If it were only so easy....

The Op-Ed page of today’s New York Times contains a piece by Paul O’Neill, the former CEO of Alcoa, former Secretary of the Treasury and co-founder of the Pittsburgh Regional Health Initiative. He contends that President Obama should propose the audacious goal of asking “medical providers to eliminate all hospital-acquired infections within two years.” It’s another example of the type of argument the mainstream media loves to promote. At its core the premise holds that healthcare providers simply don’t care enough to eliminate infections. And although I would be the first to admit that we still have a ways to go in reducing nosocomial infections, his argument is profoundly flawed in assuming that these infections can be eliminated. I recently gave a talk on healthcare associated infections attended by approximately 75 physicians trained in infectious diseases, most of whom were in practice at prominent academic medical centers. At the outset I asked how many in the audience believed that healthcare associated infections could be eliminated. Not a single person raised their hand. As I have stated in this blog before, I believe the majority of HAIs can be prevented, and progress in reducing infections is evident. But these infections cannot be eliminated and it’s a lie to state otherwise. As I made rounds today, the patients I saw were incredibly ill, many were profoundly immunosuppressed, and invasive therapies were the rule. Moreover, the severity of illness, levels of immunosuppression and use of invasive technologies all continue to increase, making patients ever more susceptible to infections. What we need is less application of naïve logic and more investment in studies to determine the optimal strategies for prevention of infection and how to best implement those strategies in an environment that is increasingly stressed and under resourced.