To: [email protected]; [email protected]: [email protected]: Mon, 26 Jan 2009 08:33:56 -0800Subject: <AWARENESS> 25 Most Avoidable Medical Mistakes 25 Most Avoidable Medical Mistakes How to play the most important part in preventing your own medical mishap By Alyssa Shaffer Posted January 22, 2009 from Woman's Day; February 10, 2009 We’ve all heard the horror stories of a surgeon operating on the wrong leg or leaving a sponge inside. But in reality, most medical mishaps are due to a series of errors, not a single doctor’s blunder. And believe it or not, you play an important part in preventing them. “Very few medical mistakes are caused by a doctor just not paying attention,” says Henry Lodge, MD, a New York–based physician and coauthor of Younger Next Year for Women. “Most have to do with something falling through the cracks—and that’s where what you do matters.” There are important steps you can take to make sure you’re getting the best care possible, from calling to check up on test results to being bare-faced honest with your doc. Read on to find out what experts say are all-too-common mistakes patients make. 1. You don’t check the expiration date on your medications.A week or two probably won’t matter, but “over time the chemicals in the medication can change, making them less effective and possibly even dangerous,” says Sandra Adamson Fryhofer, MD, an internist and clinical associate professor of medicine at Emory University in Atlanta.Take action: Add your medicine cabinet to your spring-cleaning list. 2. You don’t factor in wait time for an appointment.It’s important that you don’t go too long between screenings—which may mean you need to schedule appointments months, even a year, in advance. “Many mammography centers are actually closing because of insurance reimbursement issues,” says Jahangir Rahman, MD, an assistant clinical professor of medicine at the Columbia University Medical School in New York. “Some women are waiting upward of 6 months for an appointment.” That means you may actually end up going 18 months between screenings instead of 12.Take action: Pick up phone. Dial. It’s that easy. 3. You’re not honest with your doctor.We know it’s hard to ’fess up to unhealthy habitslike smoking, drinking a little too much and being a couch potato, but spilling the truth can make a big difference in your care. “Your doctor’s not there to judge; she’s there to help you be the healthiest you can be,” says Dr. Fryhofer.Take action: If you don’t feel comfortable telling your doc about your bad habits, write them down for her. 4. You don’t specify who should have access to your health records.The HIPAA law keeps prying eyes away from your private info, but it also means you’re on your own when it comes to simple tasks like picking up a prescription— unless you specify who else can be trusted.Take action: Tell your doctor who can have access and ask that he put a note in your file. 5. You ask for antibiotics at the first sign of a sniffle.We know we’ve said it before, but doctors say that patients just aren’t getting the message: Antibiotics don’t work for a cold. No matter how unbearable that runny nose or sore throat may seem, chances are it’s a virus, not a bacterial infection. And if you take antibiotics when you don’t really need them, you’re helping fuel a widespread increase in drug-resistant bacteria.Take action: If you develop a persistent fever, or have discolored phlegm or sinus pain, you probably need antibiotics. Otherwise, don’t ask for them. 6. You wait for your doc to say it’s time for a test.How can you catch diseases in the earliest, most treatable stages? Screen for them at the right time, says Aage Møller, MD, a professor in the School of Behavioral and Brain Sciences at the University of Texas, Dallas. The big three screenings for women: Pap (18 and up, earlier if you’re sexually active), mammogram (annually starting at 40, earlier and perhaps more often if you have a family history of breast cancer ), and bone density (50-plus). If you’re 50, you’ll need a baseline colon cancer screening, too. And you should be getting your blood pressure and blood sugar levels tested at all regular checkups (at least every 3 to 5 years).Take action: Ask your doctor when you should get these tests and if you need any others. Don’t expect her to remind you. 7. You assume no news is good news.“Test results often get lost. No news could mean that your doctor never got a copy of your lab work or report,” says Janet O’Mahony, MD, a clinical instructor in the department of medicine at the University of Maryland.Take action: Ask when your doctor will get results, and call to follow up. 8. You’re a really obsessive Googler.“The Internet is great for getting timely information, but you can also be tricked into thinking that something like a migraine is untreatable brain cancer,” says Kimberly McMillin, MD, a physician at Baylor Medical Center in Garland, Texas.Take action: Stick to well-respected websites like MedlinePlus. gov or MayoClinic.com. And be sure to talk to a health care professional about the info you find. 9. You take your medicine at any old time.Timing can have an important effect on certain medications. For example, if you don’t take low-dose hormonal birth control pills at roughly the same time each day, they may not work. Having a set routine also means you’re less likely to forget your meds altogether.Take action: Plan on taking your multivitamin or other daily medications either first thing in the morning or before you go to bed at night. 10. You don’t have any health insurance.“People with insurance get more preventive care, which translates to fewer complications from serious health problems,” says Caroline Dorsen, MSN, a family nurse practitioner and an instructor at New York University’s College of Nursing. Plus, you never know when you’ll have an emergency, and when you’re healthy is the easiest time to get an insurance company to cover you.Take action: At the minimum, invest in a catastrophic policy (which costs anywhere from $900 to $3,000 a year). “Right now, close to 50% of bankruptcies in the U.S. are related to medical bills,” says Dorsen. 11. You bargain-hunt for prescriptions.This often results in multiple pharmacies filling your prescriptions, which isn’t a smart idea. Using one pharmacy insures that the pharmacist knows every medication you’re on and can catch dangerous interactions before they happen.Take action: Stick with one pharmacy, or at least take a list of all your medications and show it to the pharmacist every time you get a prescription filled. 12. You don’t keep your personal health records up to date.“Be a little obsessive,” Dr. Lodge says. “If everyone paid more attention to his or her medical records, we could reduce a good deal of errors.”Take action: In a safe but easily accessible place,keep an up-to-date list of all of your medications, immunizations, allergies and past reactions, and be sure to bring it with you to every doctor and pharmacy visit. If you get a test like an MRI, X-ray or EKG, ask your health care provider for a copy of the report and then take it with you if you go to a specialist. 13. You don’t have a living will.The legacy of Terri Schiavo is the lesson that everyone—no matter her age—should have a legal document that makes her wishes known in case she becomes terminally ill or permanently unconscious, notes Dr. McMillin. “I have a living will that specifies exactly what I want and expect. I have a copy with my primary care doctor, one at home in a safe and one in my personal file, and my husband and family members know my wishes.”Take action: Call your local hospitals or senior center; some provide free living will seminars. 14. You don’t tell your doc everything you’re taking.“Many vitamins, minerals, herbs and other over-the-counter remedies can interfere with prescription medications,” says Dr. Fryhofer. Also, knowing that you take certain OTC meds regularly (say, for heartburn) can clue your doctor in to when you might need the prescription- strength version instead.Take action: Write down all of the meds and OTC supplements you take on a regular basis. Better yet, bring the bottles or labels to your appointment. 15. You don’t look at your prescription before you leave the pharmacy.Scary stat: Roughly 2 million adverse drug reactions happen each year, causing about 100,000 deaths. Take action: Keep a copy of your prescription and check it against what’s written on the bottle. It’s also a good idea to look up what the actual pill looks like (do a search at pdrhealth.com) before you go to the pharmacy. Then check that what’s in the bottle looks the same as the picture. 16. Your stress levels are out of control.Sure, everyone’s got stress, but managing it is key to preventing it from taking a toll on your health. “Stress is the forgotten risk factor,” says cardiologist Michael Ozner, MD. “Study after study links chronic stress to heart attack and stroke.”Take action: When you feel the pressure, practice deep breathing. Close your eyes and focus on relaxing your muscles, starting at your feet and working your way up through each body part. Breathe in and out through your nose as you focus on a single word (like peace). 17. You share meds with other people.It may seem harmless, even virtuous, to give your sneezy, wheezy cousin a pill from your allergy prescription, but health care experts say you shouldn’t play pharmacist. “Sharing with a friend exposes that person to risks and may potentially interact with something he or she is already taking,” says Dorsen.Take action: Keep your prescription pills to yourself (but be generous with your tissues!). 18. You double up on meds.If you forget a dose, twice isn’t necessarily nice. “Medicines are prescribed to keep a steady amount in your bloodstream,” explains Dorsen. “Taking too much at one time can give you an upset stomach and possibly even create toxic levels of the drug in your body.”Take action: Ask your doctor or pharmacist if it’s safer to double up or just skip the dose. 19. You go to your doctor’s visit empty-handed.You don’t stock up at the grocery store without a list, so why take a chance on your checkup?Take action: A week or so before your appointment, write down all of your questions and concerns. Call the doctor’s office and ask if you can fax it over so they can put it in your file. Your doctor may have a chance to look it over beforehand, but bring a copy on the day of the appointment anyway. 20. You put off doctor appointments.Work, family, friends—who has time to squeeze in a doctor’s visit? You do. Especially if you’ve spotted something suspicious or have new symptoms. “Waiting even a few months can mean something like cancer that’s in an early, treatable stage has now progressed,” says Dr. McMillin.Take action: Get yourself to your doctor as fast as you can if you think something might be wrong. And don’t skip regular checkups—they’ re an opportunity to catch a condition early. 21. You don’t know your family health history.“Almost every condition has a genetic link, so knowing what your relatives dealt with is an important clue to your own health risks,” say Dr. Rahman.Take action: Map your family medical history. Start with yourself, your parents, your grandparents and your siblings. Note any diseases (cancer, including type; heart disease; diabetes; stroke) and if possible the age of diagnosis. You can even do it online: The Surgeon General’s office offers an easy personalized (and private) mapping tool at familyhistory. hhs.gov. Take a copy to your next doctor’s appointment, and keep another in your files (be sure to update it every few years). 22. You give up too soon when you’ve filed an insurance claim.Let’s face it: Insurance companies try to pinch pennies, which often means you’re the one left holding the bag on a claim you thought should have been paid in full.Take action: Call to follow up on any claims that are denied (the sooner you do this, the better), and ask to speak to a manager if necessary, says Dorsen. Keep track of whom you speak with and when so you can put your concerns in writing. 23. You don’t finish a round of antibiotics.Stop too soon and you not only risk the infection reoccurring, you’re contributing to bacterial resistance, says Dr. Fryhofer.Take action: Don’t toss the bottle until it’s empty. 24. You don’t have a primary care doctor.Many women rely on their gynecologist for primary care, but your ob-gyn is really focused on your reproductive health, so she may not be paying as much attention to other things like your cholesterol. And if you have urgent, non-ob/gyn symptoms, you may end up having to go to the ER.Take action: Visit an internist, general practitioner or family medicine physician at least once a year. 25. You haven’t gotten vaccinated since you were a kid.Grownups need a shot in the arm, too. “All adults need a one-time booster for whooping cough (pertussis), which you can get in a tetanus-pertussis combo shot called Tdap,” says Dr. Fryhofer. (After the one-time booster, you still need the tetanus shot every 10 years.) If you’re 60 or older, experts also recommend the shingles vaccine.Take action: Stay up to date on your vaccines. Then reward yourself with a lollipop. 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