Medical error is the third leading cause of death in the U.S.—right after heart disease and cancer— according to a recent study by John Hopkins University. Here’s how it can happen.
WHEN THE MEDICAL PROFESSION LETS YOU DOWN
SEVEN DEADLY SOURCES OF MEDICAL ERROR
1. A wrong diagnosis can happen even for such common illnesses as pneumonia, congestive heart failure, and cancer. Autopsy and medical record reviews indicate that such errors account for 10% of patient deaths and up to 17% of all episodes of preventable harm in hospitals. Mistakes can be caused by such things as: poor communication among clinicians, patients and families; gender biasing; a too-narrow focus on particular symptoms; presence of a potentially misleading epidemic, such as Asian flu. According to a 2015 Institute of Medicine report, misdiagnoses are the top cause of medical malpractice payouts.
What you can do: Make sure you know what your doctor thinks you have. Ask for the medical terminology, and get it in writing. Check it out on the Internet. Does this sound like what you have? If not, discuss it with your doctor. If it still seems wrong, get a second opinion from a specialist. If you get a test, don’t wait to be informed. Ask to see the results and have them explained to you. Recognize that you may need to be retested—medical tests are not 100% reliable.
2. Sloppy practices can and do happen. X-rays aren’t always clear and the unexpected can always occur. Sometimes the right treatment plan isn’t being followed. Sometimes this happens because medical personnel aren’t following current guidelines. Sometimes it’s because patients have more than one health issue and guidelines are in conflict with one another. These issues may require medical staff to put in extra time to understand and coordinate conflicting indications, but for one reason or another, that may not happen.
What you can do: Ask your doctor to give you written details on the guidelines that he’s following for your treatment. If he refuses, or simply doesn’t follow through, it might be time for a second opinion, according to John T. James, founder of the advocacy group, Patient Safety America.
3. Poor hygiene, such as a doctor or nurse neglecting to wash their hands before performing a personal service or treatment, is yet another source of trouble. While infection prevention has greatly improved in the last 16 years, it remains a serious issue. Hospital patients get an estimated 721,800 infections a year from their hospital stay. Every day, 1 in 25 hospital patients are fighting a bug they got during treatment. Each year, about 75,000 of them die from it.
What you can do: Never worry about hurting the doctor or nurse’s feelings. If they are about to touch you or otherwise administer care without first washing their hands, politely remind them to do so. Don’t be shy. The life you save may be your own.
4. Poor communication is responsible for a host of bad outcomes, especially when a patient’s care moves from one person, department, or hospital to another. The meds you’re taking, the tests that have been ordered, the emergencies you may face, etc., all are opportunities for information to get lost or distorted.
What you can do: Always have someone accompany you for hospital stays and doctor visits. Another set of eyes and ears can capture details or fill in lapses you may have missed. Whenever possible, get information and directions in writing. In addition, the National Patient Safety Foundation says that many situations become clearer with the answers to these three questions: What is my main problem? What do I need to do? Why is it important to do this?
5. Poor discharge planning and communication regarding medications, permissible activities, diet, physical therapy, home care, and recommended follow-ups can leave patients dangerously bewildered at an important medical care juncture. A 2009 study revealed that almost 20% of Medicare patients were readmitted within 30 days of discharge. Half the patients discharged after surgery were re-hospitalized or dead within a year.
What you can do: Request that all instructions regarding follow-up meds, diet, etc., be given to you in writing, as well as verbally, with an opportunity to ask questions. Find out which of your former meds (that you have at home) can still be taken and which should not. Get the name and phone number of a person you can call in case further questions or problems come up.
6. Drug blunders, such as: forgetting to check for allergies, ordering the wrong drug or the wrong dosage, etc., contribute to 700,000 ER visits and 120,000 hospitalizations a year.
What you can do: Make sure that all your doctors know about each medication you take, including over-the-counter meds (e.g., aspirin) and food supplements. In the hospital, make a point of knowing how your meds look and taste. If a nurse brings you something different, ask why. Make sure all care-providers check your hospital wristband before giving you anything.
7. Dangerous doctors: There aren’t many truly terrible doctors, but they do exist. They make their living primarily from naive and/or desperate patients. They are among the 1% of doctors who account for about a third of malpractice claims paid. Often they have been disciplined (though not necessarily barred from practice) for problems like blatant negligence, practicing under the influence, dealing narcotics, and more.
What you can do: Remember that any solution to a health or cosmetic problem that seems too good to be true, probably isn’t true. When choosing a doctor, go online and see what her patients say, check her educational background and if she’s ever been disciplined. If it’s a surgeon, choose one who has done your procedure many times. Research reveals that the amount of actual experience strongly relates to skill—more so than years in practice or fellowship training.
HEALTH CARE INFORMATION RESOURCES
Physician Compare from Medicare gives doctor background information, plus patient ratings.
Hospital Compare uses Medicare data to rate hospitals in such areas as effective care, complications, readmissions, and patient experiences.
Hospital Safety Score gives hospitals a letter grade based on a range of safety measures.
For more information:
• aarp.org - How to avoid deadly health care blunders - Original basis for this article
• hub.jhu.edu - John Hopkins University study re medical error as 3rd leading cause of death in US
• health.usnews.com - Leading cause of malpractice payouts
• patientsafetyamerica.com - Patient advocacy group. Offers info on selecting a good hospital; How to be a take-charge patient; Medicare rankings, etc.