Re: Misadministrations

["Gibbs, S Julian" <s.julian.gibbs@vanderbilt.edu>]

Most RADSAFERS are apparently not aware of the mandates of 
managed care and their effects on American medicine.  For 
example, they require that all procedures be performed by 
the least qualified person available--just to save money.  
My personal history is an example.  I have had a heart 
attack and bypass surgery.  A managed care plan that my 
employer urged me to join refused to cover followup care by 
my cardiologist.  They insisted that it could be done just 
as well by a general practitioner.  Needless to say, I 
opted out of that plan pronto!
These plans are doing similar things with radiologic 
procedures, including nuclear medicine.  These bean 
counters seem to prefer that such procedures be performed 
outside of radiology, by persons with no training 
(except from the equipment salesman!) and little 
understanding of what they are doing. Another 
example: Recently I encountered a young woman in another 
institution (not in radiology) who was performing Doppler 
ultrasound examinations with no supervision; she knew her 
machine was Doppler but did not know that it was 
ultrasound! Fortunately, these things are very safe--but I 
wondered how she could poossibly know when she had 
performed a good or a poor study.
I am in no way attempting to excuse any misadministration 
of radiopharmaceutical--or any other error in health care.  
We put protocols in place that are designed to prevent 
them, but they will be eliminated only when we can find 
humans who can achieve 100% perfection.  Christians believe 
only one person has ever done so.  Other religions are not 
so sure that anyone has.
***********************************************************
S. Julian Gibbs, DDS, PhD               Voice: 615-322-3190
Professor of Radiology                    FAX: 615-322-3764 
Dept. of Radiology & Radiological Sciences
Vanderbilt University Medical Center
Nashville TN 37232-2670        Email:j.gibbs@vanderbilt.edu
***********************************************************
Power corrupts.  Absolute power is kind of neat.
                                   --Anonymous

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