Healthcare – When is Protocol Appropriate?

In the healthcare arena we have learned to develop protocols as to what is appropriate treatment and care to develop efficiencies and standardizations to save lives. It has been very successful, fairly predictable and saved millions of lives. And yet I would like to challenge our dependence on these protocols. Has anyone considered the possibility or measured the amount of harm this has done when followed blindly?

For instance; when someone shows up with inflammation, is it appropriate to automatically give them an IV? This might make it easier to give multiple medications, but does it confuse or muddy the reaction and analysis of the inflammation? Could extra fluids worsen the condition?

Another example; when someone shows up with an infection that is not life threatening, why don’t we take the time to culture or analyze what it is? Are we playing the odds and throwing our best guess? Wouldn’t it be more productive and  healthier for the patient to determine if it is a virus, bacteria or fungus first? If we are treating the wrong thing based on a guess, I propose that we could be losing precious time that could also save a life if the correct diagnosis was made. You could start with your best guess while waiting for the culture to come back. Traditionally we guess, and then if we’re wrong and the condition worsens then we move up to a broader spectrum  approach, and after that might consider a culture. People have lost their lives from this approach. It may not be cost effective, yet was the patient even given the option?

I am grateful for and can certainly understand the importance and need to follow protocols under life threatening conditions. But when we do have the luxury of even a couple days to examine the situation, we may actually prevent further harm, expense and complications. Inflammation is the body’s response to injury and we seem to want to take it totally out of the equation. Perhaps a few days to a week of monitoring may show that the body is resolving things on it’s own.

This is obviously not a complete analysis, just food for thought. I have been in this situation myself and weighing the pros and cons. What do you think?

Explore posts in the same categories: Healthcare Service

Tags: do no harm, healthcare ethics, Healthcare integrity, healthcare practice, medical protocol

You can comment below, or link to this permanent URL from your own site.