Dr. Kovach is Part of a System…
… and the system sucks!”
That was the final line of a recent episode of ER that we just watched last night (thanks to the DVR).
The major focus of the episode was a patient in court with a claim against Dr. Kovach for mistreating him in the ER. It was an illustration of a systemic patient flow (or lack of flow) issue. The fictional hospital had 12 hour waits for ER treatment, there weren't any beds to put the patient in, so he was stuck in a hallway for days, the hospital was short-staffed, so they couldn't attend to him…. so the fictional patient has a stroke.
The problem is that things like this happen every day. A lack of funding might be to blame. A lack of lean processes is also to blame. We can't afford to throw more money at the problem. We shouldn't blame individual doctors who are doing their best as part of a broken system. If a doctor is grossly negligent, that's one thing. But, as Deming said, most of the problems are the fault of the system. Hospital administration should be held accountable for fixing the system — so should doctors, as much as they are a part of hospital administration.
Fix the system.