HOUSE: Judgment Day for Princeton-Plainsboro

The portfolio of unpunished felonies continues to pile up for Doctor House. In addition to the routinely scheduled residential break-ins, Episode 414, 'Living the Dream,' opens with House perpetrating a kidnapping in order to confirm his suspicions that a popular soap opera actor has a brain tumor. The unsuspecting actor ends up in Princeton-Plainsboro and endures a lengthy series of invasive tests and near-death medical emergencies: cardiac arrest, kidney failure, extreme fever, coma, etc. Spoiler alert: dude had a rare allergy that was previously used in an ancient episode of Murder, She Wrote.

Do not despair. Even without Angela Lansbury this episode still had some entertaining drama.

For those in the medical community, the real plotline involved Dr. Cuddy's efforts to guide the hospital through its reaccreditation inspection. Every time House behaved at his worst the inspector was a witness.

Reaccreditation is a lengthy, expensive, time-consuming show-and-tell. The agency in charge (typically JCAHO - Joint Commission for Accreditation of Health Care Organizations) inspects every hospital with announced and unannounced visits. Ostensibly, the reaccreditation process is promoted to improve patient care delivery but, ironically, an upcoming inspection cycle often distracts many hospital employees from their real responsibility...helping patients. The reality is that most health care professionals see reaccreditation as a colossal waste of time.

Nurses and administrators maintain underground communications with their counterparts at other recently inspected hospitals to discover upcoming key areas of scrutiny. For example, one year such advance 'intelligence' warned that inspectors were particularly concerned about hospital staff knowledge regarding steps to take in the event of a fire. Sounds reasonable, right?

Many thousands of manhours were devoted to briefing (and rebriefing) employees, printing clip-on cheat cards, and mounting laminated signs on both sides of every door and approximately every 10 feet along both sides of the corridors. Good news! If you can just crawl 10 feet away from that blaze you will find laminated instructions that will help you escape...so long as they haven't melted! Every experienced clinician has 2 or 3 wild reaccreditation inspection stories to share. On inspection day nobody was asked anything about fires, but the outdated anesthetic ventilation system in the operating rooms took a big hit. Ooops!

Back to the show, the unyielding inspector learned about House's radical (read hair-trigger) approach to patient care: treat first, diagnose later. The soap-opera patient survived but it had no impact on the inspector's evaluation. Cuddy's hospital was cited and got socked with a fine but House got to keep his job and survive to violate his Hippocratic Oath one more time.

Hmmm, how often should prime time fictional medical dramas get reaccredited?

Related Topics:

• Choosing a Hospital
• Taking Charge of Your Hospital Stay

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