Friday, December 7

Sick To Death – Hedley Thomas

On Christmas Eve, 2002, Indian-born, US-trained surgeon Jayant Patel received an offer to work at Bundaberg Hospital in north Queensland. A surgeon who had been prohibited from operating in one US state and had restrictions on the kinds of surgery he was permitted to perform in another state, Patel was relieved to once again have employment. And the gross errors of practice and the inability to see his short-comings, the qualities that contributed to the death and disability of patients that led to his issues in America followed Patel to Australia.
Australian journalist Thomas places the reign of Jayant Patel at Bundaberg in the context of issues in the Australian public health system in general, and of Queensland in particular. An insufficient number of doctors in general, particularly in remote and rural areas, and especially of experienced, skilled doctors, meant that the authorities relied upon to adequately vet applicants was wilfully lax. This short staffing meant that Patel, who was accepted to practice provided it was under supervision, was rapidly promoted to Head of Surgery and was therefore under no scrutiny by superiors. The focus of government of reducing waiting lists over every other criteria of a successful health care system meant that a surgeon who was prepared to tear through these lists regardless of ability or outcome was lauded by his administration. And the inherent and entrenched medical-nursing hierarchy meant that the concerns of his only witnesses, the theatre and ICU nursing staff, were systematically ignored. Patel’s willingness to perform intricate, complicated and skilled surgery despite lack of practice or ability, combined with his inability to accept that the hospital’s facilities were inadequate to care for truly sick patients, vastly escalated the number of people maimed and killed as a result of his surgery.
Thomas, who was contacted by whistle-blowing nurse Toni Hoffman, Unit Manager of ICU at Bundaberg, has meticulously researched the case and the wider contributing factors. He details how Ms Hoffman exhausted all other avenues to curb Patel’s practice and the subsequent harassment and intimidation brought to bear on her.
Some time ago I reviewed "Dancing with Doctor Death" and reported that I was surprised and a little disappointed that it had been so highly recommended by a friend. Imagine my delight at discovering this account, which actually is the recommended version and significantly better executed. If you’re interested in general issues in health care, doctor/nurse interactions, power dynamics, the affect of government policy on individual cases, lack of health care resources, the impact of inherent power imbalance between groups, the inadequacies of mandated reporting systems, the consequences of reducing oversight, or the costs of whistle-blowing, read this book. - Alex

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