Sometimes, it seems, our elected
officials think they can solve any problem if they just spend
enough on it.
Senate Majority Leader Bill Frist recently outlined a federal
approach to avian flu. "I'm very hopeful that we will invest $7.1
billion to look at prevention, to look at care, to look at
treatment," he said. "We need to be prepared."
Dr. Frist is certainly correct about preparedness. It doesn't take
a physician to know that the proverbial ounce of prevention is
worth a pound of cure. But while we need to be ready for a possible
bird-flu problem, we also shouldn't neglect less dramatic medical
problems that are killing Americans today -- especially those that
can be prevented without a massive "investment" from
Washington.
For example, hospital infections. They quietly kill some 103,000
patients each year, according to the New York-based Committee to
Reduce Infection Deaths. An estimated 2 million patients come down
with hospital infections annually.
In addition to the death toll, there's also a financial cost. A
post-operative infection doubles the cost of a patient's stay.
Staph infections triple the cost. All told, hospital infections add
$30 billion to the nation's annual health bill.
But we don't need a huge -- and expensive -- government
intervention to stamp out this problem. We don't need new drugs,
either. The situation can be greatly improved if medical personal
will simply wash their hands before treating patients.
That's right. The Centers for Disease Control reports that the
most effective way to reduce infection is for medical personnel to
wash their hands. Yet the CDC reports that, on average, doctors
wash their hands only about half the time before treating
patients.
Dirty hands carry big risks. Consider a bug called
methicillin-resistant Staphylococcus aureus (MRSA). This germ lives
on everyone's skin without causing problems. But if it gets into
the bloodstream, it can be deadly. Patients who survive MRSA
infection often face additional months in the hospital and even
operations to take out diseased tissue.
But again, this infection can be prevented if hospitals insist on
simple hygiene.
At the University of Virginia Hospital, they've virtually
eliminated MRSA. Veterans Hospital in Pittsburgh reduced its
infection rate by 85 percent. How did they do it? A program that
requires medical personnel to wash their hands before seeing a
patient. The hospitals also make sure staffers wear clean uniforms,
that all equipment is carefully cleaned and that hospital rooms are
scrubbed after each patient. Patients themselves should be checked:
If they test positive for MRSA, the hospital can isolate them so
the bug can't spread to others.
There are good medical reasons to prevent infections, but there's a
financial incentive as well.
A study of hospitals in 13 states showed that the 5 percent of
patients who get a hospital infection take up two thirds of the
hospital's profits. That's a lot of money to waste on a problem
that's easily prevented. If everyone would just wash their hands
more often, some failing hospitals could move from the red into the
black.
The importance of hand washing is something all doctors should
learn in medical school. But "most medical schools devote virtually
no time, not even one full class, to showing students how bacteria
are transmitted from patient to patient," Betsy McCaughey says.
That's why she founded the Committee to Reduce Infection Deaths. If
the group can convince doctors to scrub up, it will have taken a
huge step to improve health care in this country.
Few would disagree that we need medicine to be more "hands-on" --
but only if those hands are clean.
Ed
Feulner is president of The Heritage Foundation
(heritage.org), a Washington-based public policy research
institute.
COMMENTARY
The Downside of Dirty Hands
Jan 4, 2006 2 min read