Nurses quicker to report medical mishaps
It's often said that nurses, not doctors, provide most of the care for hospitalized patients. And, according to a new study, they also are more likely to speak up when medical care goes wrong.
Physicians at Tufts-New England Medical Center studied 26 US hospitals in which staff reported medical errors via computer, between January 2001 and September 2003. Hospital staff reported 92,548 errors during this period, although less than 1.5 percent caused patients permanent injury or contributed to a death.
One of the most striking findings was who did the reporting. Registered nurses made nearly half the reports; doctors contributed less than 2 percent; pharmacists, technicians, and secretaries reported the remainder. The authors said nurses have more training in reporting mistakes and may have a lower threshold for what they consider a mistake. Physicians, they theorized, may not report errors because of fear of reprisals or ''professional courtesy."
Harvard Medical makes classes available via iPod
Harvard Medical School administrators wanted to harness the popularity of iPods to teach students about heart attacks and infectious diseases. So on Dec. 1, Harvard became what doctors believe is the first US medical school to allow students -- as well as faculty and staff -- to download the entire curriculum including all lectures onto their iPods via iTunes.
Harvard has installed video cameras at the back of every classroom. The school transfers the video and audio of all lectures onto its website within an hour, which students can watch on a computer or download into iTunes without extra charge. Students can set up iTunes to automatically retrieve the audio for their courses daily. So far, 160 of the school's 800 students have downloaded lectures.
A big concern among faculty is whether they will face rows of empty seats as a result. Harvard is keeping an eye on this potential outcome, but so far ''they're still showing up," said Dr. John Halamka, a Beth Israel Deaconess Medical Center physician and chief information officer at Harvard Medical School. ''HMS students tend to be very compulsive people. They're so worried they're going to miss something in class, that they go."
Doctors seeing more patients, doing less research
Medical school faculty apparently could use some time off. Researchers at Drexel University College of Medicine in Philadelphia recently surveyed 2,000 full-time faculty members at four unnamed US medical schools Dr. Barbara Schindler, lead author, found 77 percent of the doctors and basic scientists didn't get enough sleep and 20 percent had symptoms consistent with clinical depression. She did not find major differences among medical schools.
The real question is why. The faculty surveyed worked an average 60.8 hours a week, up just slightly from 60.4 in 1984. The researchers did not have access to the complete 1984 data but believe the rate of depression has risen since then.
The problem may be what they're doing, not how long they're doing it.
The big difference is that now 41 percent of the doctors' time is spent treating patients, a huge jump since 1984, while the amount of time spent supervising medical residents and doing research dropped significantly. Academic medical centers have been under growing financial pressure, which often translates into pushing doctors to see more patients.
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