Commonest error in medicine

Vic Nicholls nichollsvi2 at GMAIL.COM
Mon Dec 8 00:41:13 UTC 2014

First, no we don't, *unless* you ask patients. I had my mother tell a 
former doctor to his face, "she isn't like that" (non compliant, etc.), 
when the doctor was telling her things. Between a diagnosis I had for 
years, her telling him that, me telling him symptoms that would fit the 
former diagnosis, the man should have figured it out ...

you get the idea? How hard is it to look up something in a medical 
dictionary? Its like someone being diagnosed for years with celiac 
disease, it is in the medical records of that doctor, the doctor gets 
mad and slings all sorts of mental illnesses on the patient because they 
are being told to eat 10 slices of bread a day and won't do it.

On top of that, with that diagnosis, it shouldn't take years to get 
someone to repeat the original test that you got the diagnosis for and 
guess what, its positive again. It did.

Your practice interaction sounds like a good idea, one worth persuing. I 
think you also might want to consider doing a different type of 
questioning for people who have a medical background or can read 
research. I'm pretty savvy in my areas. It would be worth asking 
questions having us do some differential diagnosis work.

Your last part is dead on the money. I wouldn't have a problem if 
someone asked, but I've seen the situation played out all too frequently 
on the part of the huge medical corporation in the area to trash the 
crap out of a patient, even if they say they're not suing you but want 
appropriate care. They shouldn't be denied that in the area just because 
they're trying to hide what a doctor messed up. If people are asking to 
be made a part of making things better, you have to wonder about the 
motives of the medical administration and establishment when they're not 
willing to look at items that are a win for patients. I'm not talking 
about firing doctors or anything else. I saw the risk management take 
steps over the period of time that were what I had talked about.

They knew I was right, but refused me ongoing care. I've never sent a 
lawyer to them, not in my interest. So far, the malpractice #'s do not 
support lawsuit fears being portrayed, nor does the climate of deny & 
defend do anything to engender trust for us in people who don't trust us.

What does that say about medicine?

That's why I'm here. Attitudes and the like can change. It doesn't 
require lawyers, 5 layers of admin. If someone comes to you with their 
cap in hand and say 'how about helping a doctor out, fixing this 
situation', blowing them out of the water will only further problems. 
Improving diagnosis would be the first problem that doesn't get fixed.


On 12/6/2014 6:14 PM, Robert Bell wrote:
> Good points Vic.
> First, do we have good information that most errors come the way you 
> suggest?
> If they do, do we need a code of practice interaction with patients, 
> different but similar to what is being worked out with the police and 
> public to de-escalate situations? Sounds like something the Speciality 
> Societies could work on as with each branch of medicine the 
> interactions would be different. But there could be a general code of 
> patient contact put out by say the AMA to start the ball rolling if 
> your thesis is correct.
> Is there any information in hospital Root Cause Analyses to suggest 
> hat you are correct?
> If there was information, then getting it published would be a way to 
> get things started.
> However, you bring to the front that generally we have no good data on 
> anything related to errors. Also, the police do not have good 
> nationwide data on how many unarmed people they kill each year.
> There is a great reluctance to make this information available on the 
> part of the hospitals, physicians, and police because of litigation 
> possibility.
> Then the question becomes do we first change the litigation laws.
> It is so complex - hard to know where to start.
> Rob Bell
> ------------------------------------------------------------------------
> *From:* Vic Nicholls <nichollsvi2 at>
> *To:* Robert Bell <rmsbell200 at YAHOO.COM>
> *Sent:* Saturday, December 6, 2014 3:01 PM
> *Subject:* Re: [IMPROVEDX] Commonest error in medicine
> The most common errors in medicine are not listening to the patient 
> and respecting that the patient might be telling you the truth, 
> inability to believe a HCP can be wrong and to consider alternate 
> diagnoses. Giving mental diagnoses because HCP's don't want to be 
> bothered to do legwork.
> Last but most important is being human. I can think of a number of 
> people harmed who would expect something other than bullying, 
> gaslighting, stalking, gang stalking, risk managers/lawyers, and 
> trying to use the cops to silence people. Not everyone is a lawsuit. 
> Some people just want better & more compassionate care.
> I would add that being your own worst enemy ranks up there guys. If 
> you can't consider the patient, consider why you got into medicine in 
> the first place. When a doc says they see 60-70% talking about money, 
> we're going to respond like that.
> Victoria
> On 12/6/2014 11:21 AM, Robert Bell wrote:
>> Dear all,
>> I had the idea that instead of talking and sharing thoughts on a list server that some of the good will, and the time of the contributors could be used to actually DO something useful. Be it a resolution sent to the organizers of the list on a particular issue, or the basis for an article/publication. This, and perhaps a little naively, considering that the most successful technology companies operate on the basis of creativity and inclusiveness being intertwined. And this list had an amazing cross section of talent and diversity. Somehow I had the idea that we could miraculously DO something to help with the apperent lack of progress in the last 15 years since the IOM report on Errors.
>> But I think the hurdles of confidentiality, available tIme of contributors, differing society aims, competing projects, differing individual aims, patent considerations, litigation issues, and institute affiliations, etc., etc, are likely to make this all too great of an uphill battle.
>> Thank you for all being so gracious, to at least try to move the idea forward.
>> Robert Bell, M.D.
>> Sent from my iPad
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