Obese Kids & Proposed National Patient Safety Board

Last week we parents and other humans were greeted by the news that doctors are going to start prescribing meds to obese children to, hopefully, you know, make these unfortunate kiddos less fat.  I was talking with an older friend about this news and he retorted that parents need to take away the cell phones, video games, and junk food, and make kids go outside, play, run, etc.  Indeed, my friend is not wrong....too often when I drive through my nice neighborhood on warm, sunny days not enough kids are on the streets.  I imagine every reader of this column has made similar observations in their neighborhoods, city streets, etc. Is childhood obesity a "metabolic disorder" or a parenting conundrum?  

Now, what do obese kids have to do with the proposed National Patient Safety Board?  The proposed safety board is a bill in Congress that would assemble a national agency akin to the National Transportation Safety Board, or NTSB; the NTSB is credited with making aviation safer.  A primary goal of the proposed patient safety board is to hopefully make medicine as safe as aviation.  There are some heavy hitters in the patient safety world supporting this legislation, including the Leapfrog Group, among others. 

The obese kids, now numbering 20 percent of our youth, along with the rest of the overweight (north of 40 percent in the adult population) coupled with smokers, those who drink to excess or abuse drugs, and countless others with self-inflicted health wounds are the turbulence that this national patient safety board will face, especially if aviation safety is the bar they set.  

Could we imagine a world where pilots would be forced to fly planes akin to American patients?  Fan blades would be missing, there would be numerous cracks in the wings, and tires would be improperly inflated.  Frayed wires, oil and other vital fluids continually leaking, and controls sticking or not working would be the norm.  Planes would regularly fall out of the sky or go splat, and nobody would celebrate the safety record of aviation. Instead, we would all drive or take trains or buses from Point A to Point B.  No pilot would fly a plane akin to the regular American patient....yet doctors and nurses are tasked with "flying" such patients every day.  

The last time we had truly "bad planes" in service was the 737MAX debacle, and those birds were grounded only after two crashes.  If we are really going to raise the safety level of medicine to aviation, will doctors and nurses be able to declare that their ERs, hospitals, and medical offices are "no fly zones" for the obese, smokers, those who abuse alcohol or drugs, etc?   Could the obese or others who do not maintain their health "be grounded" by medical professionals?  Of course, these are ridiculous questions, but no more ridiculous than the tired proposition that medicine is going to be safe like aviation.  It's not a fair, ethical, or realistic comparison. 

Sure, a national patient safety board could encourage learning from common safety events and provide data and sharing of information across the healthcare system.  All for it.  We have written numerous times in this space that gag orders have limited post-event learning; a dedicated federal agency might help this problem. However, before anyone or any agency or organization tells physicians and nurses they need to be more like pilots, they should first have a frank discussion with the American people: Put down the cell phones and video games, quit eating crappy food in large quantities, and go exercise. Take care of yourself.  Quit trashing your health and hoping that some doctor is going to pull a rabbit out of the proverbial hat to save you.  Your health is your responsibility. 

And don't worry if some are offended by this frank messaging, because it beats the alternative: Chronically ill patients who overburden our health system and increase the likelihood of medical errors.  Unfortunately, such messaging is missing from the website of the National Patient Safety Board and most other patient safety groups.  Nobody wants to address or talk about a major contributor to our patient safety problems.  Instead, it's too easy and politically correct to tell the doctors just be like the pilots and everything will be dandy....

Through the years at Sorry Works!, I have believed we owe audiences honest and realistic messaging.  If we are going to make the difficult ask of doctors and nurses to apologize for legitimate medical errors, we have to be willing to see the world from the clinicians' perspective and provide holistic solutions to complex problems (as opposed to finger pointing).  Unfortunately, in our world today, too many people like to point the finger and offer up simplistic, emotionally pleasing solutions to challenging situations.  Saying medicine should be like aviation without telling patients/families to clean up their act falls into this dirty box.  Yes, there are too many medical errors, but surely too many medical errors are caused by chronically ill patients with self-inflicted bad health who overburden our medical system.  As my late father would say, if you continually shove 20 pounds of shit into a five-pound bag, bad things are going to happen.  Well, bad things are happening every day in our overwhelmed healthcare system.  

The obese kids coming down the pipeline are going to make this situation worse, and no amount of pill pushing or platitudes will fix this problem.  Only the truth will..... 

Sincerely,

- Doug

Doug Wojcieszak, MA, MS
Founder and President
Sorry Works!
618-559-8168 (direct dial) 
doug@sorryworks.net