Nine Strategies to Avoid Being a Victim of Medical Malpractice

Medical Malpractice relates to the negligence that results in errors and injury to a patient during the course of care. The Journal of Patient Safety estimate that there as many as 400,000 deaths per year due to medical error. Errors leading to harm could be as high as 10-20 times that number. In other words, perhaps as many as 4 to 8 million people are harmed each year. Errors that are preventable are the basis for malpractice because often there is some form of negligence. To avoid errors occurring there are proactive steps you can take to avoid being one of these statistics.  

Misdiagnosis is a common medical error. Getting a second opinion can help avoid errors in care.

To take steps to avoid errors in your care, it is important to know the types of common errors, which include misdiagnosis, failure to effectively treat, incorrectly administered or prescribed medications, surgical errors, anesthesia errors and more. Errors are often the result of several contributing factors that add up to contribute to an adverse outcome. Breakdowns in communication tends to be a contributing factor in over 90 percent of adverse events or medical errors.

Pressures on our Healthcare Systems

Medical care is becoming more and more complex as technology interfaces with traditional forms of medicine. Disintegrated systems increase complexity, and many healthcare providers work in a system not designed well for their success. Human factors errors are common in complex fast paced environments.

Due to rapidly expanding costs of care, healthcare is under extreme delivery and payment reform pressures.

How care is coordinated, managed, transitioned are all being impacted. Payment is moving away from fee-for-service to value-based payment.

Our healthcare system is not structure well across the board to meet challenges. It is made up of separate independent, incongruous healthcare providers. Medical records are not standardize making communication challenging.

Patient acuity and volume is increasing on balance as the US population ages and baby boomers continue to retire. As demand for services increases and people live longer, the demand on healthcare providers will increase, unless there are expansions in our current systems from primary care to acute tertiary and quaternary care. One might expect these demands, as we saw during Covid-19, will strain our system, making the system and those in it prone to errors.

Our Role in Avoiding Error

Healthcare isn’t something that should happen to us.

Our health should be driven first by us as individuals, secondarily by our family and third by and with those we choose to seek care from, should we have a choice. We drive our care through knowledge and engagement. We seek information, we ask questions, we get other’s opinions, we change behaviors, we participate fully.

Standards of Care & Evidence-Based Medicine

Rapid advances in medicine creates a gap to disseminate medical practice effectively across a complex system of rural and urban providers of different specialties and levels of care. Advances in care lead to new standards of care. A standard of care is simply the best-known way of delivering care for a patient’s specific diagnosis given a patient’s unique physical condition. A patient’ condition may be impacted by many factors such as age, gender, other health concerns, such as co-occurring conditions.

Evidence-based medicine has a track record for effective, measured and documented results or outcomes proven by similar providers, in similar settings with similar patients. As new proven methods of care increase in efficacy, it creates a new standard of care.

When you seek care, you want to ensure you are receiving the current best standard of care for you and that it is followed as prescribed by your physician. When it isn’t, it creates a gap between the care you receive and the care you could have received, often leading to different outcomes. That may lead to medical malpractice.

There are things that you and your family should do when seeking medical care after receiving a diagnosis. 

1.     Understand the Diagnosis & Prognosis A diagnosis is the identification of an illness or medical problem that effects your health. In medical care, when a diagnosis is made it receives an ICD 10 Code, which is specific and descriptive so much so that can be used to estimate the amount of care needed from medical providers from a payment perspective. ICD stands for International Classification of Diseases. Understand your diagnosis and the different treatments available.

Once you know what your diagnosis is, work with your healthcare provider to understand what the prognosis is for the diagnosis, if known. A prognosis is the likely course of the disease based on your unique condition. You may require additional tests to sharpen the prognosis. Think of a prognosis as your forecast for health. It is an educated prediction based on many factors that can affect your outcome. Depending on the illness, a prognosis can be more or less accurate based on the information available. In the case of a chronic disease diagnosis, such as congestive heart failure (CHF), think of a chronic disease prognosis as a longer-term forecast. Chronic disease generally last more than one year and can continue through death.

Once you know your diagnosis and prognosis and ask questions. Take notes. Some hospitals provide free services to do evidence-based research on your illness. Take advantage of that. Research how academic medical centers are treating similar illness and ask your doctor about it. Ask if care other than what is being recommended may be right for you.

The bottom line is you must have a clear understanding of your diagnosis and prognosis to fully participating in understanding your options and creating your treatment plan that is right for you and your goals.

2.     Get a Second Opinion Just like not all baseball players are of the same caliber, neither are doctors. You may not know if you have a superstar doctor or a benchwarmer. One key to ensuring your diagnosis and prognosis is accurate is to get a second opinion from a medical provider who reviews all of your tests, imaging, exam notes, labs, etc. Many medical malpractice claims are based on failure to diagnose and treat. Getting a second opinion will help mitigate the potential of his happening. Perhaps a second opinion discovers that the diagnosis is wrong. If so, you may have avoided a treatment plan that could have harmed you. Maybe you luck out and get that superstar doctor who gets it right. And if not, a confirming second opinion may begin to build a plan of care that you have confidence in to produce the best outcome healthcare can support given the range of treatment options.

3.     Know the Outcomes A good plan of care should be well defined with relatively predictable outcomes and probabilities base on factors like age, disease stage, etc. Based on your conditions and factors, know what the probabilities are. This will help you ensure you get the appropriate care to match your condition. Also, know what you can do to improve your prognosis. The key is that you want to establish a plan of care that matches the standard of care that exists resulting in the best outcomes possible. Once you know the desired outcomes, understand the plan of care that is being delivered. This may seem obvious but to many it is not. You want to connect what must be done in your plan of care to the achievement of the outcome you want. That will help you understand why you are getting specific care. It will also support your engagement in your care. Physical therapy after a total joint replacement will help you get back to the mobility goals you have. Cardiac rehabilitation will help you improve cardiovascular health after treatment.

4.     Know Signs and Symptoms of Adverse Events For every medical procedure, there is risk. Know what the risks are and the associated symptoms so that you can seek care immediately. The longer a patient is in a hospital the greater the chance of developing a hospital acquired condition, such as a pressure injury or fall or infection. If you went through surgery, be sure to recognize the symptoms of an infection. Many discharge instructions inform patients to be aware of certain adverse conditions. Be sure to call your doctor immediately if you suspect something isn’t right.

5.     Identify Your TeamUnderstand who needs to be on your healthcare team. What specialists must be coordinating care with your primary care physician (PCP). Do you need diet support, home health support, medication support from a pharmacist? Ensure that you know who is on your team and bridge the gaps that may exist. You are the link between all of them. If you have challenges navigating your team, there are resources such as patient and family advocacy available at hospitals at no charge to you. Case managers or care coordinators can also help. These healthcare experts can help bridge gaps between providers and resolve problems before they impact your healthcare outcomes. Check with your insurer, hospital or PCP office may have case management services that can help coordinate care.

6.     Be the Conduit and Center for Communication Communication problems exist in nearly all patient safety events when performing root cause analysis. That means that communication was a contributing factor or a causal factor in outcomes. To overcome poor communication between healthcare providers, be the conduit for communication. Repeat your story and history, ensure to reiterate tests, labs, image you have been given. Ask if pertinent information has been reviewed, and if not, ask your provider to review it. Share what you have been told and what you have been prescribed to do. Never assume someone knows your needs. Engage your family members to be your patient advocate. Empower them to be involved, to ask questions and advocate collaboratively with healthcare providers. Being the conduit for communication can come in many forms. It will feel very repetitive. But you are ensuring everyone has critical information.

7.     Understand Your Treatment Plan This may seem obvious. The reality is that healthcare is complex, and many patients may not know the reason why they are taking certain medications or having tests performed and what the results mean. When you don’t understand your treatment plan, you cannot drive your healthcare decisions.  Many hospitals and healthcare entities have created communication guides and pamphlets on certain common conditions. If they exist, ask your doctor to review it with you until you feel you have a clear understanding of your treatment plan. Your treatment plan should span the continuum of care, which simply means across all levels of care. Your primary care physician should be coordinating care with your specialist, and both perhaps with a surgeon, or home health services. Your physical therapist must be aware of how to support your needs by following an established plan of care. By understand your treatment plan, you and your family can bridge the gap and ensure transitions of care are smooth and that care is managed effectively so things don’t fall through the cracks and you get injured in the process. 

If you have surgery, understand your postoperative instructions. Get those instructions to your other healthcare providers.

8.     Access Your Records Be sure to take advantage of online health portals that have your records and notes available. If the notes of your care are not available, ask that they be provided. This will help connect each intervention provided with the overall care plan. If things don’t add up, write down questions and ask doctor during your next visit. Many medical errors are discovered by patients reading in their charts.

Remember that as a patient, you own your record. You have the rights to see the information about your care. Accessing records often leads to finding discrepancies. You may need to follow up for a test or imaging in a prescribed timeframe but have not been informed. Knowing what follow ups are required can prevent care management blunders from ending up in a major medical error or a major change in prognosis.

Many healthcare organizations embrace OpenNotes, which helps improve access to information such as physician notes to enhance communication.

9.     Do Not Sign an Informed Consent Unless You Understand Every Aspect of It An informed consent is a document you will need to sign consenting to specific types of care, such as a procedure, surgery or testing. If you receive a Consent as a paper to sign, don’t until it is reviewed with you by the healthcare provider seeking the consent, your doctor.  Be sure to understand every aspect of the informed consent. The risks, the associated probabilities, the anticipated outcomes of the procedure, test, etc., and the outcomes if care.  

These strategies can help you avoid becoming a statistic of medical error. Medical malpractice is more common than we realize as we learn of only publicized cases in the news. As the data in the Journal of Patient Safety suggests we are at risk for a healthcare error when we seek care. Using these strategies can help prevent medical errors before they occur.  

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EvaluCare provides medical care review services for patients, families and attorneys. If you have concerns about the care you, a loved one or a client received, EvaluCare can arm victims with the knowledge they need to get the settlements they deserve. If you or a loved one needs medical care reviewed, email info@EvaluCare.net or visit EvaluCare.net