How parents can help prevent doctors' errors

Claire McCarthyDoctors make mistakes. And they make them more frequently than you might think.

That’s the finding of a new study published in this month’s Pediatrics, the journal of the American Academy of Pediatrics. The researchers surveyed more than a thousand pediatricians—community pediatricians, academic pediatricians, and pediatricians in training—and found that 54 percent of them reported making a diagnostic error at least once or twice a month.

It’s not quite as bad as it sounds. Trainees made the most errors, and they are supervised—so more experienced doctors are poised to catch the errors before anything bad happens. And really, the errors were generally minor. The most common error reported was diagnosing a viral illness as a bacterial one. These are errors like thinking someone has strep throat, and prescribing antibiotics, when they actually just have a cold. It’s never good to overuse antibiotics, and antibiotics can have side effects, but it’s an error that’s unlikely to cause real harm. In fact, the survey showed that three-quarters of the doctors said they made an error that caused harm once or twice a year, or less.

But still, it’s a study that we should pay attention to. Doctors are human just like everyone else—and medicine is far less precise, far more of an art, than most people realize. The doctors in the study had various ideas about how to reduce medical errors, including having electronic medical records, increasing the amount of time spent with patients, doing closer follow-up of patients after seeing them, and improving teamwork.

That teamwork includes patients and families. It’s not just doctors and hospitals that have the power to decrease errors; patients and families do too. Here’s what you can do:
• First and foremost, understand—and accept—that doctors can make mistakes. This doesn’t mean that you can’t trust doctors, it just means that you should be an active and vigilant participant in your health care and the health care of your family.
• Make sure you give the doctor the best and most complete information possible. Know the details of symptoms, such as the exact temperature, when a rash started, names and doses of medications you’ve given, or how many times your child has thrown up. If your child has a chronic problem, like stomachaches or headaches, keep a journal of the symptoms and anything that seems to trigger them or make them better. It’s frustrating when families come in with vague complaints; it makes it so much harder for me to figure out what is going on.
• If your doctor doesn’t ask about something that you think could be important, bring it up. Don’t assume that it isn’t important just because you weren’t asked about it.
• Slow the visit down. When we doctors get busy, we naturally start wanting to move through a visit quickly.  I’m not suggesting you tell your child’s life story from conception, or go through the recipes for everything he ate, or otherwise keep the doctor there for an hour, but slowing things down a little can help everyone pay closer and more complete attention. Invite the doctor to sit down, answer questions slowly and completely, have your child undressed down to underwear to make a thorough exam easier. If you have any questions, make sure you ask them.
• If after the visit your child isn’t improving, or things change, let the doctor know!
• If your gut is telling you that your doctor has missed the mark, say something. You might be wrong—but then again, you might be right.

That’s the thing: all of us are capable of making mistakes. But when we work together, we can catch each other’s mistakes—and make them less likely to happen in the first place. So join the team—and help keep you and your family safe and healthy.