After falling down a flight of stairs, breaking his neck and nearly dying, a Massachusetts physician is now speaking out about the stark deficiencies he saw in his own treatment -- and how those shortcomings relate to more general problems he sees plaguing medical care in America.

Writing in the New York Review of Books, Harvard Medical School faculty member Arnold Relman -- who is in his 90s -- documents the course of his treatment from arrival at Massachusetts General Hospitals emergency room on June 27 to his discharge from Spaulding Rehabilitation Hospital ten excruciating weeks later.

As he says, Since then, I have made an astonishing recovery, in the course of which I learned how it feels to be a helpless patient close to death. I also learned some things about the U.S. medical care system that I had never fully appreciated, even though this is a subject that I have studied and written about for many years.

Specifically, Relman says, I always knew that the treatment of the critically ill in our best teaching hospitals was excellent. That was certainly confirmed by the life-saving treatment I received in the Massachusetts General emergency room. Physicians there simply refused to let me die.

But what I hadnt appreciated was the extent to which, when there is no emergency, new technologies and electronic record-keeping affect how doctors do their work. Attention to the masses of data generated by laboratory and imaging studies has shifted their focus away from the patient.

Doctors now spend more time with their computers than at the bedside. That seemed true at both the ICU and Spaulding. Reading the physicians notes in the MGH and Spaulding records, I found only a few brief descriptions of how I felt or looked, but there were copious reports of the data from tests and monitoring devices.

- Arnold Relman

"Conversations with my physicians were infrequent, brief and hardly ever reported.

Within this vacuum of personal care, Relman says the role of nurses has never been greater in ensuring a patient is not only comfortable during their convalescence, but actually ultimately gets well.

I had never before understood how much good nursing care contributes to patients safety and comfort, especially when they are very sick or disabled, he wrote.

See the rest here:

Harvard Medical School doctor becomes patient, and gets a crash course in America's medical care