"I will do no harm."
It's a famous line from the Hippocratic Oath, which, until recently, every medical student pledged upon graduation.
But in the past few years, medical students have started rewriting their Physician Oath. Medical schools might have their own version, or the graduating class may get together and pen their own.
It's important to know that there are still echoes of Hippocrates in these new promises, including not bringing harm or injustice to any patient.
Yet harm does come to patients. Medical errors are, unfortunately, part of the practice. Though the number of deaths varies based on the reporting source… In fact, it's a hotly debated topic. We lean toward studies like a recent one in The Lancet that found about 114,000 deaths per year had medical errors as a direct cause or contributing cause.
In addition, 21% of Americans reported that they experienced a medical error. That's from a survey out of the Institute for Healthcare Improvement/National Patient Safety Foundation Lucian Leape Institute. And according to the U.S. Department of Health and Human Services, one in seven Medicare patients in hospitals experience a medical error.
The statistic that really makes me pause: One in 10 doctors surveyed for Mayo Clinic Proceedings admitted they'd made a medical error within the prior three months. And those were only the ones brave enough to admit it.
I have tremendous respect for physicians. I remember the physical and emotional strain from pulling long shifts at the hospital. But we need to focus on patient safety.
You need to be your own health care advocate. Educate yourself, ask questions, and take notes. It could save your life.
One of the top causes for medical errors comes from communication. It's typically doctors and patients not understanding one another. But there are a few things you can do to improve communication. It starts with a checklist.
Longtime readers know I love medical checklists. They save lives every day.
In 2001, a doctor at Johns Hopkins Hospital here in Baltimore proved it. He studied the often deadly infections that occurred in patients who needed an intravenous line ("IV"). The infection rate was 11%.
Dr. Pronovost created a simple checklist of the procedures doctors are supposed to do, including washing hands, using clean gloves and gowns, and so on. After he convinced the hospital to mandate use of the checklist for a year, the rates of infection went from 11% to zero.
Many hospitals now use the Pronovost checklist. It has cut infection rates everywhere.
That's why I want you to make your own checklist for your next doctor's appointment, hospital stay, or any other medical care.
Your Medical Checklist – Part 1
1. Take a list of any symptoms or complaints you have. If it's a recurring issue (like extreme heartburn), keep a log of when it happens and any other factors that might help (like what you ate that day, any activity you did, and how you slept).
2. If your doctor requests blood work, imaging scans, or any other test, ask why. Make sure you understand what they're for and what they will tell your doctor.
I would also ask about false-positive rates. Some tests have high false positives, which lead to unnecessary treatment. A good resource I use is the U.S. Preventive Services Task Force ("USPSTF"). Ask if the test requested has a good rating from the USPSTF. An A or B grade means the test provides benefit as proven by solid evidence.
3. Ask when and how you'll get the results. Never assume that not hearing anything means you're in the clear. Always check in with the office staff that your phone number is correct. And if you don't get a call in the timeframe you expected, don't be shy about calling the office and following up.
4. If you receive a diagnosis, make sure to ask what it is and get it written down for you. Ask if there's confirmation from tests and if so, which ones. This is especially true for cancer – you want to make sure your cancer diagnosis has a confirmation from a biopsy. You can read more on this in my book, The Living Cure. We're working on a new edition, which should release soon.
5. Provide a list of medications. You'll want to include every medication you take, why you're taking it, the prescribing doctor, and the dosage. You'll also want to include all vitamins and supplements to make sure there are no interactions. Keep a journal like this:
On your list, include any allergies you have. Make sure each of your doctors has a copy. Give a copy to your spouse or anyone who will go with you to appointments.
If you get a new prescription, make sure you understand how to take it. Ask questions like – do I take with food? Anything I should avoid? Remember, grapefruit juice interacts with some medications, so you might need to skip your glass at breakfast.
This list is just the beginning of taking charge of your own health care. I have more tips for your checklist should you need to go to the hospital... And I'll share these with you next week.
What We're Reading...
- Some staggering stats on medical errors (with source links).
- Something different: A look at the new medical oaths.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
April 2, 2020