campaignZERO

Defensive Medicine Isn’t Safe Medicine

Karen Curtiss — Sun, 28 Feb 2010 18:15:47 +0000

Last week, Gallup published the results of a study showing that a whopping 26% of our healthcare costs cover “defensive medicine.”

If you’re not familiar with this term, think about the times your doctor has ordered a test for you that seems a little on the “iffy” side – you’re not quite sure what the heck the test is for, or you’ve been through it before, and it seems like a big waste of time to you. But you dutifully follow doctor’s orders because, after all, insurance is paying for it anyway.

On the other hand, maybe you’ve insisted on a test that gave your doctor cause for pause. You didn’t want to go to the effort of getting a second opinion so you insisted – and your doctor relented, and then off you went… for a CAT scan, MRI, stress test, or blood work.

In these scenarios, the undercurrent driving tests and procedures is fear – fear in your doctor’s heart that if any possible stone is left unturned, you, dear patient, will see your doctor in court.

You must be wondering why this concerns us at campaignZERØ. What does defensive medicine have to do with patient safety?

Here’s our take on the connection –

When doctors feel defensive, they don’t have the luxury to feel introspective too. It’s a common sense fact — the two emotions simply don’t coexist peacefully in a single caring soul.

If doctors can’t be introspective, they can’t get to “sorry” when they make an error (as all humans do sometimes – despite very best efforts and intentions.)

If doctors can’t get to sorry, they can’t learn from their mistakes. They can’t become better doctors and better human beings.

So, while money and cost should be a concern for all of us, we should care just as much about the caretaker — who will then do a better job of taking care of us.

Let’s break the vicious circle of defensive medicine. Let’s start building a caring circle of better, safer medicine.

Be a Savvy Advocate: Six Steps to Take When Your Loved One Confronts a New Medical Condition

Karen Curtiss — Wed, 30 Sep 2009 03:52:37 +0000

By Margo Corbett
Author of The Savvy Patient’s Toolkit and Founder of The Savvy Patient School

Your loved one is having new symptoms. You think they may be serious, and worry is setting in. You seek help and receive a diagnosis. What does this diagnosis mean for him? What treatment(s) will she receive? How will it affect his life? The questions go on—consciously and subconsciously.

Do you leave it up to the doctor to tell you everything he thinks you and your loved one need to know, recommend a treatment plan, and hope for the best? Or do you get involved and make sure you help them proceed in a way that’s right for them?

The doctor will base his recommendation on his knowledge of the illness and what he remembers about the patient, the new information you provide, and that which works best for most people—unless you give him reason to do otherwise. Has he thought about alternate diagnoses or treatment options? Or has he proceeded on his first instinct?

Here are six steps you can take to increase the chances for an accurate diagnosis and the best treatment plan as you make decisions in partnership with your loved one and the doctor:

Research, using reliable resources. Seek to understand how the body works and learn as much as you can about the medical condition/illness and the treatment options.
Become as aware as you can of your loved one’s symptoms and how she feels. Document her symptoms as they occur, actions taken and the results of each action (such as medication). Help her verbalize her symptoms.
Be as clear as possible in the descriptions you give to healthcare providers. If the doctor doesn’t get an accurate description, he could make a wrong diagnosis. Include and remind the doctor of things such as current medications, medication changes, past medical history and family history. He cannot remember everything about every patient.
Learn the most effective language you can to communicate the symptoms and concerns. Doing research often helps you find the right words.
Be actively involved in finding the right treatment plan for your loved one. Be sure to discuss all treatment options, ask the doctor for her recommendation and the reasoning for it, and how the treatment will affect other conditions your loved one has and/or medications he takes. If not all options are explored, your loved one could be given a treatment that could have adverse affects on other conditions, or negative medication interactions.
Be assertive. Don’t be afraid to ask questions. The more you learn, the better your questions will be. If you don’t understand the answers or don’t get answers that make sense to you, persist with your research and questions until you do. Inaction on your part can lead to treatment of the wrong illness or inappropriate treatment.

It never hurts to get a second opinion—some insurance companies even require you to do so for certain conditions.

You may not realize it, but the key to a timely diagnosis and appropriate treatment plan often depends on your ability to be a savvy advocate for another.

More information can be found at www.savvypatienttoolkit.com and www.savvypatientschool.com.

Buy Margo’s book:

Founder’s Note to Advocates

Karen Curtiss — Wed, 30 Sep 2009 02:43:21 +0000

When it comes to health care – especially in a crisis — conventional wisdom tells us, “Get a second opinion and take someone with you.” So we often find ourselves accompanying our spouse or parents to doctors’ appointments and through hospital stays to be a second pair of eyes and ears, absorbing critical information it is so hard for patients themselves to process in a worried state.

This convention, this way to help those we love most, is great advice and we take a large measure of comfort in following it. But think about it …

…How are any of us really trained to be effective health care advocates, an effective “Someone” for those we love?

Sure, we all know how to hold a hand, wipe a brow and occasionally fetch a nurse. My guess is that many of us also rely heavily on quick, prayerful barters with God. (Please make her well and I will never skip Sunday mass to play golf again.) But in our hearts we know that if the chips are down, our role as a Someone is to be our loved one’s lifeline to the best possible care—someone who may even make the difference between life and death.

A few years ago, our family of six siblings made a pact to be advocates for my father as he recovered from a hard-won lung transplant at a major academic hospital. Grateful for our dad’s second chance after his diagnosis of incurable idiopathic pulmonary fibrosis, our entire family gladly turned our lives upside down to take turns at Dad’s bedside during his recovery. Seven months and one day after his lung transplant, my father passed away after suffering a dozen preventable medical errors. He never left the hospital and his new lung never had a fighting chance.

Two months later, I accompanied my husband as he underwent “routine” surgery. Beset by error after error in surgery prep, on the operating table, in the ICU and on the acute care floor, it took him 18 months to recover instead of the seven days we expected. During that time, our 11-year-old son was scheduled for emergency surgery to remove an appendix that turned out to be perfectly pink and healthy.

What our family did not know then—which we fully appreciate now—is that hundreds of thousands of patients are killed by medical errors every year. The death rate from preventable medical errors exceeds the death rate for AIDS, heart attack and stroke combined. Hundreds of thousands more are harmed but, like my husband and son, they are the lucky survivors—emotionally and physically maimed no doubt, but alive.

At some point in all of our lives, we will be the link between a patient we love and a medical team. We can act on a wing and a prayer or we can be prepared, informed, confident, capable and effective.

You’ve read this far… so I think I know your choice, and you have no idea how happy that makes me! Won’t you join campaignZERO? There are no dues, no fees, no sponsorship needed. Just read everything, download the information and strategies we offer and share our website with your family and friends.

Let’s build awareness together. Let’s support our healthcare providers. Let’s take care of each other.

Sacramento-area hospitals use simple ways to cut mistakes

Karen Curtiss — Tue, 15 Sep 2009 05:52:16 +0000

FROM THE SACRAMENTO BEE, SEPT. 14, 2009

By Anna Tong

In this story about cutting-edge innovation in hospital care, you won’t read about robots or nano-devices so small you need a microscope to see them.

These next best things in health care are socks, sashes, work sheets and cards; homely items are transforming hospital care in Sacramento and around the country.

After introducing a sock color-coding concept, patient falls at Kaiser Permanente Medical Center, Roseville dropped 25 percent.

At the same hospital, nurses using yellow sashes while administering medication – and issuing bar codes to patients – slashed medical errors by 80 percent.

At least 100 Americans will die today from a preventable medical error. Annually, somewhere between 44,000 and 98,000 preventable medical mistakes are fatal, according to the Institute of Medicine, a federally chartered nonprofit group that researches health improvement. That’s more than from car accidents, plane crashes and workplace injuries combined.

It’s a serious problem with an answer that isn’t necessarily high-tech, experts say.

“A computer will allow you to make a mistake faster and with greater magnitude than a paper system,” said Fran Griffin, a director at the nonprofit Institute of Healthcare Improvement, which has led several national campaigns to improve hospital safety.

Improvement happens when front-line hospital workers identify an issue and find a simple solution that can be incorporated into their daily routines.

Alicia Zuniga, a patient at Kaiser Roseville’s orthopedic ward, wears bright red sock booties instead of the traditional hospital blue or gray.

Dubbed “Ruby Red Slippers,” the socks are a homegrown solution that alerts staffers that Zuniga is at high risk for falling. They know immediately she needs assistance.

Zuniga said she’s been found wandering the hallways alone.

“Somebody always rushes over to me right away,” she said from her hospital bed. “They pay more attention to me because I have these socks on.”

Zuniga was waiting … Read More .