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WASHINGTON (AP) - The U.S. health care system is a tangled maze that too often leaves Americans with inadequate, outdated, even unsafe therapy, according to a scathing report Thursday that recommends an urgent overhaul to bring 21st century care to more patients.
U.S. specialists know sophisticated and effective ways to fight killers like diabetes, heart disease and breast cancer. But too many patients slog from doctor to doctor in search of one who can even fit a basic physical examination into their crowded schedules, much less one who understands and uses the best treatments, says the report by the Institute of Medicine.
``The frustration levels of both patients and clinicians have probably never been higher,'' the report says. ``Health care today harms too frequently and routinely fails to deliver its potential benefits.''
The report is a follow-up to the institute's groundbreaking 1999 announcement that medical mistakes kill from 44,000 to 98,000 hospitalized Americans a year. While some scientists quibble with the toll, that report has sparked major changes as hospitals nationwide adopted new programs and technology to cut mistakes.
The new report looks at overall health systems, from private doctors' offices to insurance. The institute, a private organization that advises Congress on scientific matters, recommends an overhaul toward patient-focused health care that gives Americans more information about their health and makes more doctors follow the latest scientific evidence instead of outdated treatments.
It urged Congress to set aside dlrs 1 billion over the next three to five years to boost programs that would spur such change.
Another big recommendation: If someone gets sick late at night or on a Saturday, and it's not an emergency, they still should be able to get care, even if all they need is a doctor's e-mail recommending self-treatment.
That represents ``a fundamental shift in the culture of medicine,'' Dr. Kenneth Kizer of the National Quality Forum, a nonprofit health improvement research group, said after reviewing the recommendations.
One of the report's most alarming findings: It can take 17 years for important research discoveries to become accepted and used by the average doctor.
Heart medicines called beta blockers, for example, were proved more than 10 years ago to increase significantly a person's chances of survival after a heart attack. But nearly half of heart attack victims still don't receive them, Leape said.
Other problems: Women forced to wait nine weeks for a biopsy after a suspicious mammogram; patients denied access to their own medical records, so that they can't weigh treatment options; paper medical records that emergency rooms can't get during a crisis and that are easily lost when patients switch doctors; sufferers of complicated chronic illnesses bounced from specialist to specialist who don't coordinate their care.
On the Net: National Academy of Sciences: http://www.nas.edu
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