An error of omission
A few weeks ago there was a lot of news about how medical mistakes are the third leading cause of death in the US, behind heart disease and cancer.
A medical error is defined as “an unintended act (either of omission or commission) or one that does not achieve its intended outcome.”
And now a Philadelphia paper is highlighting one very common mistake: when you and/or your doctor are not informed about a serious finding on a medical test.
The article explains that a well-known local musician (which is why this story is popular on Twitter, I think) is being treated for inoperable and metastatic lung cancer. That’s difficult enough, but he also learned that the tumor was first seen and reported four years ago when he had a chest CT scan for some broken ribs.
The radiologist noted the small tumor in the report, but for some undisclosed reason the patient’s doctor never notified him of that rather significant finding.
The musician remained unaware of the probably easily-treated cancer until it had grown and spread.
No news is not good news
It’s just no news.
Remember that saying “No news is good news”?
Years ago I actually used to say that to patients. Medical test results could take days to make it to the doctor’s inbox (the old paper days!), and then a couple more days before either the doctor or I called the patient back.
Except if the medical test showed something bad. Then the lab or radiologist almost always called the doctor right away, and the doctor called the patient back, too, sometimes on the same day.
So I felt confident telling patients to be patient, and “No news is good news.” We’d know pretty quickly if something was wrong.
Be a proactive patient
Now I tell patients, friends and family members to take charge of their own health care.
First, sign up for whatever type of patient portal is part of your doctor’s electronic health record (EHR) system. You usually need to create a password-protected account, but then you can see the results of lab tests and other diagnostic medical tests as soon as they are reported—sometimes before the doctor!
However, there are obstacles to accessing online health records. Some smaller hospitals and clinics haven’t made the (huge) investment in EHRs. Many older patients aren’t comfortable with technology. Low-income patients might not have access to the internet.
Related post: Is your electronic health record (EHR) accurate?
Know exactly what medical tests you are having done and why. Ask your doctor and the lab technician when you can expect to get the results of each test. Then if you haven’t heard by that time, you can start pestering the doctor’s office. As a former office nurse, I can tell you that the
squeaky wheel persistent patient gets taken care of quickly.
I always ask my doctor to send me a hard copy of my results. Different doctors use different EHRs, so when you see a new doctor it’s helpful to be able to bring a copy of any previous medical tests with you.
And read the reports carefully, always looking for mistakes, such as the wrong name or birth date (it happens), or information you weren’t expecting (such as a lung tumor in addition to a broken rib!).
Poor communication—or no communication—is an all-too-frequent cause of medical harm. Our best protection is to be alert, informed and take-charge patients.
Resources for proactive patients!