By Michael Smith
For the Salisbury Post
Imagine you’re in your surgeon’s waiting room. You’re scheduled for major surgery. Your operation will be in your local hospital, performed by your local surgeon. Most physicians are highly trained, so you trust your surgeon and have no reason to think your hospital might not produce excellent results.
Still, your anxiety level is cranking. Maybe reading will calm your nerves. A nearby magazine cover says, “Medical mistakes in N.C. hospitals result in injury or death for almost 1 in 5 patients.”
You know that magazine wouldn’t be in a surgeon’s waiting room, but pretend it’s a 2010 copy of The New England Journal of Medicine about a study of 588 medical injuries reported by 10 randomly selected N.C. hospitals between 2002 and 2008. Fifty of the injuries were life-threatening, 17 caused permanent harm, and 14 were fatal.
North Carolina hospitals were used in that actual study because of the N.C. Hospital Association’s efforts to reduce medical errors since 1999, when the Institute of Medicine reported that — annually in the U.S. — about 98,000 deaths and a million injuries were caused by medical mistakes. The study found the rate of injuries did not decrease from 2002 through 2007. About one in five North Carolina hospital patients could still expect non-serious to fatal injuries.
In 2007, Public Citizen reported its study of the government’s National Practitioner Data Bank. That study showed that preventable medical errors markedly increased since 2003, and that doctors responsible for repeated incidences of malpractice were rarely disciplined.
Each year, HealthGrades.com releases a largest-of-its-kind evaluation of hospital care using records from the Centers for Medicare and Medicaid Services. In 2011, HealthGrades found that, nationwide, from 2008 to 2010 there was a 13 percent improvement in mortality rates from medical mistakes during 18 types of medical procedures. But HealthGrades found that patients have a more than 73 percent lower risk of dying in best-rated hospitals.
In late 2011, my wife had her hip joint replaced by a local surgeon at a local medical center. That operation left her permanently crippled, in almost constant pain, and suffering frequent bouts of severe depression. Her life is forever altered. We no longer enjoy walking hand-in-hand or riding our bikes together. We face numerous operation-related expenses.
You can profit from our experience. Becoming an informed participant in your own medical welfare takes effort, but the Internet can help. HealthGrades says, “59 percent of all adults in the United States look for health information online. Increasingly, patients are moving from searching for disease or treatment information to using the Internet to find quality information on doctors and hospitals.”
There is no government hospital rating source. HealthGrades, however, rates hospitals with respect to different medical procedures with an easily understood system. But also search for patients’ comments about particular hospitals. Use Google to search the name of the hospital and try to get impressions from as many patients’ ratings and reviews as possible. Vitals.com, Superpages.com and Yelp.com are very informative.
Federal and state governments should inform us about negligent physicians. But Public Citizen says, “Information about doctor discipline, including state sanctions, hospital disciplinary actions, and medical malpractice awards, is now contained in the National Practitioner Data Bank (NPDB). While the Department of Health and Human Services, which controls NPDB, makes available a Public Use File for statistical research, the names of the doctors are kept secret from the public.”
Public Citizen also found that state medical boards rarely discipline physicians and that their Web sites offer little information about physicians. The N.C. Medical Board is charged with overseeing physicians. Visit www.ncmedboard.org and click Consumer Resources then Annual Disciplinary Report to view disciplinary actions in preceding years.
There’s information like a list of physicians disciplined in various ways but not reasons for disciplinary actions; nor the content or existence of patient complaints about particular physicians; nor information about physicians disciplined by other state medical boards but then relocated to North Carolina and licensed by the board to practice here.
You will not find disciplinary actions for any physician’s negligence unless it violated the board’s Medical Practice Act. Yet the board’s own complaint guidelines state, “It is important to understand that … only about 1 percent of the 1,200 complaints received annually result in public action being taken against the provider’s license.” The board’s guidelines also say that in “30 percent of cases, the complaint leads to private discipline, such as a confidential letter expressing the Board’s concern.” You’ll never know what the board said or didn’t say.
You must arm yourself with knowledge about hospitals and physicians. That information is there. HealthGrades researches and reports on actions taken against physicians by medical boards in all 50 states. If a reason for an action is available, HealthGrades reports it plus where the physician is presently practicing. For patient reviews of physicians, turn to Vitals. Some reviews will be positive, some negative. Try to get an overall “feel” for the physician. To help, Vitals reports patient ratings in various categories, information about each physician, and means to compare your physician against nearby physicians in the same area of practice.
Bottom line, get clicking. Get to a computer and start doing your homework.