My institute of residency training is in hot water again, and I groan in despair (see Heart Tests at Harlem Hospital Went Unread). The New York Times reported that Harlem Hospital had performed nearly 4,000 cardiac echo exams in a two year period and none of them had been read by a physician. The Times alleges that the responsibility of reviewing these labs reports had been given to the cardiac techs and now the consequences of that decision was coming back to haunt the entire hospital.

This scandal reminds me of another that occurred over 25 years ago. Hundreds of New York City women entrusted their PAP smears to city hospitals that were never read by a gynecologists. By the time the debacle was discovered years later, some of these women developed cancer. With a failing economy and budget constraints, I’m sure someone had the misguided perception that they could save money and resources if the technicians read the lab reports and reported the “abnormals” back to the physicians. The same principals apply to nursing. Medical assistants are now expected to perform duties traditionally done by nurses as a means of “saving” money. These “cost-saving” strategies have a chilling effect.

Harlem Hospital is an historical haven for the poor. Despite limited resources, its dedicated staff saves lives on a daily basis. However, please don’t push the envelope. The quality of medical care greatly diminishes as the volume of patients increases. Delegating a physician’s duties to a technician will NOT remedy this problem.

A team of 15 to 20 physicians from other city hospitals were assembled to review the cardiac records and miraculously no abnormalities were found. There were also disciplinary actions that resulted in the termination of a clinical director and the demotion of a physician. The take-home message for ALL patients regarding this debacle is to obtain the results of all of your medical tests. Do not assume “no news is good news.” And if someone wants to give you an injection, please verify that they’re truly a nurse.

Our present healthcare system is on automatic pilot. It’s up to you to grab hold of the wheel.