Month: January 2007

Well, Time Mag­a­zine reports that the Nation­al Acad­e­mies of Sci­ence’s Insti­tute of Med­i­cine says that’s the fig­ure, any­way.

Doc­tors’ slop­py hand­writ­ing kills more than 7,000 peo­ple annu­al­ly. It’s a shock­ing sta­tis­tic, and, accord­ing to a July 2006 report from the Nation­al Acad­e­mies of Sci­ence’s Insti­tute of Med­i­cine (IOM), pre­ventable med­ica­tion mis­takes also injure more than 1.5 mil­lion Amer­i­cans annu­al­ly. Many such errors result from unclear abbre­vi­a­tions and dosage indi­ca­tions and illeg­i­ble writ­ing on some of the 3.2 bil­lion pre­scrip­tions writ­ten in the U.S. every year.

The cure, accord­ing to the sources cit­ed in the arti­cle, is auto­mat­ed pre­scrib­ing. Physi­cians would use a web-enabled phone to select med­ica­tions and dosages from menus, so names and num­bers would­n’t be mis­writ­ten or mis­heard (mis-select­ed is always pos­si­ble, but you can’t removed all pos­si­bil­i­ty of error). Most of the mon­ey for the sys­tems will come from health insur­ers, so I don’t know how all this will work for peo­ple who pay for their own pre­scrip­tions.

The whole arti­cle left me with many ques­tions, in fact, about choice, and prod­uct posi­tion­ing — will doc­tors even be able to pre­scribe med­ica­tions that aren’t in the “for­mu­la­ry” when they know that some­thing else will work bet­ter? Will they be able to select some­thing out­side the stan­dard range of dos­es? What about com­pound­ed pre­scrip­tions?

This lit­tle sta­tis­tic sur­prised me, but there’s no source cit­ed, so I’m not sure I trust it.

Sure­Scripts CEO Kevin Hutchin­son says one key to reduc­ing med­ica­tion errors is to get the most pro­lif­ic pre­scribers to tran­si­tion to elec­tron­ic pro­cess­ing. “Not a lot of peo­ple under­stand that 15% of physi­cians in the U.S. write 50% of the pre­scrip­tion vol­ume,” Hutchin­son says. “And 30% of them write 80%. So it’s not about get­ting 100% of physi­cians to e‑prescribe. It’s about get­ting those key 30% who pre­scribe the most. Then you’ve auto­mat­ed the process.”

Unfor­tu­nate­ly, Time does­n’t both­er to give any sug­ges­tions as to how to save lives until this utopi­an sys­tem to con­trol those wild and wooly scrib­blers is in place. I guess I’ll have to give it a go.

Please remem­ber that when I say “you,” I mean you or your advo­cate.

First, be sure that you always know what your doc­tor is pre­scrib­ing for you, and why. Take notes. Write down both the name and the dosage of every med­ica­tion, and what it’s for. If you’re unclear on the spelling, as the doc­tor or his staff to spell it out or write it down for you.

If your doc­tor is giv­ing you refills on your nor­mal med­ica­tions, look at the refill pre­scrip­tions. Do they seem to say what you expect them to say? If not, ask about them. Be sure. He might have mis­re­mem­bered or writ­ten down the wrong thing. Doc­tors are not infal­li­ble. It has hap­pened to me! If you’ve already left the office, con­tact his staff. It’s bet­ter to be safe than sor­ry!

Com­pare your notes to the pre­scrip­tion bot­tle before you leave the phar­ma­cy. If the pre­scrip­tion has been filled with a gener­ic and your doc­tor gave you a brand name, dou­ble check with the phar­ma­cist (not just a clerk) to be sure that they real­ly are the same med­ica­tion. If your doc­tor said you were to take the med­ica­tion twice a day and you’ve only got 30 pills to last 60 days, don’t leave the phar­ma­cy.

Read the infor­ma­tion includ­ed with your pre­scrip­tion. Make sure that it agrees with what­ev­er the doc­tor told you, or makes sense con­sid­er­ing why the doc­tor pre­scribed this med­ica­tion for you. If you don’t under­stand, again, call the doc­tor’s office, or at least the phar­ma­cy. “I have fibromyal­gia, and my doc­tor pre­scribed this med­ica­tion, but the insert just talks about depres­sion. Why?” It’s a per­fect­ly valid ques­tion. If the doc­tor already explained that to your sat­is­fac­tion, of course, you need­n’t call—but do call if any­thing does­n’t make sense.

Tak­ing these pre­cau­tions should pro­tect you, whether your doc­tor scrib­bles, has beau­ti­ful pen­man­ship, or uses an auto­mat­ed sys­tem.