How to prevent becoming the victim of a medical error

About 25 percent of all hospitalized patients will be harmed by a medical error, Johns Hopkins Hospital surgeon Marty Makary shared last weekend in the Wall Street Journal.

His article, “How to Stop Hospitals from Killing Us,” probably isn’t something you want to read over eggs and bacon while fretting about your upcoming colonoscopy. But as one person wrote in response to a blogger’s commentary on the article, “If patients were taught to fear the dangers from their medical interventions as much as they fear disease, we’d begin to see some … changes in how medical care is … delivered.”

Makary seemed to suggest this himself. Over the years, he’s asked patients why they chose his hospital. Responses included distance from home and the fact that the hospital owned a Life Flight helicopter.

“You wouldn’t believe the number of patients who have told me that the deciding factor for them was parking,” Makary wrote.

As Consumer Reports has stated on its website, “Choosing a doctor is one of the most important things you will do in your life.” And while MedicineNet.com’s article, “How to Choose a Doctor,” presented proximity to home and parking as the first in a checklist of questions to consider, Consumer Reports advised against making such random selections.

Instead, ask for a referral from a family member, friend, or doctor you’ve already come to trust, it said. Then research the doctor’s training, credentials, and disciplinary actions via your state’s medical board. (For The State Medical Board of Ohio, click here.)

As Makary suggested, “If you won’t sit down for a meal before checking Zagat’s or Yelp, why shouldn’t you be able to do the same thing when your life is at stake?”

With that in mind, he offered several steps that hospitals can take to improve patient safety, including:

• Providing online dashboards – sort of like Google Analytics – on which people can review a hospital’s infection rate, readmission rate, patient satisfaction scores, and the number of times a hospital committed a medical error that should never happen, such as leaving surgical tools inside the patient. According to Makary, “Nothing makes hospitals shape up more quickly than this kind of public reporting.”
• Giving patients online access to the notes their doctor took during their last appointment, so they can add to or correct them, if necessary.
• Videotaping surgeries. Makary reported that colonoscopies demand “meticulous scrutiny of every nook and cranny of the colon. Doctors tend to rush through them; as a result, many cancers and precancerous polyps are missed and manifest years later – at later stages.” A hasty colonoscopy could also result in a perforated bowel.

After reviewing 100 procedures, Dr. Doug Rex of Indiana University told his partners that he was going to time and score future procedures. “Overnight, things changed radically,” Makary reported. Doctors began taking their time, and the length of a colonoscopy increased 50 percent.

• Encouraging teamwork. As suggested in a Legal Examiner post last month, doctors sometimes need a little help. Makary wrote that a nurse who feels confident enough to bring a possible medical error to a doctor’s attention could save a patient’s life.
• Making medical malpractice lawsuits public. “[I]f you are the victim of a medical mistake, hospital lawyers will make never speaking publicly about your injury a condition of any settlement,” Makary noted. “It wouldn’t be going too far to suggest that these types of gag orders should be banned by law.”