When a Windsor, Ont., surgeon misread the pathology report and removed 44-year-old Laurie Johnston’s left breast and six lymph nodes—despite the fact that she didn’t actually have cancer—it made news-paper headlines across the country. Johnston’s was a particularly horrific case of hospital error, but misdiagnoses, equipment malfunction and mistakes during testing, surgery and treatment are by no means unusual in our country’s hospitals.
Alarmingly, preventable medical errors (or “adverse events” in medi-speak—whether ER mistakes, equipment failure, prescription errors or misread medical tests) contribute to 440,00 deaths a year in America, according to the most recent comprehensive study, according to research published in the Journal of Patient Safety in 2013.
“I don’t know any healthcare provider who deliberately goes in to work with the thought that they’re going to harm somebody,” says Hugh MacLeod, CEO of the Edmonton-based Canadian Patient Safety Institute (CPSI). “But when you combine the pace and complexity of health care today with the kinds of potentially risky interventions we do, errors happen.”
The good news: You can take a proactive role to get the hospital care you need and minimize your risk. Here’s how:
1. Keep asking questions
If there’s one thing Jayne Chong of Brampton, Ont., has learned, it’s this: “You have to be a pain in the butt.” A series of misdiagnoses resulted in her needing a heart and kidney transplant at age 26. A correct diagnosis earlier might have saved her from this major surgery. “Just keep saying, ‘There’s something wrong,’” she advises. If the ER doc can’t come up with a diagnosis, ask to see another doctor. Michael Decter, a Harvard-trained economist who has written about navigating the heath care system, agrees. And if doctors seem uncertain of what ails you, he adds, ask questions like: What else could this illness be? What other tests can you do? What symptoms should I worry about?
2. Bring an advocate
“You need someone to ask the important questions,” says Decter, “to represent your interests and make sure the continuity of care is there.” The more serious the problem, the more crucial it is to have representation, points out Kate Pocock of Toronto, who advocated for her sister Mary when she was going through cancer treatments (sadly, Mary died in 2004). Pocock advises bringing a tape recorder or notebook so you can review it later when you’re considering your next step.
3. Keep your medical history handy
“Most people have a file folder at home with their insurance policies and financial records,” says Decter. “But we don’t take the same care with our medical history and records.” To lessen your risk of dangerous drug interactions and to avoid unnecessary tests, he suggests keeping a file folder about medical treatments and care you’ve received, as well as a list of any allergies, a printout of your prescriptions and insurance medicals, if any, and test results. That way, if you need emergency medical care and you’re not thinking clearly, you’ve got all the details in black and white.
4. Get a second opinion
Anne Doig, MD, past president of the Canadian Medical Association, suggests that patients should be “unafraid” to ask for a second opinion. If you’re uncomfortable asking a specialist for a referral for another opinion, ask your family doctor for another specialist.
5. Recognize that “practice makes perfect”
Research that compares volume of surgeries to outcomes has made it clear that this old adage is true. If you’re facing surgery, advises Decter, “ask your referring physician good, practical questions, like ‘Is this procedure something that is done frequently at this hospital? Which doctor/hospital is doing the highest volume of these procedures?’”
6. Wash your hands—and make sure everyone else does, too
One comprehensive study found there were an estimated 722,000 healthcare-associated infections in the United States in 2011; according to CDC data. More than half occurred outside of the intensive care unit. Make sure that the patient, visitors and care providers all wash their hands.
7. Something not right? Tell everyone
When Jayne Chong was in hospital after her kidney transplant, her catheter became blocked. She told everyone, even the cleaning staff, that she felt pressure in the area of the catheter. It took two days, she says, but “finally I found this doctor who listened. I’d never seen him before and I never saw him after that, but he got it fixed.”
When MacLeod talks to people who have lost a loved one because of a medical error, many have one thing in common, he says. “They tell me they knew intuitively that something was wrong. But they didn’t speak up. And they’re going to carry that for the rest of their lives. That haunts me.”
November/December 2010 issue of Best Health magazine