Medical errors happen
The other day I saw my doctor for an annual exam.
This year I was determined to ask my doctor NOT to order a vitamin D level.
I have had my vitamin D level tested for the last three years and it costs me approximately $100 out of pocket. (It is not considered preventive by the Affordable Care Act.)
Earlier this year, the health advocacy group Choosing Wisely recommended against routine screening for Vitamin D level in healthy adults. Well, I am a healthy adult, and my previous vitamin D levels have been normal—albeit at the lower end.
Luckily, my doctor agreed. She did, however, want to check my cholesterol and glucose and blood count. Feeling as if I had won a small victory for frugal health care, I walked down to the lab and happily surrendered my arm for the blood draw.
The next morning, I received a message from my doctor’s office that my lab results were available on my electronic health chart. I logged in and clicked on “New Test Results.”
And there I saw it: Vitamin D (25 OH) Level. What the…?
I spent the rest of the day wondering whether I should call attention to this obvious error (whose error?) or just let it go. Finally, I decided that she and her office had to be accountable for ordering a test that I did not need, and that I had specifically requested NOT be performed. I sent an email and my doctor responded promptly that yes, they had made a mistake, and she would try to have the charge removed.
Obviously, she routinely orders vitamin D levels on her patients and either she or her staff forgot to alter the “standing” (i.e. routine) lab order for me.
Medical errors: “Internal Bleeding”
I was reminded of Robert Wachter’s book, Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes. He believes most medical errors are “slips”—when routine, automatic behaviors result in a mistake. Like when you’re driving down a familiar road and unthinkingly zoom pass the exit you wanted.
Of course, an extra blood test caused me no physical harm, and the financial harm, if the charge cannot be removed, will be minimal. However, in the bigger picture of health care, these kind of “slips” happen too frequently, resulting in too many tests being performed and too much money being spent on health care.
Dr. Wachter lists many ways the medical system can improve itself through technology, increased standardization, and checklists. But each of us must also do what we reasonably can to protect ourselves from such medical errors.
I should have checked with the lab personnel before my blood was drawn; I should have checked which tests had been ordered.
I should have remembered the advice I give others: Be alert. Ask questions. Check and check again.