Tuesday, April 12, 2011

Maureen Dowd's "Giving Doctors Orders": Physicians Her Latest Prey

Almost everyone can recount a story where a doctor behaved arrogantly or erred, and doctors as a group are an easy target for an op-ed. In her latest New York Times op-ed "Giving Doctors Orders" (http://www.nytimes.com/2011/04/13/opinion/13dowd.html), Maureen Dowd observes:

"When my brother went into the hospital with pneumonia, he quickly contracted four other infections in the intensive care unit.

. . . .

Michael died in that I.C.U. A couple years later, I read reports about how neckties and lab coats worn by doctors and clinical workers were suspected as carriers of deadly germs. Infections kill 100,000 patients in hospitals and other clinics in the U.S. every year."

I am, of course, sorry about Ms. Dowd's loss of her brother, but are deadly infections in hospitals mostly caused by doctors' unwashed hands, dirty neckties and lab coats, or is something else happening?

Regrettably, Dowd does not trouble herself to mention the frightening evolution of antibiotic-resistant bacteria. Examples:

• MRSA bacteria, found on the skin and in the noses of healthy persons, can cause infection if they penetrate the body during surgery or following insertion of a catheter. Although penicillin was once effective against these bacteria, most strains must now be treated using next generation antibiotics through an IV.

• VRE bacteria can sit dormant in a person's intestines until administration of an antibiotic. Given that many patients in hospitals receive antibiotics, VRE infections are common in hospitals.

Sure, hospital hygiene is important, and unnecessary administration of antibiotics, often at the demand of patients and parents, has also contributed mightily to the problem over the years, but to put the blame on doctors is absurd.

There is an evolutionary arms race between antibiotic-resistant bacteria and the ability of the pharma companies to create new drugs capable of fighting off these microbes. Unfortunately, no one knows which side will ultimately prevail in this war.

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