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The North Carolina Medical Board recently reviewed a case where doctors and interns tried to induce labor on a patient, and then performed a Caesarean section, but found there was no baby inside the woman’s womb, Foxnews.com reports. Apparently an intern did an ultrasound before the surgery and could not find a heartbeat. It was at this time that the patient convinced doctors to induce her. The medical board said the intern did not have enough experience to make the “appropriate diagnosis.”

No kidding.

It was determined that the patient suffered from pseudocyesis, which is the medical term for “false pregnancy.” A person suffering from pseudocyesis may often have all the same signs and symptoms as a person who is actually pregnant, but there is no fetus.

While I accept the likelihood that pseudocyesis was the patient’s root problem, I am curious about the failed ultrasound. As father of three and grandfather of two I’ve seen a few fetal ultrasounds. Although I’m not expert enough to use them for diagnoses, I think even I could determine if a full-term fetus was there or not.

The desperate need for process improvement in healthcare continues to blare forth in the headlines. I may need to start a regular feature on the subject!

Ready-Fire-Aim. Once again the healthcare profession finally gets around to looking at data, only to discover that it is actually harming patients by treating them. The Los Angeles Times reports that a major nationwide trial called ACCORD released Sunday show that lowering either blood pressure or cholesterol levels below current guidelines do not provide additional benefit and, in fact, increase the risk of side effects. A third arm of the study, released two years ago, shows that lowering blood sugar levels excessively actually increases the risk of heart disease.

The Lean Six Sigma and Quality professions learned long ago that there is no substitute for facts and data. In pursuing Lean Six Sigma so many myths are exploded that we soon come to question any so-called fact that can’t be supported with evidence, with the important exception of creative ideas and innovation. As time goes by the value of this position becomes obvious. As change agents trained in the approach move into positions of leadership the organization’s DNA begins to change.

In most industries mistakes result in an economic loss. Although serious, it is usually possible to learn from mistakes and improve. In contrast healthcare mistakes create health consequences, sometimes as serious as death. Yet the healthcare profession remains incredibly resistant to using facts and data to guide their recommendations and treatment. The ACCORD study is but the latest example. A few years ago the ENHANCE study produced similar lessons regarding the treatment to prevent heart disease. Other studies show that low cost diuretics are as effective as the high priced prescription medications normally prescribed. Another study showed that the standard treatment for sudden deafness is no better than a placebo. Still another showed that the standard of care for certain breast cancers was based on fraudulent research and killed patients.

All of these studies have a number of things in common. All were conducted to verify treatments that had been in use for many years. All showed that the treatments were either worthless, or worse than worthless. And most have been largely ignored by the healthcare profession.

It’s anyone’s guess when the healthcare profession will join the business community in embracing process improvement. Let’s hope it happens soon, before change is forced upon them.

The person who discovered the test used to screen 30 million American men for prostate cancer, the prostate-specific-antigen or PSA test, says the test is a hugely expensive healthcare disaster. In the New York Times Op-ed piece  The Great Prostate Mistake Professor Richard J. Ablin  states

“I discovered P.S.A. in 1970. As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.”

Americans spend an enormous amount testing for prostate cancer. The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration. Meanwhile, the test is hardly more effective than a coin toss. P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t.Instead, the test simply reveals how much of the prostate antigen a man has in his blood. Infections, over-the-counter drugs like ibuprofen, and benign swelling of the prostate can all elevate a man’s P.S.A. levels, but none of these factors signals cancer. Men with low readings might still harbor dangerous cancers, while those with high readings might be completely healthy.

So why is it still used? According to Ablin it’s because drug companies continue peddling the tests and advocacy groups push “prostate cancer awareness” by encouraging men to get screened. Shamefully, the American Urological Association still recommends screening, while the National Cancer Institute is vague on the issue, stating that the evidence is unclear.

The bottom line?

“Testing should absolutely not be deployed to screen the entire population of men over the age of 50, the outcome pushed by those who stand to profit.”

This according to the man who discovered the test over four decades ago.

Personally, I think the logic used in Professor Ablin’s op-ed piece should be used to assess the value of all recommendations used to test and medicate Americans into bankruptcy without improving health in the slightest.