Tuesday, August 24, 2010

Medication "Safety"?

Dangerous Medications

Who can we “blame” for the drug problems on Long Island and maybe even in your community? There is a heroin epidemic and serious problems with prescription drug abuse. Some people try to blame the family, or society, do we need to blame anyone at all?

Before the patient ever leaves the hospital, discussions MUST include information about the medication such as, if it can be addicting, where to store it and how to dispose of it to keep it away from anyone who may want it to use or sell illegally..

Doctors should not be afraid to tell the patient if their medication may be appealing to someone who can get a few dollars for it on the street or use it without authorization.

Did you know a pharmacist or pharmacy intern must actually provide patient education:
• Before dispensing a medication to a new patient of the pharmacy;
• Before filling a new prescription for an existing patient of the pharmacy and
• If the dose, strength, route of administration, or directions for use has changed for an existing prescription previously dispensed to an existing patient of the pharmacy.

When you sign for your medication, you are actually signing away that right to counsel. READ what you are signing!

I picked up a controlled substance for my son from my local pharmacy. We never used this medication before but we had some warnings from the doctor about its side effects. I don’t know if it’s addicting, nor do I know if it can be sold on the street but I can tell you there was a large “COUNSEL, NEW DRUG ” alert which went completely ignored by the young girl behind the counter.

At a recent workshop hosted by PULSE of NY, we learned that a pharmacist is taught to ask: What is the name of the medication you are taking? How were you told to take it, and what do you expect to happen from taking this medication? None of this was asked, the pharmacists was never called upon, the young girl handed me the bag, told me to sign and walked away. I never signed.

I felt like I was just handed a gun.

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Friday, August 20, 2010

The Price We Pay

The Cost of Preventable Medical Errors

Would you be comfortable using a hospital knowing that 32 people died in hospitals from your state from preventable medical errors? We do it all the time. The only difference is in Oregon is that you can see the numbers.

Unfortunately, that’s all we are, numbers. In Oregon the number being reported to the public should be a demand for accountability. 32 people died but how many people feel the impact? That’s a number not being reported. The parents, children, friends and community left behind.

What about the financial loss to businesses? If half of those people held jobs for more than 10 years, they now have to be replaced. New employees mean training new people. These 32 people are no longer paying life insurance, but instead collecting it. The payout from one insurance company to 32 people in one year just from preventable medical errors can be devastating! You don't have to be a highly paid researcher to come up with some numbers to build a case. But no one is looking at these numbers….

We know that every preventable medical injury is tragic but we really don’t have all the numbers. If 32 are being reported, how many hospitals are not reporting?

Are there things the public could do to have helped prevent any of these 32 deaths? And how about the many injuries associated with medical care? As usual I bring many questions and often don’t have the answers accept to educate and inform the patient and their close community to help avoid these outcomes.

Saturday, August 14, 2010

Legal Seafoods and Safety

Patient / Customer Safety and Satisfaction

I am not a restaurant reviewer but thought this trip was worth commenting on. I met a colleague for lunch at Legal Seafoods in Garden City, Long Island. It was not crowded and the waiter was nice enough, thorough, but not warm and fuzzy, which was just fine with me.

After taking our order, the waiter said “Oh, and by the way do you have any allergies we should know about?” My guest and I both said “no” but were both equally surprised at the question.

When the waiter returned, I asked him what the history was of that question. I pictured patrons passing out on their floor at some point struggling to breathe after eating shellfish.

He wasn’t sure, but assured me they have been asking that question for years. I wanted to know more. Asking for the manager, a very well dressed young man came by and introduced himself as the Assistant General Manager. I asked what the policy was if I were to say I was allergic to a food that I didn’t order. What if I was allergic something completely unrelated to seafood?

He explained that when a customer says that they are allergic, the waiter / waitress takes the order to the manager. The manager then goes to the manual and the chef, where it is checked for any cross contamination and the order is actually delivered by the manager to the customer for “assurance” that it was handled appropriately.

What a great idea that “patient’s safety” is now taken out of the health setting and reaching more people.

We tell people to keep lists on them of their allergies and medications and this is an obvious way it can come in handy outside the hospital or health setting.

Reading hospital material encouraging patients to write lists is often too late. This is a perfect reminder that people with health conditions, any kind, need to keep that information available - always. I still wonder the history of this policy and if other restaurants are doing this.

Monday, August 9, 2010

Do You Know Your Doctor?

Changing Physicians

A woman called me today about her doctor. She has been seeing the same gynecologist for 8 years and decided to look up his information on the New York Doctors Profile website, a NY State website and law I was involved in getting started in 2000 after 3 years fighting for it. She was surprised to find her doctor had 5 settled claims in 10 years. “One every other year” she told me.

She was now searching for a new doctor but wondered if she should be alarmed or even concerned and should she even bother changing doctors. Finding the PULSE of NY contact information in America’s Top Doctors book, she thought I may be able to give her some advice.

After reminding me numerous times that she did not want to hurt her doctor’s reputation or “put him out of business” she only wanted to know what to do and if she should be concerned, I asked her; “Why did you call me?”

She thought for a moment and said she was concerned.

“So” I told her “you don’t need me to tell you what to do”. If someone can’t have an honest trusting relationship with their doctor than that is not the basis of a partnership. She said many times that she has a great relationship and likes her doctor. This was making it difficult to leave this group of doctors. "They know me and have all my records" she told me. I suggested she can ask the doctor about the lawsuits. She wanted to know why so many. “Ask” I told her.

I suggested she look to see how many ob-gyn’s have settlements too. Very few she told me. “And if this doctor tells you that you are fine, will you accept that information or will you question everything he says?” She said she would have to go to another doctor to confirm what this doctor says.

The time to change doctors, if you want to change, is now before you are sick or in need of care. Find the hospital you want to be affiliated with and go backwards, if possible. Find the doctor who uses that hospital. If a doctor needs to do a procedure or surgery, that’s where you will be going. Don’t stop at one doctor. If you are a match, you will know it. If there is no energy, change again. There are no rules that you can’t shop for the right doctor.

And finally, just because a doctor has never been sued or has a great reputation, doesn’t mean things can’t go wrong. This is why being involved – always- is so important. I can’t refer people to doctors for this reason. We can’t guarantee things won’t go wrong.