Patients Want More Information

It lurks beneath the surface, a sharklike predator that slips in undetected. As a surgeon secures a bodily opening in an otherwise successful operation, this stealth invader begins to feast upon its prey. While medical proficiency has risen to great heights, the rate of infections also has soared. It has gotten to the point that candidates for surgery include infection risk in their decision-making process.

On July 20, Gov. Rendell signed an overdue law that will pressure hospitals to police their environments.

Nearly two years ago, I underwent a procedure at one of Philadelphia's top hospitals to remove a thyroid lobe. The surgery was quite successful, and the surgeon did a masterful job of closing the wound and restoring my neck nearly to its original state. But beneath the stitching, something was at work.

The drainage wouldn't stop. Ten days after surgery, I was readmitted overnight and administered antibiotics while a new draining process began. In all, four rounds of antibiotics and a consult with an infectious-disease specialist during the next few months revealed that I had staphylococcus aureus, better known as staph infection. After several months, the infection went away and the wound healed.

But then the bleeding started again. Tests revealed that there was a surface infection caused by the still open wound. It eventually healed for good. But during the nearly yearlong process, this non-worrier considered normally unthinkable ramifications - imbedding of the infection in the bones, amputation of infected limbs, death.

Since my case, I have learned of similar infections at a number of hospitals.

The new law will require hospitals to screen high-risk patients - especially those admitted from nursing homes - as well as staffers in close contact with them. Public disclosure will encourage underachieving facilities to improve and reward improvement with higher state reimbursements.

The seeds for this market-driven response have been cultivating. The Pennsylvania Health Care Cost Containment Council (PHC4), in the nation's first hospital-by-hospital disclosure in November, found reports of 19,154 hospital infections in 2005, up from 13,711 in 2004. The PHC4 also noted that commercial insurers paid an average of $60,678 for each infected patient, as opposed to $8,078 for those infection-free. National fatalities were estimated at 90,000 each year.

Consumers crave this kind of information. A paper presented at the Society for Healthcare Epidemiology in Chicago last year found that that infection rate would influence hospital selection of 93 percent of consumers.

Noted philosopher and mathematician Alfred North Whitehead once illustrated cause and effect using the analogy of a "flash of light, feeling of eye closure, instant of darkness." For hospitals, the flash has occurred. Now let them open their eyes and prevent the entry of predators who negate masterful work.

Opinion & Editorial
Aug. 01, 2007
The Philadelphia Inquirer
Commentary by Jeff Hurvitz