5 Things to Do to Hold Your Physician Accountable

Truth or Consequences
@Ron Levine, Getty Images
In a recent Health Affairs article:
  • Two-thirds of doctors responding to a survey agreed that they should disclose serious medical errors to patients.
  • One-third did not completely agree that they should.
  • Nearly two-fifths said they did not completely agree that they should disclose their financial relationships with drug and device companies to patients.
  • Just over one-tenth said that, in the previous year, they had told patients something that was not true.
Lisa Iezzoni, lead author of the article incorporating the survey results and, a physician and professor of medicine at the Harvard Medical School and director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston said that ‰ÛÏPatients who do not get the full story might not be able to make an informed choice about the best course of action for their care. Until all physicians take a frank and open approach to communication, it will be very difficult to enact patient- centered care more broadly.”
Iezzoni and colleagues surveyed 1,891 physicians nationwide in 2009 to find out if they followed the standards on communication laid out by the ABIM Foundation‰Ûªs Charter on Medical Professionalism. That landmark document, published in 2002, urges doctors to be open and honest with patients and to disclose medical errors promptly.
Although the vast majority of physicians completely agreed that physicians should fully inform patients about the risks and benefits of treatment, many admitted not always following the Charter‰Ûªs standards on honest communication or maintaining trust with patients.
  • Nearly 20 percent of physicians said they had not fully disclosed an error to a patient in the previous year because they feared the admission would trigger a malpractice case.
  • More than 55 percent of physicians said they often or sometimes described a patient‰Ûªs prognosis in a more positive manner than the facts might support.
  • Women and under-represented minority physicians were significantly more likely to follow the Charter‰Ûªs provisions on honest communication compared to white male doctors.

  • More than a third of physicians did not completely agree that they should disclose all financial ties with drug and device companies to patients, even though such ties can influence treatment.åÊåÊ
So what to do.
  1. Consider the services of a patient advocate.

    Advocates are there on your behalf and will ask the tough questions and assure your care is coordinated. My friend Trisha Torrey has developed a number of tools to help patients get the support they need, and to help advocates and those who hope to become advocates develop the additional skills they need to do so.

  2. Visit Physician Compare to find baseline information about your physician.

  3. If your physician is prescribing a certain medication or suggesting a certain procedure, ask him/her to disclose relationships with drug or device companies.

  4. For family caregivers, consider the services of a geriatric care manager that can coordinate care for you if your loved one is a far distance away.
  5. Know what the most prevalent medical errors / causes are. They include: åÊ
  • Medication Errors

  • Bad Communication

    Click for the ten questions every patient should ask their doctor.åÊ

  • Infection

    Hospitals are one of the most likely places to receive an infection. This article reports on the incidence of high IV infection rates.

  • Falls

    Ten percent of falls for the elderly occur in hospitals. Patients who have other mobility issues like a broken leg, walker, or cane, can also find the clean hospital floors more slippery than those at home.

  • Surgical Errors

    Wrong site, wrong procedure, and even wrong patient surgeries are some medical errors. Speak to your surgeon about the procedure you are having, why you are having it, and what the surgeon will be doing during the surgery.

  • Pharmacy Errors

    Pharmacies can also make errors on your medication. In fact, according to this article from CNN, 30 million Americans are the victim of outpatient medication errors each year.

  • Lab Errors

    Types of common errors can include MRI or CT taken incorrectly, samples taken incorrectly, or results misinterpreted. If you feel your lab results are misleading, you are within your rights to ask for another lab test to confirm.

  • Treatment Errors

    Be sure to ask why you are having the treatment, how long the doctor has been doing them, and if there are any alternatives. This website is full of guidelines for treating many common illnesses.

  • Follow Up Care

    When discharged from the hospital or clinic, be sure and know what your follow up care is and what to expect from it.

  • Birth Injuries

    It may be the most joyous time in your life, but birthing a child can also lead to medical errors. The most common can result in serious injuries such as cerebral palsy and paralysis. Check several hospitals in and outside of your area. See the incidence of birth injury and, if possible, read reviews by other mothers who gave birth there.