Less than 24 hours after this weekend’s two part series in the Washington Post on substandard conditions at an outpatient facility at Walter Reed Medical Center, Army officials and VA spokespeople were at the facility apologizing and pledging repairs. An undercover investigation by Post reporters Dana Priest and Anne Hull found serious problems at Mologne House, ranging from run down conditions in patient rooms to shocking levels of bureaucratic incompetence. 

From the Post’s report:   

The common perception of Walter Reed is of a surgical hospital that shines as the crown jewel of military medicine. But 5 1/2 years of sustained combat have transformed the venerable 113-acre institution into something else entirely — a holding ground for physically and psychologically damaged outpatients.

The story was quickly picked up by the national press. White House spokesman Tony Snow found himself dodging questions from the press corps about the way the Bush Administration has handled care for veterans returning from the war. Democrats called on the Department of Defense to launch an investigation into conditions at nearby Bethesda Naval Medical Center, where critics allege similar problems have been ignored in the past.

The Associated Press reports that the Army has launched a formal investigation into Michael J. Wagner, the VA official who until recently ran the outpatient center in question. Wagner now heads the Military, Veteran and Family Assistance Foundation,
a Dallas based charity that specializes in providing care for troops
returning from Afghanistan and Iraq. He is accused of raising funds for
the charity while still working as a VA employee.

Three years ago, a story like this would have been considered off
limits by editors worried that readers might be offended.  Expect more
pieces like it to follow as other journalists follow the Post’s lead.

The killer quote of the day: “If Iraq don’t kill you. Walter Reed will.”

Michael L. Millenson, president of Health Quality Advisors in Highland Park, IL and author of the book Demanding Medical Excellence, has previously contributed to The Health Care Blog and been featured in a THCB podcast

Those who pore over The New York Times and Wall Street Journal for their news miss a chance to feel the real pulse of health care public opinion – the comics. This past Sunday, Dilbert, compulsory reading in cubicle world, neatly skewered the idea that “empowering” consumers is a sure-fire route to better care.   

Catbert, “evil director of human resources,” announces, “The new company health plan is Google. From now on, employees must use Google to diagnose their own illnesses.” After a quick search on his BlackBerry, Catbert diagnoses an employee’s hitherto unnoticed growth on the neck as caused by the actions of a “pregnant termite” and hints menacingly at treatment involving “an arc welder and a barrel of kerosene.”

Interestingly, Dilbert author Scott Adams felt compelled to counter the impression left by his own long post a year ago about the way in which Google helped him correctly identify a rare and serious condition that his doctors failed to diagnose. The key difference, of course, is the context: Web searching as a supplement to top-notch doctors or Web access as a cheap substitute for actual medical advice. Those who soothingly promote cut-rate “consumer-driven” care should note that actual consumers will be less credulous than the consultants’ current Catbert-like customers at big corporations.

Providers are also becoming targets for satirical barbs. The sardonic Sylvia, which comments on the trials and tribulations of modern life, devoted two consecutive daily strips last summer to drug errors. The first, noting that 1.5 million Americans are harmed by medication mistakes, features pickets holding warning signs in front of the local hospital (e.g., “Danger! Do Not Enter”). The second strip , searching for a solution, muses whether we all should have an RN accompanying us to the doctor’s office. 

Meanwhile, the satirical weekly The Onion ran a fictional news item in which an Iraqi hospital begs for a new supply of bilingual “Employees Must Wash Hands” signs. The hospital’s director notes that the importance of hand-washing “could not, unlike doctors and nurses, be overstressed.”

We are still a long way from the time when the 45 percent failure rate in the practice of evidence-based medicine unleashes a barrage of biting commentary on Leno, Letterman and The Daily Show, the accepted articulators of American angst. But Time has recently noticed the importance of EBM – and that’s a start.

As a paraglider myself, I hope for luck this good for all paragliders.

German paraglider survives being sucked into killer storm