Re: Cost of medical error

[Guest guest]

I could not agree more with this, and our Doctors get paid more money than their

predessors, and make more mistakes. There are also too many drugs for them to

make mistakes with, and I am quite sure that the high ammount of cancer today is

caused by drugs. They simply do not know anything about the drugs they prescribe

in many cases.

The lack of diagnostic skills is also deplorable, not to mention the amount of

marital breakdowns caused by illhealth and wrong diagnoses. The effect it has on

the children and the cost involved in housing.

Worst of all just how many have died through Doctors errors.

Some of my records that could have helped me have in fact been removed, but how

many other peoples records have been removed.

I would like to type this article out that appeared alongside another article

about 1999-2000 as follows------

GPs HAVE LOST THEIR VOCATION SAYS SURVEY

Family doctors have lost their sense of vocation over the past quarter of a

century, a survey suggests.

Despite growing militancy in the profession and complaints over excessive

workload, todays GPs have, however an easier time in many respects than their

predessors. They make fewer night visits, work less at weekends, and take more

holidays. Being a doctor has become more of a job and less of a calling.

The marketing firm Sofres Healthcare interviewed 200 GPs in

Britain and compared their responses with those of a similar survey interviewed

in 1976.

Only 3 per cent of todays doctors say they entered the profession out of a

lifelong sense of vocation with 39 per cent in 1976.

One of the major complaints is that GPs have too little time with

patients--between six and 11 minutes, but their 1976 predessors were worse off,

spending between five and nine minutes with each patient.

END OF ARTICLE

It is quite clear from this survey that today no Doctor enters the profession

due to a calling if only 3 per cent did at the time of this article,but clearly

for the wages, so one can see why errors are being made.

They don't even visit patients at night,and also reluctant during the daytime

and at weekends and nights there is only the ambulance service, unless one is

lucky enough for someone to take them to the GP CALLOUT OR A & E.

They work even less since this article, but I wonder if mistakes have gone

higher since this article, if so one cannot blame this on too much work for the

DOC.

NO VOCATION for the job must surely mean that they do not care, in turn this

uncaring attitude for the job means they are prone to make errors.

HIGHER WAGES, LESS WORK, NO CALLING FOR THE JOB AND MORE ERRORS BEING MADE.

There may well be 250,000 citizens wrongly diagnosed with the wrong type of

Hypothyroidism, but what about all the rest of wrongful diagnoses and errors

made.

I also deduce from s article that Doctors have now got to have some

electronic brain to use instead of their own to diagnose, so do we need Human

Doctor or an elecronic brain to talk to for our diagnoses.

Kathleen

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> MISDIAGNOSIS LEADS TO BREAKDOWN IN DOCTOR-PATIENT

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> RELATIONSHIP

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> Charity urges NHS to provide doctors with diagnostic support systems to help

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> reduce levels of misdiagnosis

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[Guest guest]

Hi Sheila,

This is a great post - is anyone able to get onto Isabel and try to find out what they say about thyroid diagnostics.

best wishes

Mandy

[Guest guest]

As bad as it is in the UK, I honestly don't think it's much better in the US.

The DRs here are nothing to admire, not personally or professionally.

What always enters my mind is why do some patients listen to their Drs and why

do others turn and run? Why do some people keep sliding down the downward

spiral, when others are allowed to heal? I ask people all the time why they

continue to be treated by incompetent Drs, and their answer is usually something

like, *He's conveniently located.*

We can light a candle, say a prayer and hope that people will find a support

group. We can hope that they will use their intuitive and seek a better

alternative.

In the meantime, we need to fight the good fight for better care.

Cheers,

JOT

[Guest guest]

It would depend upon who was 'feeding' the information into the

electronic brain to start with Kathleen - if this would be the British Thyroid Association

activists, then we would be no better - i.e. no diagnosis if TSH is returned

with reference range 0.5 to 10.0 - if a diagnosis is given, treat ONLY with

levothyroxine. If patient treated with levothyroxine-only still complains of

symptoms and her thyroid function test results are within the 'normal'

reference range, that patient is suffering from a " functional somatoform

disorder " - meaning it's all in their head so they are offered

antidepressants.

Dfiferent forms of 'Hypothyroidism' demand different ways of

diagnosing and different thyroid hormone replacements.

Type 1 hypothyroidism, is defined as primary,

secondary, and tertiary hypothyroidism and is properly associated with

insufficient secretion by the thyroid gland, thereby reducing the

prohormone thyroxine (T4) available for conversion, to the active

hormone triiodothyronine (T3) to energize the body. The most

common cause originating within the thyroid gland is disease process. It would

however still be considered primary, secondary and tertiary hypothyroidism

(Type 1), even if it is due to a damaged gland, e.g. when damage is caused in

an accident or damaged due to excessive exposure to radioactivity. Type 1

Hypothyroidism may be corrected by using levothyroxine (T4-only) replacement.

Type 2 hypothyroidism is defined as deficiencies in

the peripheral conversion of T4 to T3, the subsequent reception of T3, and the

use of T3 by the body's cells. This ignored hypothyroidism reduces the

amount of the active thyroid hormone T3 in the body, producing the same sort of

symptoms that Type 1 hypothyroidism does. Environmental toxins may also

cause or exacerbate the problem. The pervasiveness of Type 2 hypothyroidism has

yet to be recognised by mainstream medicine but already is in epidemic

proportions. Type 2 hypothyroidism can be corrected by T3 hormone replacement

therapy - and not by thyroxine-only therapy.

….but telling that to the British Thyroid Association

activists makes no difference to their recommended diagnosing and treatment

protocol - everybody should still get well with levothyroxine-only.

Luv - Sheila

There may well be 250,000 citizens wrongly diagnosed with the wrong type of

Hypothyroidism, but what about all the rest of wrongful diagnoses and errors

made.

I also deduce from s article that Doctors have now got to have some

electronic brain to use instead of their own to diagnose, so do we need Human

Doctor or an elecronic brain to talk to for our diagnoses.

Kathleen

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[Guest guest]

Hi All,

Funny this should come on post - I was just saying to my husband that I think the changes that are going to happen in the NHS are going to make a natural turn towards better diagnostics.

It is already being said that BP tablets are unnecessary for a lot of people when other changes could be made - that statins should not be given out like smarties - (this is coming from the scientific field not the government by the way) this can only be a good thing and what I hope will happen will be a natural progression - as they cut down on the drugs bill - towards preventative medicine.

Of course the 'vested interests' in the NHS won't like it - they are SO militant the GMC - but given time I think this is the only way it can go - I see it as the industrial revolution within the NHS.

I went to see one of the new GP specialists the other day about a mole on my face - he told me he had instructions to cut down on any unnecessary treatments for skin issues (not the Government but the GMC) - he was not happy with this - but we had a discussion - he was very informed - he said he is getting all the latest scientific research sent to his mobile now - so because of the responsibility he now has in his new role - he has had to update his skills. I don't think the GMC intended this to happen they are just being bloody minded about their new role as budget watchers - but out of this could come a new type of medicine and that can only be applauded - it won't be long before GP's are reporting thousands of people with endocrine disorders and asking for the endo's to do something about it.

Fingers crossed a new dawn in the NHS and long may it continue.

By the way I got permission for my mole to be removed !!!

Best wishes

Mandy

[Guest guest]

Hi Sheila, Can we have this in the files? it's so very important. ( deliberately not cut sto encourage as many folk as possible to read this)thyroid treatment From: sheila@...Date: Fri, 22 Apr 2011 18:11:10 +0100Subject: Cost of medical error posted the following link to me andI think you should all read it. This is what we are up against as over 250,000citizens in the UK alone are being misdiagnosed with the wrong type of'hypothyroidism' and not given the correct thyroid hormone replacement to helpus regain optimal health. http://www.isabelhealthcare.com/pdf/misdiagnosis.pdf Luv - Sheila MISDIAGNOSIS LEADS TOBREAKDOWN IN DOCTOR-PATIENTRELATIONSHIP Charity urges NHS to providedoctors with diagnostic support systems to helpreduce levels of misdiagnosisSixty percent of people fearillnesses will not be correctly diagnosed when they visittheir GP, a YouGov surveycommissioned by The Isabel Medical Charity revealstoday. Concern aboutmisdiagnosis also remains a significant factor when patientsundergo treatment at NHSHospitals – with almost one in three (31%) agreeing thisis the type of medicalmistake which concerns them most according to the research.A third of respondents haddirectly experienced, or knew someone who hadexperienced, a medical error,with 57% of the mistakes due to misdiagnosis.The findings follow aNational Audit Office report, which found that accidents withinthe NHS needlessly kill 2,000patients a year1.In response, The IsabelMedical Charity last night stepped up its campaign for thewidespread adoption withinthe NHS of diagnostic support systems. The charity’sown, unique system is calledIsabel, and was developed to aid doctors in makingdiagnoses as just onepotential solution to help reduce the level of diagnosticmedical error in the NHS.Mr Maude, Co-founder ofThe Isabel Medical Charity, says: “It is clear thatmisdiagnosis is a huge issuefor clinicians and the general public. Patients are rightto demonstrate such concern.My own daughter very nearly died after beingmisdiagnosed so I know thatthe aftermath of even one mistake can be devastating,and our report shows that 32%of the medical errors experienced by our respondentsled to death or permanentharm.â€Although the NHS, throughConnecting for Health, is spending £6.2bn on installingelectronic medical recordsacross the UK, information systems designed to activelyhelp doctors in makingclinical decisions are only scheduled for the final phases ofthe programme which wouldmean delivery by 2009 at the earliest, even thoughmany of these systems areavailable and working today.Sir Jarman, formerpresident of the BMA and Head of the Dr Unit atImperial College commented:"Connecting for Health's stated objective is to harnessinformation technology toolsfor the benefit of patients. Although their deliverytimetable is centred aroundbig projects like 'Choose and Book' (which is already 18months behind schedule) itcould be very helpful for clinicians if practical andclinically proven2 systemslike Isabel, which I understand could be put to practicaluse immediately, were to bemade more generally available".US physicians have been quickto reap benefits from the Isabel system and five topchildren’s hospitals in theUS have already adopted the paediatric version.Dr Bergsagel, apaediatric oncologist at Atlanta and Emory University School ofMedicine, claims thetechnology has helped him identify the right diagnosis severaltimes. The most dramaticexample involved a patient where all signs initially pointedto acute myelocyticleukaemia, he comments:“The Isabel system remindedme of a rare form of leukaemia which we had notconsidered and requires a bonemarrow transplant. Aggressive chemotherapy wouldnot have been helpful andpotentially very dangerous. Isabel prevented a seriouserror in diagnosis and islikely to have saved this patient’s life.â€More than two thirds (67%) ofthose questioned for the survey, agreed that theywould approve or be reassuredif their doctor referred to a specialised computersystem which could remindthem of likely diagnoses.1 Report published 3 November20052 See notes on research inpoint three below-ENDSForfurther information on thesurvey or to arrange an interview pleasecontact: Pearson at MediaStrategy – 020 7400 4480 orspearson@...Editors’ Notes1. The survey: Researchwas conducted online by YouGov between 14th and 17th October2005. YouGov interviewed arepresentative sample of 2,155 GB 18+ adults. Results areweighted to be representativeof the GB adult population. A copy of the full findings isavailable on request.2. History of the Charity: and Charlotte Maude founded the project in July 1999together with Dr phBritto, then Paediatric Intensive Care Consultant at St ’sHospital in Paddington,London. Three months prior to this, the Maude’s 3-year-olddaughter, Isabel, had beentransferred by a police escorted ambulance from her localhospital to St ’s whereshe was to spend two months in hospital, including a month onIntensive Care, afterdeveloping multiple organ failure and suffering a cardiac arrest. Allthis because doctors hadfailed to recognise that the symptoms she was developing werepotentially fatalcomplications from chicken pox. During their time in hospital, the idea of adiagnostic tool slowlyevolved during conversations between the Maudes and Dr Brittowho gradually gathered thesupport of a number of high profile professionals fromhospitals around the UK andaboard to start work on the Isabel system.Apart from the human cost ofthe error, the cost to the NHS of this mistake is estimated at£150,000. Had the illnessbeen recognised and treated earlier the cost would probablyhave been no more than £50 ofantibiotics. The charity estimates that the cost to the NHSof preventable diagnosticerror to be at least £500million per year not including anysubsequent litigation costsor the associated human costs.Today the Isabel system, nowdeveloped and marketed by the charity’s trading subsidiaryIsabel Healthcare Ltd, coversall age groups and all major medical specialities and is inuse across top hospitals inthe US, UK, Ireland and India.For further information: www.isabel.org.uk3. Research into theeffectiveness of the Isabel diagnosis reminder system: Since2001 the Isabel system hasundergone a rigorous validation programme much of whichhas been funded by theDepartment of Health. Instudies to demonstrate its accuracy Isabel has consistently shown that, whengivena patients initial signs andsymptoms, the correct final diagnosis will be included in itslist of suggested diagnoses95% of the time. Instudies to show what effect the use of Isabel could have on a clinician’sdiagnosticskills the results have shownthat between 10% and 14% of times that a clinician usesIsabel he will be reminded ofan important diagnosis that he had not thought of. Inmore than half of theseoccasions it turned out to be the patient’s actual finaldiagnosis. These studiesdemonstrate strongly that Isabel could help clinicians reachpatients accurate diagnosesmore quickly.4. Peer reviewed research onmisdiagnosis: Unfortunately there have been no studiescarried out in the UKspecifically on misdiagnosis which was why the charitycommissioned this YouGovsurvey. However studies have been carried in many othercountries, especially theUSA. We highlight below three significant articles which haveappeared during 2005 alone. QUANTUMOF DIAGNOSIS ERROR:Gordon D. Schiff, SeijeoungKim, Abrams et al. Diagnosing DiagnosisErrors: Lessons from aMulti-institutional Collaborative Project . Advances inPatient Safety 2005;2:255-278A recent multi-institutionalcollaborative project by Schiff et al, funded by the Agencyfor Healthcare Research andQuality (AHRQ), reported that diagnosis errors faroutnumber medication errorsas a cause of malpractice claims (26 % versus 12 % inone study;32 % versus 8 % inanother study). A poll commissioned by theNational Patient SafetyFoundation found that 1 in 6 people have experienced amedical error related tomisdiagnosis. Most medical error studies find that 10–30 %(range = 0.6–56.8 %) oferrors are errors in diagnosis. A recent review of 53 autopsystudies found an average rateof 23.5 % major missed diagnoses (range = 4.1–49.8%). FACTORSCONTRIBUTING TO DIAGNOSIS ERROR:Mark Graber, MD. Diagnosticerror in internal medicine. Arch Intern Med. 2005 Jul11; 165(13):1493-9What factors contribute todiagnosis errors? A July 2005 study of diagnosis error byphysicians, Mark Graber,M.D., chief of medical service at the VA Medical Center inNorthport and vice-chair ofthe Department of Medicine at SUNY Stony Brook, NY,analyzed 100 cases ofdiagnostic error involving internists. 90 cases involved injury,including 33 deaths. Theunderlying contributions to error fell into 3 natural categories:“no fault,†system-related,and cognitive. 7 cases reflected no-fault errors alone. In theremaining 93 cases, weidentified 548 different system related or cognitive factors (5.9per case). System relatedfactors contributed to the diagnostic error in 65% of thecases and cognitive factorsin 74%. Failure to continue considering reasonablealternatives after an initialdiagnosis was reached, was the single most commoncause. INCLINATIONTO USE CLINICAL DECISION SUPPORT: P. Friedman, PhD etal. Do Physicians Know When Their Diagnoses AreCorrect? Implications forDecision Support and Error Reduction. J Gen InternMed 2005; 20:334-9.The decision to seek help oruse a diagnosis decision support system can bepredicated by the alignmentbetween a physician’s confidence in a diagnosis andcorrectness of the diagnosis.A study by Friedman et al at the Centre for BiomedicalInformatics, University ofPittsburgh, PA, found that subjects’ confidence andcorrectness were only “mildlyâ€aligned. Residents were overconfident in 41% of caseswhere their confidence andcorrectness were not aligned, whereas faculty wasoverconfident in 36%.Residents & faculty (correctly diagnosed 44% and 50% ofdifficult cases,respectively) were overconfident, placing credence in a diagnosis thatwas in fact incorrect, in 15%and 12% of cases.Doctors own views of medicalmistakes: In June 2004 a survey by Doctors.net.uk of 2,582doctors showed that 80% hadeither seen a colleague make a mistake or had made onethemselves that had had an impact on the care of a patient.

[Guest guest]

HI ALL

I would like to add the danger of Antisychotic drugs that should be banned. They

are being prescribed without proof or even blood tests that one needs them. I

have been on enough to know that they are not safe, and in fact bcaused me to

have cancer. I was even told the drug was safe, but how wrong could they have

been.

I have more recently been asked if I would like to have another one said again

to be safe, and provided with 2 A4 pages of side effects. I have however come

across more pages and side effects. One of the side effects is that they can

cause sudden death in an older person. I for one would not take the risk of

having a drug of this nature and I can say " thank goodness for the internet that

the side effects that Doctors are not informing us of can be found out "

These drugs have been used in homes for the elderly where they have made them

worse and even caused death, and all I can say is " are they being used for

euthanasia without the permission of the patient "

Doctors have also been advised not to use them on older patients, yet they are

still being used.

I for one no longer trust the health service, and trust in my own judgement

more, as I know how I feel, but antisychotics in turn prevent one from knowing

the bad effects that other drugs are having on you, and blood tests are

definatley not reliable.

A Doctor who gets such high wages without having to work the hours of his

predessors should in fact be able to diagnose correctly by ones symptoms.If not

is there a purpose to have a Doctor.

My experiance of hospitals has not been good either, having been placed next to

a patient with a nasty chest which in turn caused me to get pneumonia having

ended up in another hospital as an emergency. I do not blame the poor patient

but the hospital I do, especially when so much has been put to hospitals to

prevent infections.

I have to wonder if as a result of hospital infections that it would be safer to

have an operating theatre come to the patients home with the aftercare, as no

patient can cause another to be infected.

I for one will refuse to go into a hospital until the situation improves,

despite any advice from a GP, as I have seen this before and the patient has not

come home, but died.

Perhaps the TPA could have a vote to see just how many of us would trust a

hospital or a Doctor. How about this Sheila?

I also think patients will trust charities more, and in turn charities will

learn more. It also helps patients to know that others suffer from the same

symptoms and that it is not in our minds, and we are neither mental or

hypochondriacs, as many of us have had this thrown at us by our Doctors, but

what has this in turn done for us in trusting the profession.

I hope Mandy that your views on the changes in the NHS prove to be correct.

Kathleen

>

> Hi All,

>

> Funny this should come on post - I was just saying to my husband that I

> think the changes that are going to happen in the NHS are going to make a

> natural turn towards better diagnostics.

>

> Best wishes

>

> Mandy

>

[Guest guest]

i have a close relative on these and she has ended up with shaky hands now. i

wondered if it's 'tardive dsykinesia'. in any case i think she has become worse

on them.

>> These drugs have been used in homes for the elderly where they have made them

worse and even caused death, and all I can say is " are they being used for

euthanasia without the permission of the patient "

> Doctors have also been advised not to use them on older patients, yet they are

still being used.

i think they're also used as chemical cosh, to sedate people who are 'too much

trouble'.

chris

>

> These drugs have been used in homes for the elderly where they have made them

worse and even caused death, and all I can say is " are they being used for

euthanasia without the permission of the patient "

> Doctors have also been advised not to use them on older patients, yet they are

still being used.