Saturday, July 19, 2008

Don't be a victim of medical errors by Elizabeth Cohen/CNN

 
http://www.cnn.com/2008/HEALTH/07/17/ep.surgical.errors/index.html 

Solid numbers are hard to come by, because most states don't require doctors to report surgical errors. To make sure you're not the next victim, you might have to get pushy, like my husband did.

"You need to be that thorn in their side," said Dr. Samuel Seiden, an anesthesiologist who's co-author of a study on surgical errors. "You will catch things. You might also frustrate the nurses, but you have to look out for yourself."
 
5. Train someone to be your advocate

Don't just bring a friend or family member to your surgery; train them to advocate for you. You're likely to be anxious and a little addled before the surgery (not to mention asleep during it), so you'll need help.

So, how did my husband know to follow Tip No. 4, before he had the chance to read his lovely wife's column? He says it was just common sense -- and his submarine training. When you give an order in a submarine, the other person repeats it back to you, and then you repeat the order again. In engineering lingo, it's called creating a "closed loop."

* * *

Many medical errors are a result of miscommunication. 

I'd say maybe my problems wouldn't have happened if I had followed this advice and asked the doctor to repeat back to me what he thought he heard but, in fact, the handwritten notes taken during the appointment are accurate, indicating that he heard exactly what I said about my prior diagnosis.  It's the typed notes that introduce the false/erroneous statements -- the doctor didn't like what he heard so he did some creative writing in order to support the conclusion he wanted to reach, and hoped that noone would ever go back to the original handwritten notes to see where he twisted my words.

Similarly, the doctor who prescribed something I already knew didn't help is contradicted by his own report, which says on page 1, that I had already tried that and it didn't help.  It wasn't miscommunication, it was definitely an error in the doctor's thought process.  Although he wrote down what I said at the beginning of the appointment about things that I'd already tried, he wasn't actively listening so it didn't sink in that what he usually prescribes to patients with my symptoms had already been tried without success.

Read Dr. Groopman's "How Doctors Think" -- an indictment by a doctor of the medical culture, which should be required reading in every medical school in order for the students to be aware of how medical errors come about, and how to prevent them.

Unfortunately, doctors are human and humans make errors.  Equally unfortunately, some of those errors occur despite the patient giving the doctor all the necessary information to get it right, because the doctor has already leapt to a conclusion and isn't really paying attention to anything the patient says.

As Dr. Seiden says, you have to nag until you're sure that the doctor has in fact correctly heard what you said.  If the doctor doesn't know how to differentiate CFS from depression and treats you for the wrong one, he's not the one who's going to pay the price with a lifetime of pain and disability.  It's YOUR life and health that's on the line; if he makes a mistake, it doesn't affect him at all.   You can inconvenience him for a few hours with a deposition in a malpractice lawsuit, but his malpractice insurance will pay the judgment, not him.  Since you're the one who will suffer, you must take responsibility for doing everything possible to ensure that the doctor has given you the correct diagnosis and the correct medication for that condition.      

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