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.

3 thoughts on “How parents can help prevent doctors' errors

  1. I am a medical transcriptionist with a large transcription provider and I catch errors in dictations all day long. As I transcribe dictation into what will become the patient’s permanent medical record, every little yawn, crunch, cough, and noise in the background can make it hard to hear (yes, some of you doctors do love to dictate with a mouthful of your subway sandwich). As a doctor slurs his/her speech rushing through a dictation to get home, it becomes more challenging to accurately transcribe what the doctor is saying. The doctor can dictate an error, I can make an error, but then it is my job to catch that error or admit defeat and flag the problem area for review, and believe me I take catching those errors very very seriously. My point is, errors in the medical record can occur at many points between dictation and it landing in the chart. Of course, there are safeguards in place and we all strive to make sure every patient has an accurate medical record. Knowing this, I make it a point to make sure my pediatrician and my own doctor are looking at an accurate medical history. Being a mother of 5, I have made many trips to the clinic, and some of those are for chronic problems for a special needs child. Especially in visits with specialists for chronic problems, I think it is so important that parents are knowledgeable about their child’s diagnosis and are able to make sure the doctor has accurate and detailed information, and not just assume the chart he/she is reviewing is accurate.

  2. in 12 years of managing my son’s complex medical treatment, I have learned a few things. I write brief questions prior to the appointment and bring a copy for the physician as well as my son and me. In this way the doctor knows what we need to know, even if we cannot get through the list, he or she can get back to us at some point. If I am uncomfortable with the direction of treatment or recovery, I do alert the doctor(s), when my concerns are not addressed, seeking a second or third opinion is not only in the best interest of my child, it is being the best advocate possible for him or her. They often do not have the ability to speak for themselves, but I have always included my son in the decision anyway about when to move to a new doctor, or opinion. when he was overwhelmed with the amount of doctors, he needed to have a voice. I always made sure doctors were aware of this. We were not always heard on this fact, making my son feel un -heard even more. This caused me to become even more vocal on this point. It is the parent’s job to continue speaking for the child who often feels un-heard and overwhelmed in the midst of medical care.

    Mistakes happen in complex care. In my son’s care there was misdiagnosis, lack of prompt diagnosis, wrong medication used, low dosages used, and a multitude of problems complicated by his complex medical issues. “Doctors are human” is a good thing to remember and yet often bitter pill to swallow as the adolescent turns “adult”.
    Watching your child’s care is a right, a privilege, a fearful time for all parents. Doing the very best you can do for your child includes forming a working team with physicians. The team is an imperfect experience at time and highly emotional one because it involves your highly cherished entity, your child.

    Ginny Miller

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