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Volume 13, Issue 3 July 2009 September 2009 West Virginia Board of Medicine Quarterly Newsletter The Patients Doctors Don't Know By ROSANNE M. LEIPZIG (Reprinted from July 2, 2009, New York Times,
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As the doctors prepare for rotations, they have been exhorted to stay healthy. Yet if the medical staff at the most prestigious hospitals has its way, the new graduates in the next few weeks will suffer far more than is normal. From coast to coast, hospitals offer new medical trainees — sometimes in excess of 1,500 per year — a series of tests for high cholesterol, cholesterol levels, blood sugar and smoking, in addition to a blood-test battery known as an end-of-rotation survey. The hospitals' doctors hope that these tests will help the new interns predict their future heart disease risk, and that when their scores get too high, they'll be counseled to take more cholesterol-lowering drugs. The tests are common but controversial, a clash of medical ethics and patient safety. The results of one recent survey suggest that many interns have been given incorrect information, leaving them ill-equipped when they go home for the summer; other surveys have confirmed lower-than-expected scores. To get at these questions, the health department has convened a board to review the end-of-rotation survey program. It's the ninth-year anniversary of the Board's survey program, and medical ethics are not on anyone's mind. The board's president, Dr. Thomas J. Barrow, an internal medicine physician, does not like to think about this, at least not until there is a decision. On the evening of April 13, at Barrow's office, board members gathered to review a recent survey, and they were in no mood to dole out punishment. The health department had come under great criticism before for failing to provide interns with important information about what might be a lethal disease. Last summer, the board fired 11 of the country's largest hospital networks for a similar offense — sending their interns home with inaccurate information. (The other major hospital networks had not been involved in the disciplinary measures.) The health department has come under great criticism before for failing to provide interns with important information about what might be a lethal disease. Since the most recent report by the Centers for Disease Control and Prevention that obesity may be linked to a host of fatal diseases, some hospitals have tightened up their intern-survey protocols. The boards that oversee the health departments of the top 31 hospitals — which include Stanford Medical Center and Memorial Sloan-Kettering Cancer Center, which has the largest share of intern physicians in the country — were asked to decide whether the networks had obeyed federal guidelines.

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