I may be a medical doctor, but I am also somebody’s son, brother, husband, father, and friend to many non-medically educated people who might need to engage the health care system. Patient safety and prevention of medical errors is a matter of deep importance to me and should be to us all. As much as life can be unpredictable, medical errors that are preventable should be prevented from happening in the first place. There are things the public can do, and that is the focus of why I am shining a light on the topic.
I have a story about a friend who presented with pain in the left side of the abdomen. She went to an emergency room and was correctly diagnosed to be having a kidney stone. The problem occurred because the report given to her stated an error in the placement of the decimal point. She was told that her stone was 2.8 millimeters. It was actually 2.8 centimeters (ten times larger, and not quite the size of a pebble, but rather a golf ball size with a different expected outcome). She was also told it would pass and to strain her urine to recover the stone for testing, which was actually ridiculous based on its true size and actual location.
Based on the erroneous information, she underestimated her risk of problems, and went on a planned trip with friends out of state. When she had another attack of pain, she sought care at an out of state emergency room and was correctly told of the large stone that had not moved at all, but was causing swelling in her kidney and that the pain was a result of the obstruction caused by the stone.
When she told me the story, and the information that was provided by the out of state hospital not agreeing with what she had been previously told, my immediate response was for her to request the local records and look at the original information.
The point that I want to make is that when something doesn’t make sense, don’t rely on the judgment of others. Get the original reports, ask questions, and come to your own conclusions.
Many physician practices, hospitals, and other health care providers now offer a window into your own health information. These windows are often called “patient portals.” If you have the opportunity to sign up for access to your medical records, you absolutely should do so. When you have a test, the raw, unfiltered data should be available to you shortly after it is reported to the ordering doctor. If abnormal results are flagged, and the results have not been adequately explained, that should be a trigger for you to ask questions.
Had my friend had access to her results promptly, she may have better questioned her diagnosis, and may have chosen to follow up more urgently and delayed her trip out of state until she was well. She will ultimately need surgery to remove this stone, and it won’t be passing on its own. Definitive treatment was delayed by this error and she has suffered because of it, but fortunately she will not be permanently harmed by that delay.
The real point is, is that we also have a responsibility for our own health. We should avail ourselves of the original clinical information and data whenever possible. We’ve almost certainly already paid for it. Don’t be afraid to ask questions. Questions should not offend anyone if they are asked honestly and for a reasonable purpose. I am aware that medical information can be intimidating and sometime difficult to understand. Your doctor or nurse practitioner should make it a point to explain the findings in layman’s terms, and in such a manner that you should be able to take control of steering your own health care decisions. As Justice Brandeis once stated, “sunlight is the best disinfectant.”
Dr. MacMillan specializes in Gastroenterology and Liver disease and is a member of the North Andover Board of Health. Dr. Macmillan was recently elected by his peers to be vice Speaker of the House of Delegates at the Massachusetts Medical Society and alternate Delegate from Massachusetts to the American Medical Association. Dr. MacMillan is on staff at Holy Family Hospital Haverhill and Methuen, Anna Jaques Hospital in Newburyport, Lawrence General Hospital, and Parkland Hospital in Derry, NH and is the President of the Massachusetts Gastroenterology Association. Dr. MacMillan also serves as Massachusetts Governor of the American College of Gastroenterology and is a Fellow of the College.