Treatment more harmful than misdiagnosis in the elderly

Bob Gorman bgorman at KNCELL.ORG
Mon Sep 21 19:07:08 UTC 2015


On 9/19/2015 12:52 AM, robert bell wrote:
> Dear Ruth,
>
> To my mind multiple medications in the elderly are an error if 
> there are undesirable side effects.
>
> Misdiagnosis is said to be 30% of the error pie - but I do not 
> know where those figures come from.
>
> The Improve Diagnosis Society has established a consortium of 
> societies to try and do something as per the suggestion in the 
> article below.
>
> However, that ignores the 70% of errors that you mention, that 
> to me are so important and kill or maim so many.
>
> the IOM on Tuesday is coming out with their report and that 
> may take us further down the road to be doing something.
>
> Rob Bell

This issue is personal. I'm 74 and in the last 4 years I came 
very close to death from medical mistreatment. Specifically, it 
was my cardiologist that over prescribed High Blood pressure & 
other medications. In all 4 cases he did not detect the error; I 
had to figure out what was wrong and instigate action, often by 
denying to take certain medications.


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>> On Sep 18, 2015, at 12:41 PM, Ruth Ryan <ruthryan at COX.NET 
>> <mailto:ruthryan at COX.NET>> wrote:
>>
>> New article in/Annals of Family Medicine/cites a study in New 
>> Zealand from malpractice claims data showing that the elderly 
>> are more at risk from treatment errors, particularly 
>> medications than medical error.  Misdiagnosis is far down the 
>> list, #12.
>> Authors conclude, “The no-fault perspective reveals the 
>> greatest threat to the safety of older patients in primary 
>> care to be, not error, but the risk posed by treatment 
>> itself. To improve patients’ safety, in addition to reducing 
>> error, clinicians need to reduce patients’ exposure to 
>> treatment risk, where appropriate.”
>> In my view, the cascade of new recommendations to prescribe 
>> statins to virtually everyone, meds and combination meds to 
>> ratchet down cholesterol, blood pressure and blood sugar to 
>> ever lower levels ignores the special risks of polypharmacy 
>> to the elderly. As we are beginning to see with some 
>> screening recommendations, there might be a good age to quit 
>> doing that.
>> It’s also interesting to read about the no-fault approach to 
>> compensation for harm from medical treatment.
>> //
>> /Ann Fam Med/2015;13:472-474. doi: 
>> 10.1370/afm.1810.http://annfammed.org/content/13/5/472.full.pdf+html
>> *Ruth*
>> Ruth Ryan RN, BSN, MSW, CPHRM
>> Medical writer
>> Risk management/patient safety
>> Continuing medical education
>> Telephone (504) 256-8797
>> Emailruthryan at cox.net <mailto:ruthryan at cox.net>
>> <image002.jpg>
>>
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>
> Robert M. Bell, M.D., Ph.C.
> P.O. Box 3668
> West Sedona, AZ 86340-3668
> USA
> Tel: Fax: 928 203-4517
>
>
>
>
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> Moderator:David Meyers, Board Member, Society for Improving 
> Diagnosis in Medicine
>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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