Medical safety net

Doctors, even the best of the best, don’t always have the right prescription the first time around.

It’s up to patients to make sure their doctors are doing everything within reason to ensure their good health. Mistakes happen, but they happen less often when both doctor and patient work in tandem.

The medical field is trying to stem the tide of what’s known as system errors. In 1997, the American Medical Association created the National Patient Safety Foundation toward that end, and in December 2004 it partnered with the Institute for Healthcare Improvement with the goal of saving 100,000 lives that might otherwise be lost by medical errors through June 2006.

Dr. Nancy Nielsen, speaker of the American Medical Association’s house of delegates, wants to make it clear “nobody makes mistakes as a choice.”

Dr. Nielsen says the complications inherent in medical care, from prescribing medications to assigning treatments, can be fraught with educated guesses.

The simple act of picking up a medication can cause problems if something goes awry.

Take medications with similar-sounding names, like Xanax, used as a tranquilizer, and Zantac, prescribed to battle stomach acid. One of Dr. Nielsen’s patients once got Xanax instead of Zantac at the local pharmacy and had the wherewithal to double-check with her before taking it.

“Everybody worries about lookalike or sound-alike drugs,” she says.

Patients also need to keep tabs on any test results promised by their doctors.

Most doctor’s offices insist the physician in charge signs off on test results to make sure important information isn’t overlooked, Dr. Nielsen says. Still, no system is foolproof. She suggests patients check back with the doctor via e-mail to avoid being put on hold indefinitely.

“Communication is the key. Mistakes happen more often in the areas of hand-off,” she says. That can occur when a patient moves from, say, the intensive care ward to another part of the hospital. The patient’s information has to be written again and sometimes bits of information get lost in translation.

One simple way to stop mistakes before they happen is for patients to keep an up-to-date list of their complete medical history to give to their doctors.

“I’ve been in practice 23 years and I can count on both hands how many times that happened,” Dr. Nielsen says.

Sherry Marts, vice president for scientific affairs for the Society for Women’s Health Research in the District, brings her doctor such a list every time.

Ms. Marts says the paper includes her medical history as well as information about any medications she may be taking plus how her parents and grandparents died.

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