Protecting Yourself from Medical Errors
By Pamela D. Wilson, CSA, MS, BS/BA, CG
“About 15 to 20 percent of all diagnoses are missed or flat-out incorrect,” according to Lori Parch in an article titled Danger at Your Doctor’s Office. (1) Today, more than ever, it is important to understand the details, manage and advocate for medical care. This is especially relevant for older adults who see doctors as individuals to be revered versus questioned when they don’t understand a medical treatment or why a medication is being prescribed. A recent client of mine had a doctor increase the frequency of chemotherapy treatments and when I asked why; my client could not give me an answer because he didn’t question the doctor.
The more accurately we communicate our needs and ask questions, the better our doctors and those providing healthcare assistance will be able to respond and to support. The average doctor visit today averages fifteen minutes which corresponds with the time usually allotted by the insurance company. This time constraint has caused the system to speed up and for diagnoses to be made more quickly with the possibility of greater error. Additionally, patients who are part of a group medical practice may never see the same doctor on each visit. Many times patients are no longer seeing the doctor but a physician assistant or nurse practitioner. This allows medical offices to better manage payments from insurers by allowing care from different levels of practitioners.
Due to advances in medicine, there are more treatment options which have complicated the system. The most common medical errors relate to incorrect reading of test results, inadequate follow up care and missed or delayed cancer diagnosis. Many errors stem from miscommunication. In a 2004 study of 75 errors reported anonymously by family physicians, 47 errors were triggered by miscommunication. Many doctors tell patients they will call if there is an issue with test results, the better action as a patient is to request copies of all of your test results regardless of whether the doctor calls you or not. (1) Many mistakes happen when tests are completed, results are lost at the lab or lab tests for patients are mixed up with results for other patients. I personally have had to have lab tests re-done because the lab either lost my original samples or the samples became mixed up with another patient due to incorrect labeling.
Prescription samples are another area of concern. While it’s nice to receive free samples, one in five of us have had our doctor prescribe a medication that resulted in an allergic reaction. This happened to me personally several years ago when I had a case of bronchitis. I have a sulfa allergy. The physician assistant not asking about my allergies, prescribed a medication, Bactrim, which even my pharmacist even missed. After looking the medication up in the Physician’s Desk Reference I noted that the medication should not be taken by anyone with an allergic reaction to sulfa. At the time I was going to a medical practice where I rarely saw the same person each time I visited which likely resulted in this common error.
Safety has become more of a concern in hospitals, however there are few guidelines for doctors in private practice to educate themselves about medical errors and put in place technology that can safeguard patients. According to Jerome Groopman, MD and Professor of Medicine at Harvard Medical School, author of How Doctors Think, in about half of cases where a diagnosis is never made or delayed significantly, the result is real harm to the patient. The time for patients to become more educated and demanding has arrived, especially for older adults who may benefit from family or professional advocates to assist with medical care and oversight.
There are many areas outside the medical system that support patients, however the main role of a doctor is to treat medical issues, not necessarily deal with the social aspects of medical care in spite of the fact this is a significant need for most patients. This is when a doctor’s recommendation to a professional advocate is able to save money and time in navigating a system that usually begins with medical care and diagnoses and extends to issues that affect the entire life of a patient.
Many older adults find it useful to have family members, if available, attend medical appointments. For older adults without family, a professional advocate can help navigate appointments, medical treatments, information and insurance to ensure that the older adult understands the information provided. Additionally some advocates are well versed in many other aspects of the system that can be helpful to patients and their families. The role of a professional advocate is to assist their client with all aspects of the medical and social system to maximize education and choices and to minimize frustration.
(1) Parch, Lorie A. Danger at Your Doctor’s Office. Health, 9/2008, p 129-133.
(2) Groopman, Jerome. How Doctor’s Think, www.jeromegroopman.com
©Copyright 2012, 2013 Pamela D. Wilson, All Rights Reserved.