Is it “Macaca” Time in Healthcare?

By  |  August 19, 2008 | 

August 11th was the 2nd anniversary of the epic implosion of George Allen’s presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering whether healthcare has also entered the YouTube era.

Remember the George Allen fiasco? A 20-year-old Indian-American named S.R. Sidarth, working for Allen’s opponent Jim Webb, was filming an Allen campaign stop in Breaks, Virginia. Twice, Allen pointed to him and called him “Macaca,” a racial slur meaning “monkey.” Once the video hit YouTube, it went completely viral (this clip, one of many, has been viewed 350,000 times) and Allen’s promising political career was toast.

What does this have to do with healthcare? In the past 18 months, two powerful, highly troubling videos have surfaced of patients being left to die in ER waiting rooms. The first, in May 2007, involved a woman named Edith Rodriguez. Rodriguez began vomiting blood while waiting outside the King-Drew ER, and soon collapsed. Rodriguez’s husband called Los Angeles’s 911 system, but got nowhere. Then someone else in the waiting room called:

Caller: “There’s a lady on the ground, here in the emergency room at Martin Luther King and they are overlooking her, claiming that she’s been discharged. And she’s desperately sick and everybody’s ignoring her.”

911 Dispatcher: “What do you want me to do for you, ma’am?”

Caller: “Send an ambulance out here to take her somewhere where she can get medical help.”

911 Dispatcher: “OK, you’re at the hospital, ma’am, you have to contact them.”

Caller: “They’re the problem. They won’t help her.”

It’s not that the ED staff did nothing – the video clearly shows a janitor coming out to mop up the patient’s bloody vomitus partway through her dying process.

The disgust over the YouTube video was the last straw for hapless King-Drew, leading to the hospital’s closure late last year.

Last month, another videotape surfaced showing a woman collapsed on the floor of the Kings County psychiatric ER waiting room in Brooklyn, NY. After sitting for a day waiting to be seen, the woman fell to the floor, where she lay face-down for about an hour before anyone appeared to notice her now-dead body. A few weeks ago, the family notified the hospital of their intent to file a $25 million wrongful death lawsuit.

In both the King-Drew and Kings County cases, the videos made a splash when they hit the news. But what really kept the stories alive was their viral spread on YouTube – for example, as of last night, the Kings County video had been viewed 470,025 times and had generated 1,845 comments!

Add to this brew the ubiquity of cell phone cameras, the increasing interest in physician and hospital rankings and comments (Yelp, Zagat), and the public’s growing skepticism of the safety – even the motives – of hospitals and doctors (for example, see Tara Parker-Pope’s recent article in the NY Times), and you have a formula for more “Macaca” moments, seen everywhere, by everyone.

So if professional ethics are not enough reason to be respectful of and polite to patients, perhaps the desire to avoid YouTube immortality is.

About the Author:

Robert M. Wachter, MD is Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. He is also a national leader in the fields of patient safety and healthcare quality. He is editor of AHRQ WebM&M, a case-based patient safety journal on the Web, and AHRQ Patient Safety Network, the leading federal patient safety portal. Together, the sites receive nearly one million unique visits each year. He received one of the 2004 John M. Eisenberg Awards, the nation’s top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past eight years, the only academic physician to achieve this distinction; in 2015 he was #1 on the list. He is a former chair of the American Board of Internal Medicine, and has served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller.


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  1. dale August 19, 2008 at 10:26 am - Reply

    If you read the book, The World is Flat by Thomas L. Friedman, he touches on this very topic. A hospital leader recommeded it to me about 4 years ago. His logic seems to be unfolding. Be good or they will find out, he states, through technology. Not only will they find out but your actions will be broadcasted so your integrity should shine.

  2. Jon September 24, 2009 at 2:12 pm - Reply

    Great book!

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