July 7, 2008 -- According to a report in last week's Los Angeles Times, about 100 Californians a month are seriously and needlessly harmed while receiving medical care. This number comes from the reports of the "preventable and should never happen" category of adverse events required by California state law but is almost certainly just the tip of the iceberg of medical mistakes that happen throughout the country every day.
Two such mishaps were reported in the Los Angeles Times piece: Technicians at a hospital in Santa Cruz unintentionally placed a CT scan of one patient into the electronic file of another, leading physicians to remove the wrong patient's appendix. An elderly woman died at a hospital in Pomona after a nurse gave her two medications that were not prescribed. My former secretary was recently diagnosed with cervical cancer requiring a hysterectomy because she never received the news that her Pap test was abnormal and needed further testing. She would have needed much less invasive treatment just one year earlier.
I have dedicated much of my career to teaching people how to manage and control their own health care. Hearing yet again about avoidable medical errors reminds me to speak out. So many medical mistakes could be avoided if patients were placed front and center of their health care information and health care decisions rather than passively accepting care, often on the sideline.
To start, all patients must control their own complete cradle-to-grave medical records. Today such records exist piecemeal in a variety of offices and hospitals, and the information is rarely available when patients need it most.
I offer you five simple but powerful steps that you can take to avoid the many pitfalls of health care and get the best care possible.
1. Keep track of your own medical records
We no longer live in an era where we have just one primary care provider for our entire lives. The more doctors we see, the more information that can get lost in the shuffle.
Come to your doctor's visit prepared with copies of medical records, recent test results and family history information. Your doctor will have a better picture of your previous medical care and can keep it in mind for future treatment.
Also, carry an emergency health information card with you at all times, which lists up-to-date medical conditions, medications, family history, emergency contacts, allergies, immunization status and information on advance directives. Whether you store your records in a folder or on a home computer or server, always keep at the ready a hard copy of the most recent and critical information to share with your doctors.
Seniors -- keep your information in the kitchen and an emergency card taped to the refrigerator where emergency personnel can quickly find it.
2. Trust your instincts and ask questions
Medicine is a fast-paced field, with advancements and discoveries happening by the minute. It's impossible for doctors to be aware of everything new.
If you see something in the news that might apply to your care, write it down and ask about it on your next visit. If you experience any strange symptoms throughout the year, make sure you ask about those as well. Your health radar works better for you and for your loved ones -- no doctor or nurse could possibly know all there is to know about you.
3. Talk with your doctor about which tests and treatments are right for you
Age, race, lifestyle, family history -- and yes, even your insurance coverage -- all play a role in determining what tests and treatments a doctor will automatically administer. Don't be afraid to ask about the most up-to-date tests and treatments that may be right for you.
For example, women with very dense, lumpy breasts should talk to their doctors about getting a digital mammogram and possibly a breast ultrasound as part of regular breast cancer screening. Men, especially those with a family history of prostate cancer or who are African-American, should ask about the PSA/prostate cancer test and rectal exam. Women with vague abdominal symptoms such as bloating, constipation or other changes that are unexplained and don't go away after two to three weeks should ask about the CA 125 blood test and vaginal probe ultrasound to detect early ovarian cancer.
Remember, it is your life on the line.
4. Monitor and manage your health care
For the 364 days of the year between doctors' visits, you must be responsible for your own health.
Use this time to set and keep track of target goals. This could include getting more exercise, more closely tracking your blood pressure and blood sugar with a home monitor, or doing a monthly self-breast exam.
Additionally, as doctors have less time than ever to talk with their patients about conditions and treatment options, it is essential that you do research and learn all you can about your health care needs. To keep track of your treatment goals, download this helpful form: for men and women.
5. Follow-up on test results!
Many of the avoidable medical mistakes underscore the fact that no news is not necessarily good news when it comes to test results. It's a good idea to give your doctor's office a self-addressed stamped envelope so that all results can be mailed directly to you.
If you don't receive your results within two to three weeks, give your doctor's office a polite call to follow up. It is not good enough to hear your test was normal; ask for an original copy of the results. That way you can learn more about your own health and share the information with future doctors.
If each one of us did our part as patients, this more than anything else could be the best medicine of all for what ails our overworked and rushed health care system.
Have you tried to get copies of your test results? What problems have you faced in asking for them? What advice can you share with others that may help all of us prevent mistakes? As always, I welcome your comments and questions.