwards. This could lead to an increase in litigation because patients will lose confidence in doctors.
There is a danger that we will drive standards down and we are going to shoot ourselves in the foot. We will not need to be doctors anymore, because some of the business people who have taken over the running, will say: We can get nurses or laboratory technicians and train them. This is a spin-off from the privatisation of the public system.
We need to lay down certain standards. Nobody should operate on patients unless they have examined them before hand and unless they are prepared to follow them up afterwards. That is a standard that we should not throw away. I don’t think we should over-regulate people because then you end up not being able to practice. There is a fine balance.Michael O’Keefe is a consultant ophthalmologist and organiser of the International Refractive Meeting, which will be held in Dublin, Ireland in October 2008.


Seamus Mac Suibhne said...

A very thought-provoking editorial by Dr O'Keefe. While he is right to indentify corporate pressures as helping drive the deprofessionalisation of medicine, we should not forget that public expectation and publicity about new procedures also drives demand. We have a responsibility to engage with the media to educate the public not just about specific advances or specific conditions but in a wider way about how medicine, and any new technological intervention, works.

steph said...

I wish someone would tell our Minister for Health and the CEO of the HSE that patients deserve the best care!

Their persistence in pursuing a 2-tier health service through co-located (for profit) hospitals is going make the worrying trends that Dr. O'Keefe refers to, even worse.

Thumbs up to Dr.O'Keefe for sticking to his principles and standards.