How you can help reduce errors in diagnosis

My wife’s knee problem was misdiagnosed by two certified internists, two bone specialists, and a radiologist in Maine in the United States. My interest in medical errors and the opinion of our son, who was then a medical student, led us to discover that my wife’s MRI saying “ruptured meniscus” was wrong. Her real problem was gout, which does not need the surgeon’s knife. We were able to prevent the prescribed surgery.

Every day thousands of our people suffer from the errors of professionals in giving advice or performing their job. Many of these mistakes are bound to happen and are impossible to prevent because of how our brain works. However, these can be reduced with better training and use of technology.

The most remembered professional “oops” is pilot error, where passengers and crew members are the casualties. One such event happened on March 27, 1977, on the Spanish island of Tenerife, involving the collision of KLM Flight 4805 and PanAm Flight 1736. In all, 583 passengers and crew members became statistics. This accident, considered the deadliest in aviation history, was a result of pilot error, in the judgment of the investigators.

Pilot errors are easily seen, but other professional errors are hidden from the public webcam. Lawyers, accountants, bank executives, plumbers, physicians, and others are involved in thousands of “oops” moments that are silent. Only the perpetrators know the circumstances of the error but in most instances will not admit to it. Such is human nature.

Although pilot errors are dramatic, these events are rare and relatively fewer people are involved compared to the thousands of deaths and injuries that occur daily because of medical errors. In the United States alone, it is estimated that 98,000 patients a year die from hospital errors. There is no study yet in the Philippines on medical mistakes made in hospitals and doctors’ offices.

The good news, however, is there are now better means to help reduce these errors. With the help of technology, the media, the Department of Health, and professional societies, many medical mistakes can be prevented through public-education newscasts, Facebook, Twitter, and mass e-mails.

Let us start with what you can do. One occasion for error is the physician’s diagnosis, and you can write your health history in summary form before going for consultation. Thus, time spent asking questions can be saved. Most of the time, a doctor can figure out your diagnosis within minutes by reading your chronologically written health history.

Unfortunately, many physicians’ clinics have hallways congested with waiting patients, which results in lesser time for each patient. With lesser time, critical questions are sometimes not asked, which may result in misdiagnosis. Maybe this is happening frequently in the Philippines because doctors’ offices are frequently packed.

Aside from your health history, you should also bring your medications or a list of all medications taken previously. You should also mention over-the-counter medications and herbals you have taken.

Before you leave your physician’s office, make sure that the prescription you got is legible and that you have a list of side effects to watch for each of your medicines.

Ideally, your physician should tell you or give you a list of symptoms that need a follow-up call or visit. In case your physician does not provide a list and your symptoms seem to be getting worse after a day or two, you should call or ask for a follow-up visit. Do not go to the emergency room without calling your physician—unless he/she can’t be reached, or you are having urgent symptoms like severe pain, trouble breathing, or weakness in your limbs.

Ask for a copy of all of the results of your x-ray, CT scan, MRI, and blood tests. The results of most of these tests should be available within 24 hours or, in urgent cases, within an hour or two.

Unfortunately, most physicians do not have the luxury of time to explain to you in plain language the results of your tests. You can look for a friend or relative who is in the health field. My sister, brother, nephews, and nieces always call me about their tests and sometimes e-mail a copy of the scans and x-rays.

It is best also that you read about your complaints, medications, and tests in reliable websites like National Guideline Clearinghouse  (www.guideline.gov). This is what physicians in the United States use frequently. It is free, easy to read, and based on evidence, and all accepted treatments are listed.

Another good site is Mayo Clinic (www.mayoclinic.com). It has a symptom-checker, as well as a list of commonly used drugs.

With iPads, tablets, and smartphones in your hands, you have the best health aid that can reduce medical mistakes. Literally, the best outcome of your health care is at your own fingertips. Go click or tap, now. That easy.

Dr. Leonardo L. Leonidas ([email protected]) retired in 2008 as assistant clinical professor in pediatrics from Boston’s Tufts University School of Medicine, where he was recognized with a Distinguished Career Teaching Award in 2009. He is a 1968 graduate of the University of the Philippines’ College of Medicine.