This is the final draft of my AP. Comparing this to my previous drafts, I learned to embed links to my images. This was done in the final draft that I submitted but I did not do that here. I also corrected the structure of my paper. I made implementing video games a sub-solution to the overarching solution of reforming/revising or health care system. I also fixed the topic sentences of my body paragraphs and I made sure that each body paragraph only contained one idea. In this draft, I also implemented all the research I had done and used my list of quotes to help me write each paragraph. 

 

Alicia Lin

Annie Yaniga

Writing 39C

8 Mar. 2016

Abstract

          Despite the technology we have today, medical malpractice is still significantly prevalent. There is a need to improve our current healthcare system to fit to today’s standards like implementing different newer and different forms of medical training to make health care more easily accessible. This essay aims to identify the causes of our poor healthcare system and provide possible solutions to improve our current healthcare system, making it safer, and less risky.

Advocacy Project

            D.B., in April 2013, a Vienna man in Reston Virginia went in for his colonoscopy, but just before, he wanted to record the instructions the doctor would give him after the procedure. He ended up recording the whole procedure and found that while he was undergoing the procedure, the anesthesiologist Tiffany M. Ingham and gastroenterologist, Soloman Shah had been making crude remarks about him all throughout the procedure. But what was most outrageous was that despite not finding anything wrong during the procedure they diagnosed D.B. with hemorrhoids. They also put off their duty to properly report back to the patient as they discussed using a fake page to avoid long confrontation with the patient.

 

Figure 1: This is a screen shot from the video showing what the anesthesiologist said, clearly showing how chose to misdiagnose D.B. (Please scroll to the second video).

After discovering this, D.B. was able to sue for medical malpractice, as well as defamation, claiming five hundred thousand dollars (Jackman). What is most important about this case is not what was discussed during the procedure but what was done when Ingham decided to misdiagnose D.B., who is fine and health, with hemorrhoids.

            Medical malpractice occurs when a doctor or physician “deviates from the accepted norms of practice in the medical community and causes an injury to the patient” during any act or medical task (Bal, 340). In history, medical malpractice was caused by the lack of knowledge of the human body and the lack of technology to solve certain problems and issues. Today, medical malpractice is caused by our flawed healthcare system, like the lack of quality of training of medical professionals; this can be fixed by reforming our healthcare system, making the system more patient-centered and incorporating video games into the training process/curriculum of medical professionals.           

Causes:

One important issue to address is that the current numbers that are portrayed for medical malpractice may not be completely accurate, since both patients and other medical professionals may not report some cases of medical malpractice. Not all patients report their case of medical malpractice because they may not realize it is a case of medical malpractice. Medical professionals usually don’t report each other because of the “shame and blame” approach, where the individual to report their co-worker will then be blamed by their co-workers and then possibly shunned by them and the medical community (Sharpe qtd. in Kaur, 144). They could potentially lose their current job and any job opportunities in that respective field. While medical malpractice cases may be under-reported the fact that they exist and the number that is actually reported is sufficient to show that this is still a large issue today.

            This problem stems from the miscommunication between a doctor and their patients as well as miscommunication between doctors themselves. Communication and miscommunication is a key factor that affects medical malpractice. Because a doctor must tend to a large amount of patients, it’s difficult to manage and communicate with them all equally. This makes it difficult for the doctor to adequately communicate with the patient. There is also this slight fear that the patient experiences when describing all of the exact symptoms of what they experience. This further causes miscommunication as the patient doesn’t portray an accurate representation of what they feel. This further causes medical malpractice as the patient doesn’t completely play their part describing all their symptoms, making it harder for the doctor to diagnose. Miscommunication is one of the largest causes of medical malpractice; “more than fifty percent of the time of all postoperative complications, seventy percent of all medication errors, and eighty percent of delays in treatment that resulted in death or permanent loss of function” (Gills, 13).

 

 

Figure 2: This graph shows that diagnosis is one of the main errors in medical malpractice. Because diagnosis depends on the communication between doctor and patient, this shows that miscommunication is a large issue in medical malpractice.

Communication in a healthcare system is “vital” as miscommunication increases error and “threatens patient safety” (Gills).

            Another major cause of medical malpractice is the high demand for doctors, which then causes a lack of quality training for trainees. Because there has been an increasing effort to create equal access to and affordable health care, like the implementation of the Affordable Health Care Act. There has been an increasing demand for doctors; because of this increasing demand, the training part for trainees is often rushed. The health care work force is at a “bottleneck” , as the s doctors/workers from the baby boom era begin to retire, thus diminishing the “supply” of doctors and increasing the demand for them (Schwartz, 469). This causes a ripple effect, causing trainees training to be rushed, resulting them to lack the time and training they need to accurately diagnose and treat patients. Figure 3 shows how the cost of healthcare for older people costs much than for younger people. This is because of the large supply of people who was once at the left side of the graph, who could work, aged and has moved to the right side. In an attempt to mitigate that, more and more doctors are being pushed out, even though they might not necessarily be ready to be.

 

 

Figure 3: This graph shows that as people age, the cost in health care rises. Because of there is a high demand for doctors in the US, this could explain why health care costs so much more there compared to other countries.

Solutions:     

            One way to reform the health care system would be to make the system more “patient oriented” (Lee). In other words, this means empowering all the people, letting them have options, “to make decisions” that will affect their own health. The system is driven by choice (Frist, 269).

Currently our health care system revolves around the doctors. There are different insurances that some doctors will accept while others won’t to be seen as a patient. The doctor and health insurance provider essentially has the choice to see which patients depending on the health care provider they have. By making it patient oriented, the patient has the choice, not the health insurance provider or the doctor. The policies are centered around the patient’s needs not around the doctors’ needs. The patient has the choice to choose what is best for him/herself.

By reforming the health care system to be patient oriented, communication becomes key. The patient is held accountable providing the most accurate information he or she can to aid the doctor to providing the best possible health care he or she can provide. This would then break the wall that causes the patient’s fear and social anxiety, which prevents them from fully explicating his or her symptoms. This would also approach errors differently compared to before. This system would face the fact that “human error is inevitable” (Kaur, 144). And because this is held true, there is less pressure on doctors of causing mistakes, making them more willing to treat patients, and in return causing them to make less error. This would also eliminate the need for doctors’ to report their colleagues. This would eliminate miscommunication, preventing misdiagnosis, which is one of the largest causes of medical malpractice.              

To combat the use with the lack of training, video games should be implemented into the training regimen of trainees. Video games is much cheaper than the, as Dr. Rosser would say, the “medical simulators” which cost about two hundred thousand dollars each (Marriott). Because video games are cheaper, it would be much more easily implemented into hospitals and medical schools everywhere. Funds used to invest in one costly simulator could be reallocated to buying many video games, which then would train much more trainees than one simulator. This would allow the doctor who is normally training the trainees to treat patients as the trainees go through the part of the trainee that is on video games.

The use of video games in training would be most useful in training laparoscopic surgeons. A study showed that those who plated video games in the past for about three or more hours a week correlated with thirty-seven percent fewer errors and twenty-seven faster completion rate than those who didn’t play video games. Those who current play video games make thirty-two percent fewer errors and twenty-six percent better overall (Rosser, 181). According to Dr. Hank Chien, a plastic surgeon who specializes in double-eyelid surgery and who also holds the highest score in the Donkey Kong games, video games and surgery is similar such that they both require “foresight, good reflexes, and a lot of strategy, planning, and timing” (Kilgannon). Figure 4 shows the similarities between the tools that laparoscopic surgeon uses and video game controllers.

Figure 4: The tools used in laparoscopic surgeons use is very similar to video game controllers, as one side controls the camera (just like a c-stick on a controller) and the other side controls the different actions.

            While it may seem that simulations are only useful in prepping for surgery, “over-the-counter video games” are also a good training source because it requires a similar skill set( Rosser, 182). Dr. Rosser, a laparoscopic surgeon warms up with a game of Super Monkey Ball, Mortal Kombat, or BloodRayne before every surgery (Marriott). Rosser does this because playing Action Video Games or (AVGs) increases his cognitive and perpetual skill, which enhances his capacity to “control top-down attention and learna new task” (Giannottii, 3). By warming up to a video game, this slims down the chance of him making an error during surgery. Those who how played AVGs showed to be able to be more efficient, faster, and more accurate (Oei, 4).

            Laparoscopic surgeons are not the only ones that would benefit from video game training; with more than “seventy-five percent of neurosurgical errors deemed preventable and technical”, the use of video games as training and to warm up before a surgery just as Dr. Rosser would prevent a good amount of those errors (Cobb, 1). While completely differing in topic, laparoscopy and neurology both require a good amount of cognitive skills, accuracy, as well as speed. This shows that using the implementation of video games in Laparoscopic surgery is just an example as video games training can be implemented in different types of surgeries.

            All in all, the healthcare system should be reformed to fix it’s problems with communication and video games should be implemented to the training of medical trainees to increase the quality and the amount of training done.

 

Works Cited

Bal, B. Sonny. "An introduction to medical malpractice in the United States. "Clinical Orthopedics and related research 467.2 (2009): 339-347.

Cobb, Mary In-Ping Huang, et al. "Simulation in Neurosurgery—A Brief Review and Commentary." World Neurosurgery (2015).

Frist, William H., “Health Care in the 21^st Century.” New England Journal of Medicine. 352.3(2005)” 267 – 272.

This source creates a hypothetical world where healthcare is perfect. Since the hypothetical is set in the 21^st century, specifically 2015, I can compare what people idealized healthcare to be in 2015 compared to what it actually was. This article further then revises the healthcare system in 2005, which is still similar to the healthcare system we have now. It offers viable solutions to improving healthcare, and the effects of these solutions. I plan on using this source to compare what healthcare was in 2015 to what it was hypothesized and idealized to be. I will then use the ideas offered as solutions to help support that by implementing this along with video games will lower the medical malpractice rates.

Giannotti, Domenico, et al. "Play to become a surgeon: impact of Nintendo Wii training on laparoscopic skills." PLoS One 8.2 (2013): e57372.

Gillis, Amy E., Marie C. Morris, and Paul F. Ridgway. "Communication skills assessment in the

final postgraduate years to established practice: a systematic review." Postgraduate

medical journal 91.1071 (2015): 13-21.

Graafland, Maurits, J. M. Schraagen, and Marlies P. Schijven. "Systematic review of serious games for medical education and surgical skills training."British journal of surgery 99.10 (2012): 1322-1330.

Jackman, Tom. “Anesthesiologist Trashes Sedated Patient – and It Ends Up Costing Her.” Washington Post. The Washington Post, 23 June 2015. Web. 29 Feb. 2016.

            In this source, the author describes the situation of D.B. a patient who went in to get his colonoscopy but then discovers that not only has the anesthesiologist and the doctor been making crude remarks about him, but also they diagnosed him with hemorrhoids even though he was perfectly fine. D.B. was able to sue for defamation and medical malpractice. I plan on using this source as an anecdote to begin my introduction to show what medical malpractice is.

Kaur Hothi, Daljit. "Challenges to improving patient safety in the NHS."Clinical Governance: An International Journal 9.3 (2004): 143-146.

This article outlines the current problems with out health care and then provides evidence on what causes this and how it could be fixed. It concludes that the problem with current healthcare is flawed by the low morale of doctors. I plan on using the causes outlined in this article to further show the flaws of our healthcare system to further show how implementing video games into our healthcare system can improve it.

Kilgannon, Corey. “Crowned new King of Kong.” The New York Times. The New York Times, 07 Jan. 2012. Web. 07 Mar. 2016.

Lee, Thomas H. "The strategy that will fix health care." (2014).

Marriott, Michel. “We Have to Operate, but Let’s Play First.” The New York Times. N.p., 24 Feb. 2005. Web. 2 Feb. 2016.

In this source, the author explicates how Dr. Rosser, a laparoscopic surgeon who play video games, specifically Monkey Ball before he goes into surgery. It first explains what laparoscopic surgery is and then it goes on to quote Dr. Rosser. It further explicates how Dr. Rosser is a doctor who is an excellent and it compares how is surgerical instruments is very similar to a video game controller. I plan on using this source as a first hand experience on how video games affect his ability to perform the surgery. He is a real life example of how video games help improve surgery.

Oei, Adam C., and Michael D. Patterson. "Are videogame training gains specific or general." Frontiers in systems neuroscience 8.54 (2014): 1-9.

Rosser, James C., et al. "The Impact of Video Games on Training Surgeons in the 21st Century." Archives of Surgery 142.2 (2007): 181-186.

Schwartz, Mark D. "Health care reform and the primary care workforce bottleneck." Journal of General Internal Medicine 27.4 (2012): 469-472.