Medication Errors In Half of Surgeries

On November 8, 2015, in Dr. Dino Pappas, Uncategorized, by Dr. Dino Pappas
Medication Errors

Medication Errors in Hospitals By Type

A recent article (Disturbing New Study Finds Medication Errors in Half of All Surgeries) caught my attention. WOW, what an eye catching headline. Immediately a knee jerk reaction forms with the title and the following data:

The Facts

  1. Reputation: The study was performed at a reputable hospital (Massachusetts General Hospital) which is affiliated with Harvard. The hospital is a national leader in research, specialty and sub-specialty care as well as patient safety (1).
  2. Preventable Mistakes: The article notes that 80% of the mistakes were preventable (1).
  3. Adverse Events: 1/3 of the mistakes led to adverse reaction to medication (1). Adverse events are complications from a medical intervention. Complications could include simple things like nausea, vomiting, diarrhea, headaches, constipation or more concerning events such as shortness of breath, allergic reaction or even death.
  4. Potential Adverse Events: 2/3 of the mistakes had the possibility of triggering an adverse reaction (1).
  5. Categorization: 64% of the mistakes were termed serious. 33% of the mistakes were significant and 2-3% were life threatening (1).
  6. Under Reporting:  The article notes that the study was performed at one of the most prestigious hospitals (Massachusetts General) in the United States that is strongly affiliated with one of the better medical programs (Harvard). The hospital has a strong track record in patient safety and advocacy. This means that in other hospitals and surgery centers across the United States, under reporting of medication errors and adverse events occurs (1).
  7. Medical Mistakes – 3rd Leading Cause of Death: Medical mistakes constitute the 3rd leading cause of death in the US.  The first two are heart disease and cancer. The total number of anticipated early deaths from medical errors is 400,000/year (1,2).
  8. Billions Wasted: $765 billion of health care costs were linked to preventable problems (1).

At this point, you probably have a strong, visceral reaction to the headline and stats. That reaction still doesn’t solve the problem. So please, pause, breathe and take a step back.  Let’s dissect the data a bit and come up with some solutions.

Solutions

1. Prevent The Preventable Through Early Recognition: Lifestyle factors such as obesity, poor diet, lack of exercise, smoking, sedentary lifestyle, etc. are becoming more of an issue in chronic disease and death. Chronic disease strains our health care system. The risks go up for medication usage, surgery, extended hospital stays, poor outcomes and chronic pain. So prevent the preventable through early recognition that your health habits today matter tomorrow!

2. Make Some Simple Changes: Make simple changes to your lifestyle. Simple habits repeated frequently over and over again lead to major change with time. Remember, your health is not a sprint, it is a marathon. Two examples of simple changes we’ve recommended are:

  • A). Pedometer: Get a pedometer or a pedometer app on your smartphone. Track your daily steps. A goal would be a range of 5,000-10,000 steps/day at least 3 days/week.  Incorporate a “walking buddy” into your routine.  This simple strategy has accountability (“walking buddy), data tracking (steps, miles/distance, time, etc.) and simplicity built in. You can walk anywhere at any point in time. It is not necessary to have a high priced gym membership, participate in time consuming exercise classes or have expensive and unnecessary equipment. If you repeat this simple habit over and over again, it will lead to better health. We had a patient lose 25+ lbs in a year, just by walking several times a week with her friends.
  • B). Protein Shake: People sometimes have the mid-morning or mid-afternoon energy crash. Sometimes they’ll use caffeine, sugary foods or beverages (soda, sweet tea, coffee with sugar, lattes, energy drinks, etc.) to patch the energy gap. This is an extremely bad strategy long term as this can contribute to obesity, diabetes, metabolic syndrome, heart disease and other chronic diseases. A simple strategy is to buy a gallon of healthy milk (almond, rice, cashew, flax, etc.) and a protein powder of your choice. Keep the milk and protein powder at work. Make a protein shake between meals to stabilize your energy level. This strategy provides satiety (the feeling of fullness), reduces blood sugar swings, increases energy, and reduces non-necessary calories that come with high calorie, nutrient deficient foods and beverages. I once worked with a colleague that would have a daily Starbucks Frapaccino or Venti White Chocolate Mocha depending on the season almost every afternoon. He switched to daily protein shakes between meals and made no other changes to his diet or exercise habits.  In one year he lost 20+ lbs.

Simple changes repeated over time reduce the chances for chronic, lifestyle based disease. This has the added effect of reducing the chances for medication and surgeries to treat these problems.

3. Start with Conservative Care Options First: Many non life threatening problems do not require medication or surgical management, especially those involving neuromusculoskeletal (NMS: nerve-muscle & soft tissue-bone) health. Problems such as shoulder pain, elbow pain, wrist pain, back pain, neck pain, carpal tunnel syndrome, plantar fasciitis, knee pain, hip pain, foot/ankle pain, etc. are often very treatable without medications or surgery. Make sure you exhaust conservative (non drug, non surgical) options first before you take the next step.

Research has consistently shown in the area of NMS health that the provider type that you start with is a indicator of your health care track. This means that if you start with a conservative care provider (chiropractor, physical therapist, integrative medicine physician such as an medical doctor or osteopath, naturopath, napropath, etc.) odds are that’s what treatment options you’ll receive. If you start with a specialist such as a surgeon, odds are greater that you’ll end up with medication or surgery. Some of the studies I’ve read account for crossover diagnoses meaning diagnoses that are commonly seen by both types of providers (conservative and traditional medical providers). For example, rarely do simple spinal problems like degenerative discs and osteoarthritis require surgical intervention; however, the odds are greater you’ll end up with more aggressive and costly options if you see a spine surgeon prior to a conservative care provider. Form great relationships with physicians and conservative care providers you trust to route you to the right treatment strategy for you and for your condition.

4. Identification of the Specific Problem for Physicians and Patients: The medical industry is now aware of the problem. You are now aware of the problem. Make sure your physician advocates for you and your safety. This should be apparent during the surgical consultation whether he/she is the right fit. He/she should show concern for your suffering and be engaged in the conversation.

Make sure that you are your own advocate. Ask questions. Get answers. Take notes. Don’t be afraid to get second or third opinions. Have someone close to you with you during surgical consultations and in surgical recovery doing the exact same things of asking questions, getting answers and taking notes particularly on the topic of medication dosages and frequencies. Additionally, do your homework in advance looking for reputable hospitals and surgery centers that have consistently shown excellence in overall care and surgical outcomes. Use the internet liberally here. You are looking for top level specialists and nurses utilizing a “safe” facility meaning a facility with a track record for infection prevention and outstanding outcomes. Check online or with your state health department for records of safety.

doctor-patient

Conclusion

The title of the article is certainly a bombshell!  My hope is that a couple, simple tips can help reduce your risk for non-necessary surgeries and medication errors. Remember that all human beings including doctors make mistakes. No system is perfect; however, our current systems should be better. Demand better, but also do your part to make things better.

All men make mistakes, but a good man yields when he knows his course is wrong, and repairs the evil. The only crime is pride.”— Sophocles, Antigone

References

  1. http://www.forbes.com/sites/robertszczerba/2015/10/27/disturbing-new-study-finds-medication-errors-occur-in-half-of-all-surgeries/
  2. http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx

About The Author

Dr. Dino Pappas

Dr. Konstantine “Dino” Pappas

Dr. Pappas is a chiropractic physician, certified athletic trainer and certified strength and conditioning specialist. Dr. Pappas blends the best of physical medicine with the best of integrated medicine to help patients and athletes of all shapes and sizes. He utilizes tools such as chiropractic manipulation, soft tissue work (IASTM, Graston, myofascial release, neural mobilization and joint mobilization), biomedical acupuncture, functional movement based assessment, the McKenzie Method, strength training and conditioning, kinesiology taping, customized nutrition and specialty laboratory testing (blood, saliva, urine, and stool) when needed. Dr. Pappas’ clinical focus is sports medicine, conservative orthopedics, rehabilitation and integrated medicine. His sports medicine interests are endurance athletes, overhead athletes (pitchers, throwers, volleyball players and tennis players), contact sports athletes (football, rugby, lacrosse, field hockey, soccer and basketball) and Crossfit athletes. He has worked with athletes at all levels from professional to amateur. He reads and interprets the medical literature daily to stay abreast of cutting edge advances in his field. The doctor is currently the team chiropractor for the Windy City Thunderbolts minor league baseball team and a sports medicine volunteer for Andrew High School in Tinley Park, IL. He is an avid runner and aspiring triathlete having completed 5 marathons, 3 half marathons and numerous 5 and 10k races. The doctor is also active in the local, suburban Chicago running scene. He has goals of qualifying and competing in the Boston and New York Marathons, the Ironman in Kona, Hawaii, and climbing Mt. Kiliminjaro in Kenya, Africa. One day he hopes to serve his country as a team chiropractor for the United States Olympic teams and serve as a team chiropractor for one of the professional teams in Chicago. His mantra is “Why Put Off Feeling Good?” He can be reached by email at drdinopappas@gmail.com or at 708-532-2346. ***

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