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with Lisa Zamosky

The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.

Tuesday, July 5, 2011

Danger in the Doctor's Office?

With so much attention paid to the safety risks associated with hospital care, doctors' offices and other outpatient health care settings have slipped under the radar. Until now, that is.

A study recently published in the Journal of the American Medical Association (JAMA) found that the chance of a serious medical error occurring in outpatient settings is about the same as in a hospital. At least, that was the case in the nearly 11,000 paid malpractice claims that were studied.

What's going on? A number of factors may be at play -- incorrect diagnoses, more surgeries being conducted in outpatient settings with fewer safety measures in place, a lack of care coordination, and overworked doctors.

Unfortunately, the situation isn't totally within your control. But there are steps you can take to help make your care safer in an outpatient setting.

Here are a few precautions, suggested by the Agency of Healthcare Research and Quality (AHRQ), that you can take to protect yourself against common medical mistakes.

Take an active role: According to the AHRQ, "Research shows that patients who are more involved with their care tend to get better results." Talk with your doctor and clearly state how you'd like your care to go and ask specific questions about the care you're receiving, why it's necessary and what you should expect.

Talk medicine: It's critical that your doctors and nurses know all of the medications you're taking, including over-the-counter drugs, and vitamins and any other supplements. If it makes it easier for you, bring all of your medication bottles in a bag to your doctor. Mention any allergies you have.

In addition, AHRQ suggests talking with your doctor about the medications being prescribed so that you clearly understand what you're taking, how it should be taken and why it's important.

Here is a list of suggested questions to ask your doctor:
  • What is the medicine for?
  • How am I supposed to take it, and for how long?
  • What side effects are likely? What do I do if they occur?
  • Is this medicine safe to take with other medicines or dietary supplements I am taking?
  • What food, drink, or activities should I avoid while taking this medicine?

Finally, make sure you can read any prescriptions your doctor writes for you. If you can't read it, there's no reason to think your pharmacist will be able to. Problems can happen -- just recently, the FDA warned of mix-ups in which patients who were mistakenly given the antipsychotic drug risperidone (brand name Risperdal) instead of ropinirole (Requip), a drug used to treat Parkinson's disease and restless legs syndrome, or vice versa.

Spread the word: The U.S. health care system is incredibly fragmented. Assume that each new doctor you see doesn't know your full medical history, because he or she likely doesn't. Become a broken record and share important information about your health with each new provider with whom you come in contact. And talk with your primary doctor about taking charge of your care and coordinating with other health care providers you see.

Ask for results: Never assume that not hearing results about a recent medical test you've taken means that nothing was found. Always call to find out exactly what the outcome was.

Bring a friend: It's a good idea to have a friend or family member who can advocate for you and help you ask questions.

Got a health insurance question? Post it below. I'll respond in this blog each Thursday to as many of your questions as I can.

Bishop, T. The Journal of the American Medical Association, June 15, 2011; vol 305: pp 2379-2484.
Agency for Healthcare Quality
WebMD Health News: "FDA Reports Requip, Risperdal Medication Errors"

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Posted by: Lisa Zamosky at 8:00 AM


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