Show t :r 4 ur-- "- S 1 - I - tt ke 'Tribune Monday April The Salt It'll A9 Hospital Care Nearly Impossible for Average Person to Eva1uate4 By Michael L Milieus rwa person to evaluate the rare average 4 40 About 14 percent of those injuries tod tn elpsoth etiVen 5tvt TMirm tal admissions a year the visitth works out to a chilling 166000 deaths annually related to physician treatment in the hospital Dr Troyen A Brennan an assistant professor at Harvard Medical School said he stood by the research he helped lead Other medical researchers also praise the rigor of the Ir Comparison shoppers who pride CHICAGO —When Dick cross unthemselves on ferreting out the best derwent surgery on his throat last CD player or car will come up nearly October be couldn't have been hapempty-hande- d when they search for pier with the hospital's care particu- hard information on hospital perforwith dose the attention larly paid to mance More disturbing is that most possible conaplications caused by his hospitals still don't have the slightest diabetes idea themselves of bow well their A'They monitored my blood sugar doctors treat patients compared to probably four times a day which is some sort of national norm more than 1 do at home" said the 63-The measurement of the outcome retired Sears sales managyear-ol- d of patient care remains a science in er "I can't say enough for them" its infancy Even when information The hospital that earned Cross' does exist that could allow hospitals gratitude was the Veterans Affairs to be compared the figures are Medical Center-Nort- h Chicago one gripped in tight confidence for fear of the nation's largest veterans' hosswarms of malpractice - of attracting pitals suits Yet only days after Cross' success'There isn't enough information ful surgery the Department of Vet- that's available and translated into erans Affairs in Washington quietly understandable English" tomordered the hospital's operating plained Dr Sidney M Wolfe direcroom closed for two weeks pending tor of the Public Citizen Health Rean investigation of surgical compesearch Group "If there were the tence hospitals that were doing better Earlier this month the depart- would thrive and the others would ment concluded that the deaths of six either have to improve or get out of patients over an period business" were linked to poor care by the facilThe research that has been done ity provides little comfort The disturbing problems don't Nearly one in 25 hospital patients mean the 1004-be- d hospital treats suffers injuries caused by the doctor all patients poorly Nonetheless the and more than a quarter of those inlarge gap between any one patient's juries can be blamed on negligence experience and the judgment of proaccording to a Harvard University-le- d fessional medical investigators illusstudy published this year in the trates just how difficult it is for the New England Journal of Medicine study 'Jiospitals are dangerous places" Brennan said Moreover nearly a quarter of all hospital patients probably don't need to be admitted in the first place say Rand Corp researchers who have analysed medical records Researchers have hoped to improve patients' odds by figuring out whether some type of hospital — large lir small teaching or urban or rural non-teachi- not-forpro- or can consistently be linked to better care So far they have struck out Of course wealth does have its privileges Richer hospitals can afford the best doctors and equipment whether or not they actually have them And richer patients can seek hospitals that are world renowned for treating serious diseases requiring sophisticated teamwork between doctors and nurses such as an organ transplant or some types of neuro- surgery So for example Saudi Arabia's same way they would hair stylist or lav-ymtatiafied tre not always a bad indicator" Franklin said 41 would talk to the nurse and the doctors who work at the hospital" added Barry Bader president of a medical conEockville sulting group Robert Krughoff president of Consumers' Checkbook magazines has done just that on a grand scale by surveying doctors nurses and pa tients in the Washington DC and San Francisco areas then compiling the results into rankings for individual hospitals Erughoff knows of no one else who has followed his lead and he acknowledges he has not updated his Information since 1987 The federal government publishes some statistics on death rates for Medicare patients at individual hospitals However the numbers are difficult for a coasumer to use probably not coincidentally given the influence of liospital and physician groups and the shakiness of some of billionaire King Xhalid ihn Abdul the 1Pto tint): to jet 10000 miles to the Cleveland Clinic for regular checkups and treatment of a heart condition The Mayo Clinic has become per haps the closest thing in American medicine to a rectignizable premium brand name To take advantage of d that the Rochester clinic has started branch facilities in prosperous parts of Florida and AriAcf'iliott 4" Md-bas- Minn-base- zona On a more mundane basis thou sands of Americans each year travel to Toronto's Shouldice Hospital because of its expertise in repairing hernias In general the more of a procedure a hospital does the better it does it Yet a local community hospital can be every bit as good as a prestigious medical center for most medical needs the experts agree At big hospitals specializing in research and teaching "Nobel Prize winners are not going to be exktnining you" noted Dr Cory Franklin director of Cook County Hospital's medical intensive care unit Franklin and others suggest patients should look for a hospital the f anonymity non-prof- ed Michael Milleasoa reports ea health rare for the Chicago Tribune Don't Jail Crack Mothers Treat nein:- - from getting their next fix When you're hooked on crack a highly potent form of cocaine you're only cused on crack You don't think about the baby within you or the filth you're living in or bow your addiction is destroying your other children or is hurting your parents or By Myriam Marquez nole Brevard Dade Pinellas awl Escambia counties have programs that give women that choice treat' meat or prison Simple economics dictates tine-shif- t toward treatment for pregnant' women About 10000 babies are born in Florida each year exposed in' drugs in the womb — some 60044 Them from the Orlando area Seventy percent of those babies were 'ear posed to cocaine usually combine by the mother with a heavy drinkinghabit as well Many of these 'snow" babies are now old enough to go to school 13ut their behavior problems are so great — they can't concentrate they throw things or they stare endlessly Iiitot' space — that it will cost millions more dollars to help These children learn what would come naturally to other children The Florida Depart meat of Health and Rehabilitativei Services estimates it costs $750000 d child Iron to help a to the age ef 18 And that is a conservative figure Meanwhile a woman can get into a residential program for $2100 a month and within six months she is ready to face drug-fre- e living Problem is many of these women also need job training day-car- e and other support services to inake their lives whole again Unless we find a way to pay fof these "extras" snow babies 'will ' keep coming — whether their tiek'mothers are locked up in jail or free on the streets ": o- A 414s1 SAMOITIVO- - 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Mil' 0 MAN't N 413 1 g 03 - 41 1-- trio 1 '1'- 7 s loll ---7 is1 7 04004CP630' 7 -- 7 - t - i- : - '' v --- -- - a AcToNISii0IPLAS Ittl rifici y --413 0 INTERNAL AFFAIRS t 7:7-71- all 400 1 tt: tit( kw 1 LiAirnytIceortaw- - 1 '4: 170:r 111 110101-111- The zN ID GPTIMJ014161) 1 f orgy - ' drugs during pregnancy most g11: iiih': fl 000- -4 ' 00 oopr HER6 At LICA 7 0 - (r A4n- ORLANDO— When a baby is born with her brains outside ber skull — or with some other atrocious deformity — because her mother abused A ' Palk Form Tribune Readers' Opinions Honor Scholars 4 it A group known as the" Joint Commission on Ameditation of Healthcare Orgaulzations regular-- a ly surveys conditions at about four-fifth- s of the nation's hospitals But many states have passed laws keeping those reports under wraps even though a passing grade by the commission is accepted by the federal government as enough to itllow hospital to participate in Medicare That leaves patients with little choice but to rely on the judgment and competence of their doctor 4114 on their own instincts — even if those instincts are formed by a serieS 'of anecdotes That after all is essen-- : tally how doctors and nurses form their impressions too Consultant Bader cautions againsr unreasonable expectations 'Even i the best facilities occasionally make mistakes" he said r: "Medicine is not perfect" the data Still the best available information clearly shows wide variations in hospital competence even after ad Orlando Sentinel 'low justment for all sorts of variables: lot youraluners tals will be candid with researchers' ccra er people recoil in horror And then anger sets in How could a woman let this happen to her child for the sake of getting high? Such blatant disregard for human life cries out for panistmient and justice And that is what many local police agencies in Florida and across the nation have been doing: arresting women whose babies test positive for illegal drugs like cocaine These women can be convicted of child-abus- e or even murder if their babies die laws in the These are feel-goo- d war against drugs They make society feel better like we have accomplished something by locking up a woman who has caused great harm to an innocent baby The irony is that while police are pregbusy catching the nant woman who is on the streets to get her crack there are thousands more crack babies who go undetected because they come from middle-clas- s homes That is because doctors hardly ever order drug tests on middle-class women It's the babies of indigent mothers who are scrutinized anything else Which is why punishing addicted women won't stop more cocaine babies from being born What these laws do in effect is scare away pregnant women who might have otherwise sought help to quit their drug habits early in pregnancy thereby giving their babies a shot at being healthy That's exactly what happened in 1989 after Jennifer Johnson in Seminole County Fla became the first woman in the nation convicted of delivering cocaine to her baby The Center for Drug-Fre- e Living which helps addicts in the Orlando area get into publicly funded programs when they can't afford to pay saw a dramatic drop in the number of pregnant woman seeking help once Johnson was arrested "What the Jennifer Johnson case did was frighten them away even though we kept stressing that this is a confidential program" said one center official "It took a lot of convincing to get them back" Fortunately many prosecutors in Florida have realized that arresting a pregnant clruggie won't help her baby unless drug treatment is part of the deal Now prosecutors in Semi low-inco- laws Besides these aren't stopping addicted feel-goo- d - women : drug-expose- drug-treatme- - C - Imposes lorals A "Honor Academic Winners" suggests The Tribune's April 4 editorial Neat idea! Let's see where can we start? How about in the media? Imagine if The Tribune committed as many column inches to academic achievers as to sports achievers If as you suggested the Utah Academic Decathlon was so important why no columns written on it? Why no box scores? Why no winners' names in banner headlines? Why no stories about next year's team and predictions of future success? Weber State University as an example of what can be done is currPntly offering the most lucrative full-rid- e academic scholarships in the state Its early college program rewards high school scholars by giving them a chance to begin college training early WSU honor students are allowed to register first each quarter along with athletes Plato said "What is honored in a country will be cultivated there" The media could take the leadership needed to begin honoring academic stars ADELE SMITH Ogden Donate Organs This letter is about organ donation Several months ago I had an unusual eye infection which nearly took my eye and which did indeed take the sight of my left eye I am on the list for a corneal transplant and have been since December Reactions to my plight have been varied Some friends have responded with "I hope they take everything I have left when my time comes" or "I would be willing to be a donor but I could never make that decision for someone else" or "What does the LDS Church say about being a donor?" To the first response I say thank you To the second I say "Please make that choice now for yourself then ask your spouse your parents and even your children if the age is appropriate" I am also an emergency room nurse and it is so much easier on the family when this question is not at issue at the time of a loved one's death To the third response listed above I called the office of the First Presidency and was given the following information As far as being the recipient of a donated organ they ask that you do it with a sincere prayer and that you have a competent surgeon and have explored the alternatives As far as being a donor or giving permisson if you are the next of kin it is entirely up to the individual If you have any questions regard- ing what organs can be used or the age of the donor please call an emergency room They have the criteria listed per Intermountain Organ Recovery Systems SUSAN UPDIKE Salt Lake City Forum Rules Public Forum letters must be submitted exclusively to The Tribune and bear writer's full name signature address and telephone number Names must be printed on political letters but may be withheld for good reason on others Writers are limited to one letter of 300 words or less every 14 days Preference will be given to type written (double spaced) letters permitting use of the writer's true name All letters are sub Jed to condensation Mail to the Public Forum The Salt Lake Tribune PO Box 867 Salt Lake City Utah 84110 Light Rail Useless I was amused to see that Congress- man Wayne Owens and the Utah Transit Authority had spent the day of April 8 "playing train" on the between Union Pacific right-of-wa-y Sandy and Salt Lake City Of course Congressman Owens is correct if one desires to travel between ZCMI Sandy and ZCMI Salt Lake City a light rail system would certainly be a wonderful system to use However most commuters do not live near the Union Pacific right-of-wa- y and most commuters do not work downtown Fewer than 16 percent of all Salt Lake Valley employees are employed in the Central Business District The overwhelming majority of Salt Lake Valley employees live and work at locations far removed from the proposed light rail system route Thus most commuters would not be able to commute on the light rail transit system but would be forced to use a system Each Salt Lake County taxpayer should attempt to assess whether the proposed light rail system would allow him or her to stop driving to work and instead use the system Included in the assessment should be the time lost in making two transfers in addition to the actual transit time required Most people who have done this assessment have discovered that the two transfers will require about the same amount of time required to travel by automobile to nearly any location in Salt Lake County If light rail will not work for you it will also not work for your neighbor and it will not work for all those other drivers you would like to have stop using the road you use to get to work every morning Perhaps this is why the environmental impact statement indicated that the light rail system would not eliminate much traffic from the freeway system REP DAVID S OSTLER House District 37 Salt Lake City bus-trainb- Rep Evan Olsen (Forum April 4) appears sensitive to charges that the abortion bill represents "sloppy" legislation He refutes this charge by claiming no other issue received as "much attention or public input" Yet before the Legislature's general session ended the newly passed law had to be amended Minor oversights we were told Now a special session must correct another problem with the law an oversight that would allow women to be charged with murder Other problems exist with the law the incest definition for one but we are told these are also oversights that can be corrected The reality is that sponsors of the bill were more intent on espousing their personal moral philosophy than in crafting a good defensible of the law Rep Olsen abortion task force stated in his letter he believes abortion is "killing of live unborn children" He leaves the clear impression that he has little respect for or understanding of people who share a different belief Sadly this attitude was shared by a majority of task force members resulting in a law that codifies their personal beliefs Now scarce state resources must be risked to defend this obviously flawed piece of legislation Every taxpayer should question the wisdom of this action Those of us who believe in the integrity of women will never accept the finality of this decision We will continue to educate mobilize litigate and whatever else is necessary to protect the lives and health of women This issue will not be resolved until our laws recognize that childbearing decisions should be made by individuals not legislators MARY CARLSON Director of Community Service Planned Parenthood Association of Utah " The Tribune's editorial boosting the Brady bill's seven-da- y waiting period for citizens' handgun purchases overlooked an even better measure under consideration in Congress: the StaggersVirginia Instantaneous Check bill Such a program is already in place in Virginia Florida and Delaware It satisfies the same objective as the Brady bill without generating volrecords the atumes of tendant bureaucracy to maintain them and the delay for legitimate handgun purchases Do you believe our federal bureaucracy can thoroughly examine an application and respond within seven days? 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