Mistakes- the doctor’s perspective

Many readers know I’m merciless, brutal even, regarding issues of competence and the relationship between diligent care and outcomes. Mistakes can happen. Good physicians remember the names of every patient who suffered an adverse event while in their care. It’s a sign of conscience.

One such example is Dr. Gary Brandeland. His patient’s death wasn’t his fault. Yet it sent him into a tailspin from which many of us might not have recovered. You can read his story HERE. It’s a moving testament to the kind of caring to which every physician should aspire. Dr. Brandeland is an inspiration.

It’s OK to ask you physician about patient deaths. It’s OK to ask if they cry or the effect it had on him/her. It’s your health. Your physician should care as much as you do.

STDs

There’s a lot of danger in sex. That danger isn’t decreased just because we don’t talk about it. It also isn’t decreased by not teaching about it. A recent study indicates that about 25% of teenage girls have common sexually transmitted diseases. On top of that is the possibility that the 25% is just the “tip of the iceberg” since we don’t test for all of the diseases.

Teens are pretty creative though. They understand the idea of virginity and (possibly due to Bill Clinton) don’t think oral sex is real sex. However oral cancers have been linked to the same virus that causes cervical cancer.

They’re your kids. You are the only one who has any chance of assuring they have the right information to make reasonable decisions and enter adulthood prepared and uninfected. Make sure they have the information they need. Ignoring their sexuality won’t make it go away.

It’s their health help them preserve it.

Better Data

The essence of a free market is that parties have access to essentially similar data. To his credit, Health and Human Services Secretary Mike Leavitt recognizes this.

In the case of health care that’s very difficult to assure that both parties (doctor and patient) have the same data. Physicians spend four years in medical school and at least three additional years in training. The volume of information they must manage is enormous. Few actually master the information in their own specialty.

But it is possible to supply patients with both outcome and process information regarding physicians. At least patients can make decisions based on something besides whether the front-office staff is nice.

I applaud Mr. Leavitt’s efforts.

It’s still your health care. Ask questions. Expect answers. Demand responsibility.

Mistakes

Suppose you go to your surgeon and after your operation you find not one but two scars. In spite of renewed efforts wrong site and wrong patient surgeries continue to occur.

Now how much would you expect to pay for the wrong operation? Zero is what I’d pay. But that’s not what patients are charged in many cases. Patients are often charged for the original operation and the wrong one. But it gets worse- some insurers refuse to pay for preventable errors. This leaves the patient liable for the bills.

This is worse than wrong, it’s unconscionable. Rather than contrition such physicians and hospitals have the unmitigated hubris to bill the patient- like it’s the patient’s fault! If these hospitals want to be paid then they should collect from the physician or surgeon who committed the error.

Patients need to be vigilant and participate:
1) Make sure you see your surgeon in the holding room or operating room before the surgery.
2) Make sure your surgeon reviews the consent and planned operation with you. (Not his resident, PA, or nurse.)
3) Make sure your surgeon marks the surgical site personally.
4) Make sure the consent specifies which side or site for the surgery.
5) Make sure the consent specifies who will do what part of the procedure and what part your surgeon will be present for (do not accept nebulous nonsense like “critical portions”- specify “skin prep to simple wound closure” or something similar).
6) Realize that at many hospitals rules on the part of the hospital preventing residents from operating with little or no supervision are minimal or poorly enforced.

If you find yourself a victim of wrong site or wrong patient surgery contact your attorney immediately. Remember battery is not the same as malpractice and it’s rarely covered by malpractice insurance. The best defence in these cases is a good offense.

It’s your health. Take part and take care.