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Archive for March, 2007

Malpractice Goes Online

Michael Skolnik, age 22, was playing the with family dog when he blacked out. A series of errors ensued, including neurosurgery by an inexperienced doctor who already had a malpractice claim against him in another state. After two years of hell, during which he couldn’t walk or talk, Michael died.

Do you realize that it’s very possible that the doctor who treats you or your loved one, has malpractice suits filed against him or her? Do you realize that doctor may have already been found guilty of that malpractice? Do you realize that thousands of doctors across the country have disciplinary marks on their licenses? Do you realize that, depending on what state you live in, you may have no way of finding that out?

Here’s where you can get information about malpractice and disciplinary action against doctors: California, Connecticut, Florida, Idaho, Indiana, Massachusetts, Maryland, North Dakota, New Jersey, New York, Oregon, Tennessee, Virginia, Vermont and West Virginia.

These states make this information public — and thanks to Patty Skolnik, Michael’s mother and a very active advocate for helping to make sure others don’t suffer at the hands of irresponsible or negligent doctors, Colorado will begin making this information public, too. Botched surgery, medical errors, drug or mental problems — if there has been a formal charge or conviction, it will appear online.

Where can you get this information? The medical boards in most states publish the information on their websites. For a master list of these states, link here: http://www.fsmb.org/directory_smb.html

That’s only a start, though, and may not provide all the information you need. For example, you may look for information about a specific doctor in your state, but that doctor may have been brought under a disciplinary action in another state. Also, according to HealthGrades.com, of the 35,000 doctors who have had two or more malpractice payouts since 1990, only 7.6 percent have been disciplined, meaning, the black marks on the other 92.4 percent won’t show up on their state board record.

Of note, according to HealthGrades, the most frequent malpractice incidents take place in: Bariatric Surgery, Maternal Fetal Medicine, Neurosurgery, Obstetrics and Gynecology, and Cardiothoracic Surgery.

There are a number of websites that provide bits and pieces of information about specific doctors and facilities. You can find a master list here: www.DiagKNOWsis.org/resources/quality.htm

If you prefer to find most of the information about doctors, hospitals and nursing homes you need in one place, it can be found at HealthGrades.com. You will pay for the report, but you’ll find everything in one place without having to chase it down from a variety of sources. Included are ratings and sample experiences from patients.

For those of you who live in Colorado, send your thanks, tip your hat, and say a prayer for Patty Skolnik. She continues to fight for laws and disclosures for you. She has channeled her pain to help others. You can learn much more at her website, too, at: http://www.coloradocitizensforaccountability.org/

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Here’s a footnote: After my misdiagnosis debacle, I inquired about filing a medical malpractice lawsuit. In my opinion, the oncologist who was so insistent I get chemotherapy despite tests that indicated to the contrary, had caused me enough pain to make it worth the inquiry. I wasn’t interested in money. I was interested in making the point.

I learned that in New York State, where I live, you cannot file a malpractice suit unless you can prove physical harm. In my case, since I had refused treatment until I had clearer answers, I did not suffer physical harm, so, no possibility of a lawsuit.

How ironic. Had I actually started chemo, even though I didn’t need it, a suit would have been possible. That said, I instead channeled my frustration into my role as Every Patient’s Advocate. (And you know, I’ve said it before – Everything happens for a reason!)

Emergency Room Nightmares: Tell Your Tale

I was contacted by a news reporter who is doing a story to help patients advocate for themselves in emergency room situations.

She is looking for people who live in Pennsylvania, Eastern Ohio or Western NY to interview.

Can you help? Of so, please contact me by email and I will forward your contact information to her.

Do you have good ideas for how to handle emergency room experiences? Why not add a comment to this blog so others can read your good ideas, too!

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Stents, Angioplasty and the Almighty Dollar

The COURAGE study has caused a flutter. A perfect example of my continual assertion: American Healthcare is not about health or care: it’s about sickness and money.

Yesterday, for my radio show, I interviewed Dr. Robert Carhart, a cardiologist from University Hospital in Syracuse, NY. During the show we like to go behind the medical headlines to make sure we really understand them.

Dr. Carhart actually participated as one of the clinical investigators in the COURAGE study, and he was able to clarify many questions about the results, which showed that in non-emergency situations, drugs and medicine are just as effective as stenting for people with heart problems.

Don’t forget — I’m not a medical professional. I see things as they should be seen through a patients eyes. Well, let me tell you, my eyes were opened!

Stents came on the scene a number of years ago. They are little metal mesh sleeves that get inserted into an artery when a blockage occurs. A blockage will cause a heart attack. When someone is having the signs of heart problems, including heart attacks, a procedure called angioplasty is performed (a balloon that is inflated to clean out the artery), then a stent is installed where the blockage was to keep the artery cleaned out. Sounds like a miracle, right?

The COURAGE study weighed the use of stents against traditional medicines/drugs and found that the use of stents is no better than the use of medicine for non-emergency situations. In fact, because of the danger of problems with the stenting, which is surgical and invasive, the medicine may be a better choice.

Ohhh! But cardiologists who perform stenting procedures (called interventional cardiologists) make plenty of money when they perform an angioplasty and insert stents! They don’t make money from the drugs that can be prescribed instead. They are NOT happy with this study!

(And by the way — neither are the companies that manufacture the stents, all of which saw their stock prices drop big time this week.)

Another problem, according to Dr. Carhart, is that patients who have just had a heart attack get a stent put in as part of the blockage repair, and then, the interventional cardiologist will tell them, “Gee Mr. Patient, we noticed you have two more blockages. As long as you’re here, why don’t we stent them, too?” The patient says, “Sure, you might as well,” then goes on his merry way thinking he’s been protected — and he may not be.

And the interventional cardiologist just tripled his income from the procedure — to no real benefit to the patient. Such a deal (for the doctor, of course)!

While the stenting for the blockage that caused the heart attack may definitely be a life saver, additional stents may not help much. In fact, according to Dr. Carhart, too many patients think the additional stents will absolve them of any responsibility for compliance with other important aspects of heart health such as diet, exercise and drugs. Those patients think the additional stents will protect them — and they don’t.

Here’s the bottom line: if you are NOT in an emergency situation (no impending or immediate heart attack) and you are offered stenting, talk to a cardiologist who understands the COURAGE study and then research the benefits of medicine vs stenting for yourself. To the best of your ability, make sure the doctor who advises you is giving you a balanced recommendation — meaning — he isn’t profiting from whatever he is recommending to you.

If you are in an emergency situation — by all means — if the stenting is recommended, it may be a real life saver to you, so consider it seriously. BUT — additional stents? They won’t necessarily be the right choice for you. If you are someone who knows you are at risk for a heart attack, you may want to consult with your cardiologist sooner, rather than later, about the right choices for you.

Yup — it’s that “think like a consumer” thing again. Your health and pocketbook will both benefit.

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The Edwards’ Decision: Their Business

A disclaimer here: my opinions have nothing to do with politics. Those who know me know I am NOT a political being. My opinions are about people and their healthcare decision-making.
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At least a dozen people have asked me what I think of Elizabeth and John Edwards decision to keep campaigning despite the recurrence of her breast cancer.

My answer is: it’s not up to me to pass judgement! It’s THEIR decision, and I hope only that it’s based on good partnering with her doctors, good advice, and plenty of research into the possibilities.

Watching the Edwards on TV, and reading about them in the press, have raised some of my own emotions from my cancer near-miss. Occasionally I still have some post-traumatic stress reaction — a melt down at a movie, or while reading a book, or hearing someone else’s story. Anyone who has been diagnosed with a death sentence (or who has loved someone with that diagnosis) knows how devastating it can be. I can’t begin to imagine how it feels to have licked it the first time, and then have to go through that again.

The most important impact such upsetting news has, I think, is that you find yourself realigning your own priorities. The reality check of a death sentence helps you better understand what’s really important to you. It’s no longer about things like, “before I die, I want to learn to scuba dive, and see the pyramids.” It’s more like, “I have only limited time, and this is what I want to do with it.”

I instantly found myself with two priorities: family and loved ones first, then work.

For those few months before I learned I had been misdiagnosed, I spent so much time with my loved ones! I was single and not dating anyone at the time. I was lucky in that both my daughters and my parents were living nearby, and we got together several times each week. They were so loving and supportive and that was so important to all of us, to be able to spend that time together. And when I got the final confirmation of my misdiagnosis — we were all together to celebrate, too.

Close behind spending time with my loved ones, and like Elizabeth Edwards, I threw myself into my work and my diagnosis-related research. I was manic in my work at the computer, following through with my instincts that something in my diagnosis was horribly wrong, terribly askew. And I kept up with my workload. I didn’t tell clients about my diagnosis, because I was self-employed and couldn’t afford to lose business. That frenzied approach did two things: first, it allowed me to scour all the information out there to prove my misdiagnosis. Second, I earned more money for my business in 2004 than any prior year! All that work was simply a coping mechanism, albeit a fruitful one.

For right now the Edwards seem to have chosen to put work first and family second. Because Elizabeth’s cancer can be contained and controlled for now, it makes sense to them to do so. It’s not up to any of us to second guess their decision because it’s precisely that: THEIR decision.

My guess is, as time goes on and the cancer spreads, which it will eventually, that their priorities will begin to shift more to family first. They seem to be loving and caring and dedicated people. I can’t imagine it will be any other way.

We need to support them — and I’m not referring to politics here — I mean in the caring way we would for fellow human beings who have a tough road in front of them.

We need to give them credit — because they’ve taken their decision-making and responsibilities seriously, as all sharp patients should.

And we need to thank God that we aren’t in a position to have to make the same kinds of decisions. There but for the grace of God….

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