The Joint Commission Can Kiss My Ass

I hate the Joint Commission.  I always have hated the Joint Commission.  I worked for three different hospital systems in my life and this organization always caused an uproar whenever their supposed appearances were threatened.  It was one of the few times administrators were seen throughout the hospital (where these administrators came from and why there were so many is another story).   It was as if they were the supreme leader of the Dark Force was about to arrive, at any moment you could be choked out if you said anything wrong.  The Joint Commission confuses people into thinking they are some government organization but they are a third-party, independent organization that has the green light by our government to do their bidding.  What they say goes.  No one questions them.  I remember having to remove Christmas cards, from patients, taped to my office door because it was a Joint Commission violation.  They felt it was a fire hazard as if they could spontaneously combust. No one ever checks them to see if what they are measuring was ever useful.  It is their rules and everyone obeys them. Why am I bringing this up?  Well, because the Wall Street Journal did a nice investigation on them and found them to be a scam.

Hospital Watchdog Gives Seal of Approval, Even After Problems Emerge

The Joint Commission, which the government relies on to accredit most hospitals, rarely withdraws its approval in the face of serious safety violations

Some keep points from the article:

  • The Joint Commission is the accrediting organization for almost 80% of U.S. hospitals, including those for veterans, the Federal Bureau of Prisons and the Indian Health Service, giving it a sweeping quasi-governmental role overseeing medical care.
  • This certifier of hospital quality, however, typically takes no action to revoke or modify accreditation when state inspectors find serious safety violations, according to a Wall Street Journal database analysis of hundreds of inspection reports from 2014 through 2016.
  • In 2014, about 350 hospitals found in those reports to be in violation of Medicare requirements had Joint Commission accreditation at the time, the Journal found. More than a third with accreditation went on to have additional violations later in 2014, 2015 and 2016.
  • A result is that hundreds of hospitals with safety problems could continue to display a “Gold Seal of Approval” and promote their accredited status. The Joint Commission provides hospitals with an accreditation publicity kit, and a consulting arm of the organization sells “We Are Accredited!” pins and stickers. A brochure it prepared for patients reads, “Whenever and wherever you receive health care, look for The Joint Commission Gold Seal of Approval.”

Once again, this proves the term “quality” is so ambiguous that it should NEVER be used, especially in any payment model, but I digress.

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So why do hospitals use the Joint Commission in the first place?

Hospitals can use state inspections to prove their compliance but have the option of hiring a private, federally approved accrediting organization such as the Joint Commission.

Did you know they had other options?  I didn’t.  I’ll bet you dollars to donuts (you know, the ones lying around the hospital administrator meetings) that the damn Gold Seal of Approval is the only reason the Joint Commission is used.  Administrators want a prize in their Cracker Jack box!  They want a gold star to show off like they are 5-year kids. It’s pathetic.

But, wait, there’s more!

Twenty of the Joint Commission’s 32 board members are executives at health systems it accredits or else work at parent organizations of such health systems. Some other board members are named by health-care lobbying groups, such as the American Hospital Association and the American Medical Association.

It’s like the fox watching the hen house!  The inherent conflict of interest is more than disturbing. I also find it hysterical that the Joint Commission is non-profit, once again proving this term is a joke.  They also paid their CEO over $1 million a year as they pulled in $142 million a year.  It’s a racket!

So, what didn’t this article mention?  I believe that the Joint Commission had a hand in the opioid epidemic.  This from an older WSJ article:

In 2001, the Joint Commission, which accredits U.S. hospitals, issued new standards telling hospitals to regularly ask patients about pain and to make treating it a priority. The now-familiar pain scale was introduced in many hospitals, with patients being asked to rate their pain from one to 10 and circle a smiling or frowning face.

The Joint Commission published a guide sponsored by Purdue Pharma. “Some clinicians have inaccurate and exaggerated concerns” about addiction, tolerance and risk of death, the guide said. “This attitude prevails despite the fact there is no evidence that addiction is a significant issue when persons are given opioids for pain control.”

Why is no one prosecuting or suing the Joint Commission?  They published a guide sponsored by the makers of Oxycontin!!!  Doctors were threatened to be punished if pain meds weren’t pushed.  Hospitals needed that Gold Seal of Approval so doctors couldn’t reject patients demands for narcs.  In fact, the pain scale card was pushed into every hospital room and that card was produced by Purdue Pharma with their name at the bottom. This from a New Yorker article:

Yet Purdue, according to a report issued by the U. S. Government Accountability Office, helped fund a “pain-management educational program” organized by the Joint Commission; a related agreement allowed Purdue to disseminate educational materials on pain management, and this, in the words of the report, “may have facilitated its access to hospitals to promote OxyContin.”

Can you see the trail of guilt by the Joint Commission?  Yes, they somehow have been absolved of all this. Why?

For these reasons I want the Joint Commission to kiss my ass.  I am sure I am not alone.  Please comment with your experiences with the Joint Commission below.  I want to show the world how idiotic they are.  And please share this post!

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Douglas Farrago MD is the author of four books, one of his most recent is Diary of a Drug Rep.

 

104580cookie-checkThe Joint Commission Can Kiss My Ass