I am sure this is startling news to all of you patients who have never considered hospitals or other health care facilities as dangerous places. However, expanding and preventable medical errors have been studied for years. The medical profession just doesn’t talk about malpractice very much. For example, in 1999, the Institute of Medicine reported that there was an epidemic of preventable medical errors in hospitals resulting in as many as 98,000 deaths to hospital patients per year. An earlier study by Harvard had concluded medical injuries caused by negligence had become a crisis, and the vast majority of people who are injured by substandard care do not make a claim or file a lawsuit.
As a litigation attorney, I have spent many hours over the last 30 years talking with clients about their failed medical treatments. Some tell very sad stories about life-changing injuries or death caused by medical carelessness. As I have listened to their complaints against the health care system, I have become acquainted with the various causes of many preventable harms and, in some select cases, have sued to recover justified damages. I have also learned about patient safety simply by getting older and going to more and more doctors and subjecting myself to more tests and medical procedures. In case you do not know it, we older folks spend a lot of time in doctors’ offices and hospitals. As a lawyer and a patient, I have learned a great deal about how to protect yourself from medical malpractice injury and keep yourself and your family safe when you enter medical danger zones like hospitals, clinics, and doctors’ offices.
First, I must say that Knoxville is blessed with many great doctors and some highly rated hospitals. The standards of care in the Knoxville metropolitan area are very high and, consequently, as patients, we have every right to expect the very best from our health care providers. The trick to survival is learning how to select the best doctors and create your own network of skilled and conscientious providers. Too many patients surrender themselves to their doctors’ care and just give up on close supervision of their medical problems and treatments. Like taking your car to the shop, too often we just turn it over to the one who is supposed to know what to do and we ask no questions nor attend to details. The biggest mistake we make as patients is lack of vigilance.
Find a Primary Care Physician
Search for and stick with a good and caring primary care physician. Pick a family practitioner or a doctor of internal medicine who could not only be your doctor, but your friend. Your PCP should be the hub in your medical network. If you are healthy, great; the PCP is maybe all you will need. But if you need treatment from a specialist, the PCP can connect you to the right person. Prudent referrals may be the key to the quality and safety of your care, and you cannot obtain a pass to move freely about the health care world without referrals from your PCP. You should shop around and pick the best PCP to serve as the centerpiece of your network. Look for a doctor with a good education, good solid training, experience, a caring attitude, and a willingness to take time to get to know you and understand all that is going on with you. I would give you the name of my PCP, but I don’t want you messing up my relationship. It has taken years to build my own network.
Remember, your PCP has many patients and you must make sure that you are remembered from appointment to appointment. I would recommend that you keep a medical diary on each visit and know what is expected of you and what will occur next in your treatment. Your PCP may forget to report your blood test or other testing result, but you won’t forget. I once saw a circumstance where a family doctor sent his patient for a cardiac treadmill test, but failed to give the patient the bad results. The patient died of a heart attack waiting on the results that were found after the funeral unread in the doctor’s file.
Become a Doctor’s Helper
A wise person once told me that a doctor was not smarter than me, he had just read different books. We can all educate ourselves about our medical problems and use that knowledge to improve our treatment. Medicine, like law, has become more specialized. The other day I asked a neck doctor about my pulse and he was reluctant to answer. While your primary care physician is a generalist, you will probably require the attention of a specialist or two or three. When you need a specialist, do your homework. Participate in the selection of the specialist and don’t just accept your PCP’s best friend. Search listings of top doctors and ask around to learn about the experience of others. Of course, ask your PCP for a recommendation.
A quick internet search of your diagnosis or problem may help lead you to the right specialist. With a little research, you can better understand what your specialist is talking about and you have an understanding about the questions you need to ask. Educate yourself for each appointment, but remember that sometimes doctors are uncomfortable with smart, informed patients, and that could be grounds to look for another specialist.
Communication
All the experts agree that the most common cause of medical mistakes is failure to communicate. Doctors’ offices and hospitals have many systems and most depend on good communication, but the only communication you can control is your communication with your doctor. Focus on your conversation with your doctor and your doctor’s staff to make sure other health care providers are acting consistent with your doctor’s wishes. For example, understand what tests you may be sent to have performed, and know why the test is being done, who will do it, how will it be performed, and when and how you will get the results. The person doing the test is just taking orders, and those orders may be wrong or misunderstood. To improve communication, I recommend you keep a typed list of current medications with dosages and present it at each appointment. Make sure you and your doctor are on the same page regarding all of your medications. I recall a case where the doctor failed to include the dosage on his prescription and the pharmacist filled the prescription for an adult dosage which proved dangerous when the patient was a child and the drug was a diuretic. This was a serious communication error between the pharmacy and the doctor that resulted in kidney damage.
General Tips
The following quick tips may help make you a better and safer patient:
1. Work hard at being a good historian. Make sure your doctor understands the facts associated with your symptoms because the correct diagnosis requires a reliable history.
2. Try to enjoy the long wait time in your doctor’s office by focusing on your care and not reading magazines. Check your research and review your factual history and list of questions for the doctor.
3. Use your physician’s patient portal to keep check of your care, the recorded entries of your doctor, and errors that need correcting.
4. Most medication errors involve being given the wrong medication by the pharmacy or being overdosed by a hospital nurse. Double check your medications before you take them and know the names of your medications and what they look like.
5. Try to avoid surgery. Sometimes patients are too quick to demand surgery and some surgeons can be too quick to agree to surgery. When surgery becomes necessary, do your research and know all of the risks to discuss with your doctor. Don’t just wait until the day of surgery and sign a surgery consent form immediately before the procedure.
6. Hospital falls are a major concern. Make sure all precautions are taken for you by trained personnel. Repositioning in bed and transfers in and out of bed can be dangerous and require specially trained assistance.
7. Don’t be ignored when you call for help in the hospital, but be pleasant and reasonable.
8. Question every major diagnosis until satisfied it is correct. It is not disrespectful to make sure you are not living with or dying from a misdiagnosis.
9. Nurses are required to be advocates for the patient. They are duty bound to be on your side versus doctors and other hospital employees.
10. Be your own best medical advocate. Ask questions about anything you don’t understand.
Be careful and get well.
Bob Pryor is one of the area’s foremost authorities on Medical Malpractice. When not actively defending his clients he is probably questioning his own doctor. If you have a Malpractice question contact his office at knoxvillelaw.com
A wise person once told me that a doctor was not smarter than me, he had just read different books.
I like your comment that a friend told you “a doctor is not smarter than me, he has just read different books”-I have always been of this mindset, and I always view myself as my doctor’s best helper.