The American healthcare system is regarded as the most sophisticated in the world yet medical errors have been estimated to cause 44,000-98,000 deaths in US hospitals each year. Patient safety and prevention of mistakes have become a top priority and many aggressive measures have been implemented. This can run the gamut from hand washing to marking the site of planned surgery prior to an operation. Both the complexity of healthcare delivery as well as communication issues can play a role in the continuation of this problem.
Outside the hospital, errors can occur in clinics, labs, doctors' offices, nursing homes, pharmacies and can involve medicines, surgery, diagnosis, equipment or lab reports. Communication between doctors and their patients is too often rushed or taken for granted. I think it is crucial that every patient understands everything about their diagnosis, tests that need to be done, intended treatment and medications. This takes time and requires plain language that the patient can easily understand and be able repeat when they get home.
Make sure that each of your doctors knows everything you're taking including prescriptions as well as over-the-counter medicines and any dietary supplements. It's a good idea to bring everything to your doctor once a year in a bag to review the ongoing need of each pill and any side effects. Make sure all allergies or unusual reactions to previous medicines are on record. The doctor's handwriting on any prescription should be clear and legible. It is important to understand what each medication is for and what side effects might commonly occur. This includes awareness of conflict between medications; this issue is easily resolved by the use of electronic prescribing systems. A pharmacy study showed that 88% of medicine errors involved either the wrong drug or the wrong dose and it makes sense to ask the pharmacist if your medicine is what the doctor ordered. Make sure you get written information about what side effects to expect.
If you need to be admitted to the hospital, you can ask your physician which one is best for your particular condition. Don't be embarrassed to ask healthcare workers that have direct contact with you about washing their hands. When surgery is necessary make sure that you, your doctor and your surgeon are clear about what exactly will be done and that you understand possible complications beforehand. At the time of discharge make sure you fully understand your diagnosis and treatment and what you should and should not do when you return home. Don't be shy about questioning anyone who is involved with your care and make sure that all health professionals treating you have your complete health information available. It could be helpful to have a trusted friend or family member be there with you and ask important questions. Don't be hesitant to ask why a particular test, treatment or medication is needed and what your alternatives are. A good website to learn more about your diagnosis is the National Guidelines Clearinghouse at www.guideline.gov
If you are given a prescription, ask what is the purpose of the medication and is there a generic option available at lower cost. Ask about side effects, length of treatment and if the medicine can be stopped abruptly or should be tapered. If a medical test is planned ask how it is done and what are the benefits and possible risks of having the test and when the result will be available. If your physician does not take the time to explain your conditions ask for written information directly or where you can go to learn more.
More and more nurse practitioners and physician assistants are providing care. It is your prerogative to ask to see a physician at any visit and it is also valuable to ask to see the same clinician for continuity of care rather than a different provider at each visit. You should not feel rushed through your visit and preparing a written list of questions beforehand can be valuable. Also, I think it's very acceptable when questions arise about treatment choices to consider asking for a second opinion. Ask questions and make sure you understand the answers. Choose a doctor you feel comfortable talking to and who is a good listener.
By being your own strong advocate interacting with the health care system and asking the right questions you will get better care and lower the chance of medical errors. Considering what health care costs today, make sure you get your money's worth.
Dr. Josh Schwartzberg practices in Lake Placid, Willsboro and Burlington. He can be reached at www.docjosh.com or 518-963-4355