When an article or discussion focuses on the World Health Organization (WHO), one normally thinks of medicine in underdeveloped countries, responses to Avian Flu, HIV, malnutrition, or some other such 'foreign' thing. Working here in the US, the WHO really has an 'other-worldy' quality to it. And, I admit, I fall prey to this characterization myself, noting that much of the US medical care is governed by organizations like the AMA, FDA, CMS and other similar acronyms of various repute. And so, reading this latest dispatch from the WHO regarding simple pre-operative check-lists to reduce preventable errors, I assumed they meant in resource-poor studies.
And yet...the major US surgical and anesthetic societies are currently evaluating the WHO proposal and say they are in favor of adopting them - meaning...they don't already have such check-lists in place! Excellent. We'll now pre-operatively ensure the identity of the patient, mark the site of surgery, and ask about allergies, amongst other standard check-list questions.
Now, of course, this is an exaggeration of the failure of the US surgical infrastructure. Most clinicians are already conscientious in evaluating and operating on patients and most hospitals already have such pre-operative check-lists. There inherent professionalism most clinicians have coupled with the fear of litigation or de-credentialing ensure that for the vast majority of procedures, the right thing is done. And, yet, what's troubling about the system is the vast amount of self-regulation alloted to the field. Why should it necessary for the American College of Surgeons or the American Society of Anesthesiology to endorse these guidelines? Shouldn't there be a governmental body (the Department Health and Human Services, FDA, etc.) compelling the ACS or the ASA to implement them? Have we deregulated the medical field this much?
Picture used from flickr.com user - Max the Dog
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