Analysis: Israeli hospitals exaggerate achievements

Public hospital hype – powered by competition and need for admirers and benefactors – can mislead and harm Israeli medicine’s reputation.

By
May 1, 2011 03:29
4 minute read.
Medical staff at a hospital

hospital doctors health 311. (photo credit: Ariel Jerozolimski [file[)

 
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It was news not because it appeared in the press on Thursday – but because it didn’t. An operation performed on a premature infant at the Western Galilee Hospital was, contrary to initial claims by the Health Ministry-owned medical center in Nahariya, not the first such surgery ever reported in the world medical literature.

After the hospital spokeswoman received proof from The Jerusalem Post that the claims were false and the head of the surgical team said he was unaware of and shocked by the hype, the hospital corrected its release and apologized for the “error.”

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The media thus ignored the story when they understood that it was not a “first-ever” Israeli achievement.

But it was not the first time that an Israeli public hospital – one owned by the government – had been exaggerating in the hope that it would get nationwide and even worldwide headlines. Starved for state subsidies and hungry for publicity and the resulting donors, public hospitals have increasingly been dropping their practice of holding to insistent accuracy.

And while numerous local media have fallen for this because they lack the expertise or need to fill pages and websites, a growing number of medical media experts abroad are beginning to question Israeli institutions’ reliability in supplying objective information.

But as the ministry only gains when its medical centers can obtain much-needed funds for development from impressed donors instead of itself being pressed for money, officials in Jerusalem have taken no action to hold spokesmen to the facts.

It doesn’t interfere at all. Hospital managements have tended not to go over such handouts with a fine-toothed comb before release because the selfcongratulating publicity only helps.

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Wednesday’s surgery was a competent operation in a peripheral, small and rarely publicized medical center, successfully performed on a premature baby that saved his life and doesn’t happen every day.

Last February, Rahel Sharon of Kibbutz Gesher Haziv gave birth to her third son, Micah, in his 29th week of gestation weighing 1,060 gram, little more than a bag of sugar. Identified in the uterus, a rare defect was detected as causing a blockage in his gastrointestinal system that occurs in one in 4,000 births – usually in fullterm babies and not one born as a very-low-birth weight premature infant. On Wednesday, he was discharged for the first time and went home after being bidden farewell by hospital director-general Dr. Masad Barhoum.

Nahariya pediatric surgeons Dr. Yechiel Sweed and Dr. Alon Yulavich waited two weeks to perform the surgery after consulting with experts abroad.

Without surgery, the release quoted neonatal intensive care unit Dr. Vered Sheffer Fleisher as saying, the baby’s defect prevented him from swallowing food, which had to be sent directly to his intestines.

Surgery to repair the blockage was dangerous but needed to save his life. Discharged two months later, he is now able to eat normally. “It’s our Pessah miracle,” said the baby’s overjoyed father.

But while Micah is well, the spokeswoman’s release disclosed the growing ill among Israel’s medical institutions and practitioners – exaggeration of achievements in an effort to self-congratulate, earn publicity and attract needed customers and donors. This means that serious health reporters can’t automatically trust as fact every piece of information they receive, even from respectable government medical centers.

Einav Hadari, the Nahariya hospital’s new “director of marketing, advertising and image,” released half-a-dozen photos of the lovely child and a press release boasting that Nahariya’s medical center had accomplished a “feat never-before recorded in the world, with the surgery being performed on the smallest-ever infant.”

Such an operation, at this age and weight, “has never been performed before in the whole world!!!” she told reporters around the country.

Conversant with the medical literature here and abroad, The Post identified the operation as “duodenal astresia” and suspected that it had been performed before in children of this size and even smaller. A leading chief of pediatric surgery in one’s of the country’s top medical centers confirmed within four minutes of receiving an e-mail from the newsroom that “it is nice to do, but not rare at all – just a human story of an operation already done at such weights, not a medical miracle.”

Within another minute, the Post performed a Google search and found such a case – documented in an article by “T. Chen” in a 2008 medical journal published by Elsevier on a “closed loop foregut obstruction” in a very premature baby girl, delivered at 27 weeks of gestation weighing 862 grams. Chen reported “a unique case of combined pyloric and duodenal atresia in a premature neonate...[with an] extremely low birth weight and unstable.”

Alerted to this, Hadari admitted she is “not an expert on medical matters” and said that she was given the superlatives “by the doctors,” but that it turned out that she “had erred.” She urged speaking to Sweed, who said he had briefed her but had not gone over and edited the state hospital’s press release.

“You are absolutely right,” Sweed told the Post. “I thank you. I am an expert in the field and have written for a textbook on duodenal atresia in a Springer textbook.”

Sweed was cognizant of the fact that Israeli public hospitals now tend to think they have to make a big splash to get publicity.

“This is very wrong and very serious. I regret it and will make sure that this doesn’t happen again.”

He said he would raise the problem of exaggeration with the hospital’s director-general.

“While the operation is still rare, we were not the first. I will correct the spokeswoman.”

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