I think the zero kool-aid that APIC keeps drinking is really part of post-modernism, the philosophical paradigm that holds there is no absolute truth. Postmodernism is inherently anti-science. David Gorski, a physician who blogs at Science-based Medicine, writes:
truthiness,"truths that a person claims to know intuitively "from the gut" in that it "feels right" without regard to evidence, logic, intellectual examination, or facts." According to Colbert, “It used to be, everyone was entitled to their own opinion, but not their own facts. But that's not the case anymore. Facts matter not at all. Perception is everything. It's certainty.”
A few years ago, a colleague, also a hospital epidemiologist at an academic medical center, sent me an email that encapsulates the effect of postmoderism on our field. He wrote:
“I used to think that the increased attention on HAIs would be a really good thing, despite the hassles. But I sense that the tide has turned strongly and decisively against the academic, ID-trained hospital epidemiologist. No one defers to that training or expertise anymore–they bow down instead to Toyota models and non-ID trained, self-styled patient safety gurus who preach buzzwords. At my hospital we now report to hospital administration only through someone who spent most of his career in the automotive industry. He's a nice guy and all, but come on, nobody at the table when the “hospital leadership group” discusses infection data has any ID or infection control training!”If we could be magically transported back a half century with the corpus of evidence about healthcare associated infections that exists today, it might be possible to come close to eliminating HAIs in the hospital of 1962. But advances in medicine continue to make patients more immunosuppressed and devices have become increasingly more invasive. We continue to bypass every one of the body's natural barriers to infection. This is why, as I have said previously, I have yet to meet an infectious diseases physician who believes that HAIs can be eliminated. During my travels I have found that most infection preventionists agree. This leads me to believe that there is some disconnect between APIC leadership and the IPs in the trenches. And it's a good thing I'm not a cynical person! If I were, I might think that APIC's vision would be a great way for the organization to "partner" with industry to prevent infections through some good old fashioned quid pro quo.
I decided when I was a fourth-year medical student that I wanted to be a hospital epidemiologist. I very much wanted to spend my career studying the problem of HAIs and designing ways to reduce them. I still find it fascinating over two decades later. I would love to see the day when there are no HAIs. But I live in the reality-based community that embraces modernism, a place where science is the tool to explain what we observe in the world. So I'll freely admit that I believe in microbiology, epidemiology, vaccines, climate change, and anything else that valid evidence reveals to be true. I also believe that APIC is unfortunately spinning ever further into a parallel, postmodern, anti-science, truthy universe.
Photos: Institute for Science in Medicine; BWOG