Military Officer - July 2006 - (Page 62) PROBLEM Missed diagnoses Doctors have an array of diagnostic tools and tests to get to the root of medical problems, but they don’t always follow up on test results. A 2005 study published in the Annals of Internal Medicine examined the medical records of more than 2,500 patients at Boston-area hospitals and found their doctors didn’t always know about test results that signaled a serious problem; in some cases, they didn’t even know that certain tests had been ordered. What’s being done: Some hospitals are setting up computer systems that electronically alert doctors when a suspicious test result comes in. At the VA Ann Arbor (Mich.) Healthcare System, for example, radiologists code each medical image; a “Code 8” tag, for example, indicates an unexpected sign of cancer that requires immediate follow-up. Doctors are alerted to the Code 8 scans by a written report and a phone call, which prevents patients who could have cancer from falling through the cracks. It’s also becoming easier to transmit images from X-ray, MRI, CT, and PET scans over the Internet, so doctors can access them right after a test is complete. This reduces chances that the results will be lost and helps ensure more immediate treatment. What you can do: Never assume that no news is good news. Call the doctor or hospital and ask about test results. Also, if all the tests turn out negative but you still think something is wrong, don’t hesitate to pursue the problem by getting a second (or even third or fourth) opinion. 2 PROBLEM 1 Confusing medical directions or advice Too often, patients leave the doctor’s office or hospital without a clear understanding of how they’re supposed to care for themselves. Consider asthma, a condition that affects thousands and needs daily management. A 2005 the American College of Physicians Global Asthma Physician and Pahave issued guidelines and created tient survey of 6,000 doctors showed teaching modules to help physicians that 85 percent devote less than half improve their communication skills, of their time to communicating key and most doctors have brochures facts about asthma management. and instruction sheets that explain “People are often too afraid or conditions and treatments in detail. intimidated to ask questions about What you can do: “If you don’t their health care — if they don’t ununderstand something, or if you derstand something, they just smile need more information, you need to and nod,” says Dr. James Battles, speak up and demand clear answers a senior service fellow for patient — that’s what you’re paying your safety at the U.S. Agency for Healthdoctors for,” says Battles. care Research and Quality (AHRQ). Experts recommend taking a list What’s being done: Doctors of questions to every doctor’s visit are recognizing the need to comand writing down or tape recordmunicate more thoroughly and ing the answers so you can review effectively, even if they’re limited them later. Also, consider asking a in the time that they can spend family member or friend to come with patients. National physician with you to serve as another pair organizations like the American of ears and ask questions that Academy of Family Physicians and might not occur to you. 64 MILITARY OFFICER J U LY 2 0 0 6
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.