Archive for Patient Safety

Medical Error Insurance?

My world as a patient advocacy consultant* exists in two camps, both of which influence each other constantly.

Camp #1 is the world of medical errors and misdiagnosis. That’s the world where my career began — although not by choice, certainly. It’s the world the Institute of Medicine referred to when it reported that infamous statistic that between 44,000 and 98,000 Americans die each year from a medical error or misdiagnosis. It’s the world of shattered lives, deaths of babies and children, loss of loved ones and lifelong debilitations.

The other world is of my own making — a reaction and result of landing in the misdiagnosis camp. On a daily basis, as I am reminded through reading or being contacted by someone who has been affected by camp #1, I quickly run to Camp #2 — my advocacy, assistance, advice, writing, broadcasting — the work I can do to help anyone else stay out of Camp #1.

Because I’ve always been a positive person, I try not to spend too much time in Camp #1. Each day I try to think of ways to keep everyone else out of it, too. One aspect I wrestle with is the fact that, no matter how hard I try, I just can’t help everyone — nor does everyone recognize their need for help.

In effect, what I’m doing is providing patient safety insurance. Which takes me to today’s point.

We buy car insurance so we’re covered if something happens to our car. We buy homeowners insurance to take care of us if our homes burn down, or get damaged in some, insured way. Same with every other kind of insurance. We’re guessing that eventually something terrible will happen to ourselves or our belongings, and if it does, we want someone else to have to pay for it — so we fork over big bucks for that guarantee.

So it occurs to me — what if insurance companies sold medical error insurance? Policy owners would know that if a misdiagnosis or medical error happened, all the expenses would be covered. In my case, the $7,000 out of my pocket for the fact that nothing was really wrong with me, would have been paid for.

After all — the insurance companies are the only ones who profit in our current, horribly dysfunctional system, right? They are the only ones that come out on the positive end. So maybe through sales of medical error insurance they could affect positive outcomes for patients and doctors, too?

And here’s an even better idea…. medical error insurance would be sold as an INVESTMENT — and then — only to medical professionals!! That means — the way those medical professionals would make money would be if they didn’t have to pay OUT for errors that were made!! Think of it — the investing doctors would make money because they didn’t make mistakes!! What an incentive!

I think I’m on to something here. Have to think it through some more — because the idea, in its infancy, is both sick and profitable. Which, of course, is exactly what we’ve already got.

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*Patient Advocacy Consultant — for lack of a better term to describe what I do — anyone have a better idea?

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Posted in: Doctor Communication, Health /Medical Consumerism, Health Insurance, Healthcare Quality, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Empowerment, Patient Safety, Patient Tools

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When is a doctor too old?

I’m visiting my parents for a week. They live in a retirement /transitional living center in Florida where my mother resides in the memory center (she is an Alzheimer’s patient) and my dad lives in the same building in a beautiful apartment. It allows them to spend time together each day, and it’s remarkable how well my mother is doing with my dad’s constant, quality attention…. (can you tell how wonderful I think their situation is?)….

Last night we enjoyed dinner with some friends and one part of the conversation floored me, although it should not have taken me by surprise at all. The conversation took place with Dr. W, a former surgeon who retired as Chief of Surgery from a large hospital in the mid-west. What I so very much appreciated about Dr. W is that he gets it — he gets the problems that can be posed by egos — and in this case we were discussing surgeons.

I’ll share his thoughts with you because they are truly a heads up for anyone who needs any type of surgery. And if we really want to be sharp patients, we can extrapolate them to any doctor we might turn to.

Dr. W told me that toward the end of his career, he was tapped to become the Chief of Surgery. He told them he would accept the appointment — but only if they agreed to his stipulation that he would no longer perform any surgery. He had decided that he had reached an age where he could no longer be sure patients were safe in his hands.

He explained to me that for him to decide to no longer perform surgery — on his own — was unusual. He then recounted a handful of stories about how various surgeons had been ousted from their positions, always confrontational, always problematic, always because there had been concerns about their work. That was his polite way of saying patients were in jeopardy, of course.

The lesson for us? There comes a point in any doctor’s career when that doctor can no longer do his or her job IN THE BEST INTEREST OF THE PATIENT. And that’s the important part — the best interest of the patient.

In the case of a physician, it could be any number of things, ranging from loss of physical ability to do the job (e.g. shaking hands, poor eyesight) to not knowing the most up-to-date procedures (e.g. open surgery vs. minimally invasive), to problems such as shaky handwriting that could get misinterpreted, including prescriptions or test orders or others.

Does that mean we should avoid “old” doctors? Not at all! In fact, my personal belief is that tapping in to the experience of an older doctor can be invaluable. Even an older surgeon would know what needs to be done to help — and that doesn’t mean that s/he needs to be the one to perform the surgery.

One approach to finding your best options might be this: through your information gathering, get one opinion from an older, more experienced doctor, and one opinion from a younger doctor who is more likely to know the most up-to-date information about what ails you. Weigh the opinions, consult a third doctor if necessary, and make your own decisions from there. Need surgery? Use the information provided by the older doctor to partner with the younger surgeon.

Don’t ask me what “too old” is! No way will I put a number on that. You’ll need to be the judge yourself. Just know that there is a recognition, even among their peers, that doctors do “age out” of their profession.

Don’t be the patient who suffers because a doctor doesn’t take him/herself out of the profession before mistakes are made on you.

And thanks, Dr. W, for the heads up. You’ve done us all a favor.

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Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Hospitals, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Empowerment, Patient Safety, Patient Tools

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More on MRSA – It just doesn’t stop

I heard this weekend from a woman who read my columns about MRSA. She shared her experience — how she contracted MRSA seven years ago, and a recent experience with surgery. She was frustrated because, for the most recent surgery, she was put on a floor in the hospital that was just for MRSA patients — yet, she felt like they basically ignored MRSA as a potential problem. As an example, she said that she was in the hospital for 24 hours, and in that time, only one person washed her hands, or used the santizing gel when she came into the patient’s room.

As a reminder — MRSA is the superbug — the staph infection, usually acquired in hospitals, that has learned to overcome any antibiotic developed to kill it. It will continue to infect because it can’t be killed. And too often — like 90,000 times in America each year — it’s deadly.

Now — what seems strange about this to me, is this… it was a MRSA floor, meaning, every patient had MRSA. And we already know that MRSA can be spread from any little thing — hands, certainly, or a stethoscope or a TV remote, or the sheets on a bed. Not only can a patient GET MRSA, a patient can TRANSMIT MRSA. So how could any health care worker, in particular, NOT wash his/her hands or use gel — constantly??

Clearly — and I can’t say this strongly enough — we patients have to learn to ask and tell — and insist. If you are in a hospital — regardless of WHY you are there — DO NOT LET ANYONE TOUCH YOU UNLESS THEY HAVE WASHED AND SANITIZED EVERYTHING (hands, objects) FIRST. Period. Then — insist they do so before they leave, too!

If you already have MRSA — you can transmit it, too. People and things can carry MRSA but not even know it — otherwise healthy people, whether they are in the hospital or not, can carry MRSA and have no idea they are doing so. So, to the best of your ability, if you could possibly have MRSA — INSIST OTHERS WASH OR GEL RIGHT AFTER THEY HAVE TOUCHED YOU or anything around you. That’s they only way to make sure someone else doesn’t get it from you.

Scary stuff. I’d hate to think I transmitted a bug that later killed someone, just because I wasn’t watchful and insistent.

Posted in: Health /Medical Consumerism, Healthcare Quality, Hospitals, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Empowerment, Patient Safety

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More on MRSA – It just doesn’t stop

I heard this weekend from a woman who read my columns about MRSA. She shared her experience — how she contracted MRSA seven years ago, and a recent experience with surgery. She was frustrated because, for the most recent surgery, she was put on a floor in the hospital that was just for MRSA patients — yet, she felt like they basically ignored MRSA as a potential problem. As an example, she said that she was in the hospital for 24 hours, and in that time, only one person washed her hands, or used the santizing gel when she came into the patient’s room.

As a reminder — MRSA is the superbug — the staph infection, usually acquired in hospitals, that has learned to overcome any antibiotic developed to kill it. It will continue to infect because it can’t be killed. And too often — like 90,000 times in America each year — it’s deadly.

Now — what seems strange about this to me, is this… it was a MRSA floor, meaning, every patient had MRSA. And we already know that MRSA can be spread from any little thing — hands, certainly, or a stethoscope or a TV remote, or the sheets on a bed. Not only can a patient GET MRSA, a patient can TRANSMIT MRSA. So how could any health care worker, in particular, NOT wash his/her hands or use gel — constantly??

Clearly — and I can’t say this strongly enough — we patients have to learn to ask and tell — and insist. If you are in a hospital — regardless of WHY you are there — DO NOT LET ANYONE TOUCH YOU UNLESS THEY HAVE WASHED AND SANITIZED EVERYTHING (hands, objects) FIRST. Period. Then — insist they do so before they leave, too!

If you already have MRSA — you can transmit it, too. People and things can carry MRSA but not even know it — otherwise healthy people, whether they are in the hospital or not, can carry MRSA and have no idea they are doing so. So, to the best of your ability, if you could possibly have MRSA — INSIST OTHERS WASH OR GEL RIGHT AFTER THEY HAVE TOUCHED YOU or anything around you. That’s they only way to make sure someone else doesn’t get it from you.

Scary stuff. I’d hate to think I transmitted a bug that later killed someone, just because I wasn’t watchful and insistent.

Posted in: Health /Medical Consumerism, Healthcare Quality, Hospitals, Patient Advocacy, Patient Empowerment, Patient Safety

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When Being a Tattle Tale is All for the Good

Yesterday I saw the surgeon who was part of my misdiagnosis story for the first time in 2-1/2 years. He was one of the good guys in the story. He did what he was supposed to do, and did it to his best ability.

But I realized as we were chatting, that he was also responsible for referring me to the bad guys — the doctors who screwed up — the doctors who created the mess of my misdiagnosis. They are the two doctors in the hematology-oncology practice who insisted I begin chemo, despite the fact that all evidence pointed to flawed biopsy results.

So I told him. I shared that part of the story with him. And I made him realize that sending me to those oncologists had almost killed me. At the very least, had I not trusted my intuition and advocated for myself, I would have suffered through chemo because they weren’t willing to listen to me, nor were they willing to look behind the flawed test results.

I made the surgeon understand that his colleagues’ bad medicine was a reflection on him, and if I were him I would think twice before referring patients to them again.

The surgeon was more than a little shocked. He told me he hated to hear that about his collegues, and he left it, very professionally, at that. But I can guarantee you he’s going to think twice before he refers a patient to them again. And that’s exactly how it should be.

This experience is going to find its way into my next column, for sure. It’s an extension of the idea of voting with your feet. When we experience bad medicine, it’s up to us to make sure the doctor knows how we feel — and — we need to let the doctors who make the referrals know about it, too.

Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Empowerment, Patient Safety

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