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His Advice: Speak up to Avoid Medical Error
By Linda Greider

Many people were stunned when the National Academy of Sciences estimated a month ago that medical errors in hospitals cause between 44,000 and 98,000 deaths every year.

But Lucien Leape, M.D., a professor at the Harvard School of Public Health and contributor to the report, was first stunned by numbers like these more than a decade ago, when he studied medical records in 30,000 hospitals and found similarly disturbing facts. Since then, Leape has sought ways for the medical community to report efforts, and to develop systems that will prevent them.

Leape told the AARP Bulletin he believes that medical mistakes generally result from bad systems, not bad people. "If you want to prevent error, you need to redesign the systems," he says.

President Clinton has picked up the issue, ordering health plans serving federal workers and retirees to improve the quality and safety of their health care.

In the meantime, what can patients do? Think of medical professionals as partners in your care, not gods. "Smart doctors," Leape says, "are getting used to the idea that they're not going to know everything." Do your own research, at the library or on the Internet.

Ask what-and-where questions about every diagnostic test, every procedure and especially about every drug. Over 7,000 patients die every year because of medication efforts. List every medication you take, including dosage.

Make sure you (and the pharmacist) can read written prescriptions, and that you know what the medication should look like. If you're having surgery, Leape suggests, go over the procedure step by step first.

Don't be shy. Doctors and nurses are getting accustomed to seeing patients who know a lot about their physical condition. And if the medical professionals have a problem with that, says Leape, they need to get over it.

Linda Greider, AARP Bulletin, Jan. 2000

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