I enjoy looking at health statistics. In my world, data are my friends. Data are tools that help me make choices. For instance, the odds that I will be killed in a shark attack are nearly one in 4 million; my chances of dying from a heart attack are one in five. Given these odds, I am focusing on maintain a strong heart and clear arteries. However, despite these odds, I am not going to jump into a frenzy of sharks, whereas I might skip my daily walk.
Back to health statistics, I was looking at the leading causes of death in the United States. Here are the number of deaths for the top ten according to the National Center for Health Statistics:
- Heart disease: 614,348
- Cancer: 591,699
- Chronic lower respiratory diseases: 147,101
- Accidents (unintentional injuries): 136,053
- Stroke (cerebrovascular diseases): 133,103
- Alzheimer’s disease: 93,541
- Diabetes: 76,488
- Influenza and pneumonia: 55,227
- Nephritis, nephrotic syndrome, and nephrosis: 48,146
- Intentional self-harm (suicide): 42,773
This list looks very straight forward, but is it? In a paper published in the BMJ (May 2016), Martin Makary and Michael Daniel reported that medical error is the third leading cause of death in the U.S. They estimate a death rate of above 400,000 annually. This high-ranking killer is not included on death certificates and thus does not show up in rankings as a cause of death.
This is scarier to me than jumping into a shark tank. When we are sick, we are vulnerable. Even if we trust our doctors, we are still at the mercy of a system that is bigger than our primary care providers. Between our medical team, pharmacy staff, insurance, labs, and so on, there are lots of opportunity for medical error.
You aren’t entirely helpless. There are measures you can take to minimize your risk of being a medical error victim. The U.S. Department of Health and Human Services has published the following 20 tips by the Agency for Health Quality and Research:
“What You Can Do To Stay Safe
The best way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.
Make sure that all of your doctors know about every medicine you are taking. This includes prescription and over-the-counter medicines and dietary supplements, such as vitamins and herbs.
Bring all of your medicines and supplements to your doctor visits. “Brown bagging” your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date and help you get better quality care.
Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you to avoid getting a medicine that could harm you.
When your doctor writes a prescription for you, make sure you can read it. If you cannot read your doctor’s handwriting, your pharmacist might not be able to either.
Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you get them:
- 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?
- When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?
If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four times daily” means taking a dose every 6 hours around the clock or just during regular waking hours.
Ask your pharmacist for the best device to measure your liquid medicine. For example, many people use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people measure the right dose.
Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does or if something unexpected happens.
If you are in a hospital, consider asking all health care workers who will touch you whether they have washed their hands. Handwashing can prevent the spread of infections in hospitals.
When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will follow at home. This includes learning about your new medicines, making sure you know when to schedule follow-up appointments, and finding out when you can get back to your regular activities.
It is important to know whether or not you should keep taking the medicines you were taking before your hospital stay. Getting clear instructions may help prevent an unexpected return trip to the hospital.
If you are having surgery, make sure that you, your doctor, and your surgeon all agree on exactly what will be done. Having surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. Surgeons are expected to sign their initials directly on the site to be operated on before the surgery.
If you have a choice, choose a hospital where many patients have had the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.
Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
Make sure that someone, such as your primary care doctor, coordinates your care.
This is especially important if you have many health problems or are in the hospital.
Make sure that all your doctors have your important health information. Do not assume that everyone has all the information they need.
Ask a family member or friend to go to appointments with you. Even if you do not need help now, you might need it later.
Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.
If you have a test, do not assume that no news is good news. Ask how and when you will get the results.
Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. For example, treatment options based on the latest scientific evidence are available from the Effective Health Care Web site. Ask your doctor if your treatment is based on the latest evidence.”