Missed Diagnosis - Oooops!

Doctors are missing diagnoses especially with cancer - OVER 50%!!

Are you getting the right treatment? A 2006 study* of 307 closed malpractice claims revealed that many missed or delayed diagnoses in outpatients lead to serious harm, some fatal. In this study, 30% resulted in death! Adverse outcomes occurred in 59%.

The most missed diagnoses were cancer (breast and colorectal primarily), infections, fracture, and heart attacks. Fifty-nine percent of errors were associated with cancer diagnosis - or should I say misdiagnosis? Most of these malpractice claims (59% again) showed that diagnostic errors were significant.

The most common reason for failure to diagnose was failure to order the right test (55%). The other reasons were:
-failure to follow up (45%)
-failure to obtain a complete thorough medical history and physical
exam (42%)
-wrong interpretation of medical tests (37%)
Some cases were cited where the doctor failed to check the test results, or to tell the patient the results.

This data is truly mind blowing! Though a small study, it carries a lot of weight. The percentages are phenomenally high! How can this be happening in the most medically advanced country in the world? The fact is, it's happening. It is more common than we think - hidden, not talked about. What can you do to keep it from happening to you?

Has your doctor discussed preventive tests for cancer detection? Of course, you should have a routine complete medical history and physical exam first. Using this information your doctor will know what tests you may need. If cancer runs in your family, you really want to consider preventive cancer screening.

The medical history and physical exam give your medical facts. Findings on physical exam may suggest cancer for which testing is needed. Some tests considered for routine cancer screening are:
-mammogram, MRI - breast cancer
-PSA (prostate specific antigen) - prostate
cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - body (this scan shows other things ,
too).

Screening tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up with your doctor to prevent any delays.

Get a copy of your test results. That way you will know if you were told everything and that the information is accurate. Research your results and diagnosis. Things you don't understand, ask again. Getting a second (and sometimes tiebreaker third because you were told different things by each doctor!) opinion is a reasonable research tool, also.

Patients must be their own advocate and take charge of their health. Health maintenance and prevention are so important to one's quality of life. Make it an important part of yours. Remember to do your own monthly breast exams for both sexes, and monthly scrotal check for the males.

Great health is true wealth!

(*from AHRQ, Agency for Healthcare Research and Quality, publication "Research Activities" February 2007 from study in Annals of Internal Medicine, 10/3/06)

J.L. Richardson, M.D., is a family medicine doctor, patient advocate, and author of "Patient Handbook to Medical Care: Your Personal Health Guide".

Swine Flu Resources

Swine flu information can be found at the sites below. If you have symptoms or have been exposed, seek medical attention.

Today the number of KNOWN identified cases of swine flu in the US is at 20. "CDC has NOT recommended that people avoid travel at this time."

Follow RSS feed link for current CDC updates.

Center for Disease Control (CDC)
http://www.cdc.gov/swineflu/


CDC RSS Feed
http://www2a.cdc.gov/podcasts/createrss.asp?t=r&c=252&showall=1

US Dept of Health & Human Services (HHS)
http://hhs.gov/

Follow CDC on Twitter http://www.twitter.com/CDCemergency


Your local health department is another good resource. Find your local health department at
http://www.healthguideusa.org/local_health_departments.htm

Stay safe. Wash your hands and maintain good hygiene.

by J.L. Richardson, MD is a family medicine doctor, patient advocate, and author of "Patient Handbook to Medical Care: Your Personal Health Guide".
www.mypatienthandbook.com


NOTE: The links are now working with a click. you can also Copy and Paste, or type web address into your browser. I finally figured this out. Thank you.

Doctor Search on the Internet - Healthy Thing to Do?

Have you looked your doctors up on the Internet? When you do, you may find incomplete inconsistencies. Many web sites had no listing for several doctors I was looking up. So I looked at some others.

I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.

The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.

These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?

The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at http://www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.

J.L. Richardson, MD is a family medicine doctor and author of "Patient Handbook to Medical Care: Your Personal Health Guide".
http://www.mypatienthandbook.com

TEST YOURSELF?

Many doctors are concerned that some tests like the body scan will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal” meaning that the abnormal finding is something that is just there. It is benign, and not life threatening.

What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.

What does the doctor do when a patient comes in with abnormal test results from a test they orders and paid for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.

What does the patient do?

J.L. Richardson, MD is a family practice doctor, and author of the award winning "Patient Handbook to Medical Care: Your Personal Health Guide".

http://mypatienthandbook.com

Patient Advocate Vital Signs

The “Vital Signs” of patient advocacy are important. We look for these in all our health care providers.

• TRUST
• CARING
• COMMUNICATION
• COMPASSION
• EDUCATION
• INFORMATION
• KNOWLEDGE

A patient advocate is someone who cares for and helps monitor patient's medical care. You should be your own patient advocate as well as an advocate for loved ones, friends. Doctors should act as their patients’ advocates. This seals the patient-doctor bond and assures them that they will get everything they need in a timely manner.

My health care providers are trusting communicators with caring compassion that provide education, information, and knowledge.

J.L. Richardson, MD is a family practice doctor, patient, patient advocate and the author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com

Preventive Medical Screening

Doctors and organizations may rant and rave about some preventive medical tests as "out of date". Think about the people you know who found a breast lump or had a high blood PSA test and later found out it was cancer. Today, in one day, I talked to three friends who told me how preventive tests saved their lives. They are all long term survivors.

Early detection and treatment as well as prevention can save your life. The tests are out there. You must know about them and decide for your self. Every life counts.


J.L. Richardson, MD, family medicine doctor, and patient advocate is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

Colonscopy for Colon Cancer Screening

Have you had your colonoscopy?

• baseline if 50 years of age
• history of colon cancer in family
• personal history of colon polyps, cancer
• rectal bleeding
• have a disease that is a risk like Crohn's disease
• chronic abdominal pain
• rapid unexplained weight loss

Check with your primary care physician. You will then be directed to your gastroenterologist (GI doctor, for short) for a complete evaluation. Ask your PCP for occult blood stool cards to take home to check for blood in the stools.

The Hemoccult test checks for blood that is not detected by the human eye. After you complete your stool sample cards, return to your PCP by mail or in person. They will be checked by your doctor. Any GI exam without this test and/or a rectal is incomplete.

Best health!

J.L. Richardson, MD is a family medicine doctor, patient advocate, author and publisher of Patient Handbook to Medical Care: Your Personal Health Guide.

Deaf Health - Can You Hear Me?

I ran into a 43 year old gentleman at a local place of business. He asked me for money for food. I started talking to him and saw that he was reading my lips. He read lips very well. He failed to understand sign language. We were able to communicate enough to exchange names, and find that he was deaf from an early age possibly from birth. He was unsure. He was looking for work. We discussed how it is hard for many deaf people to get jobs because they are deaf.

I tipped him for his pleasant conversation and recognized the sadness of it all.
After this encounter with fate, I reflected on yet another deaf person that had been failed by the American health system. How this system is able to allow a hearing impaired young man get well into adulthood without proper medical attention to assist with his deafness. He should know how to sign. He should have money. He should have work. He should have health care. He should have been covered since birth.

I know this scenario all to well. I have a brother who was born deaf. The system is still failing him all around, too. He and most of his deaf community are at “poverty level”. Rather than the system continuing all assistance beyond 18 years of age, they encourage working versus working plus government assistance. How does the government expect him to pay money he supposedly owes them over a 10-year debt? Does he really owe them? Without steady employment and government assistance, it is impossible. Each time he applies for government help like Medicaid, Social Security Disability Income, etc., he is cast aside with uncertainty.

It is truly devastating to the human spirit. He has struggled with part-time jobs at minimum wage with no benefits. I have helped him find the medical care he needs. The whole family chips in to help him in all ways. It is a family affair. Many of his doctors give generous discounts when he “tells” them he is uninsured. This has really helped him get the medical care he needs. Over the years I have collected his records and taught him to work his way through the medical system.

His medical record is his basic communication tool along with reading lips, and writing things down. He is a master at sign language (and so many things), but none of his doctors know sign language. He requires an interpreter, but it is difficult to arrange when you are deaf and no one knows your language or how to use the TDD (telecommunication device for the deaf) phone devices or operator services. You can even do it on line. How do you get a doctor appointment? Often the emergency room becomes the primary care clinic.

If you are not heard, you are ignored or misunderstood. We must open our ears to the deaf and all people with disabilities. To be born deaf is not ever hearing anything. It makes us realize the importance of communication, another vital sign.


J.L. Richardson, MD, family medicine doctor and patient advocate, is the author of PatientHandbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com