January 4, 2006
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.