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 remove 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.
Among the hospitals that call me in to prevent medication errors (by
giving handwriting classes to the doctors), a fairly high percentage
claim to have “computerized everything” 1 or 2 or 5 or more years ago
… yet they still have handwriting problems, because of a crucial 1% to 5% of handwritten documentation that just won’t go away.
Doctors in “totally computerized” hospitals still scribble Post-Its to
slap onto the walls of the nurse’s station, still scrawl notes on the
cuffs of their scrubs during impromptu elevator/corridor conferences
with colleagues … and, most of all, doctors with computer systems
often have the ward clerks operate the computers, use the Net, or
whatever: working, of course, from the doctors’ illegible handwriting.
Bad doctor handwriting, incorrectly deciphered by ward clerks using the computer for any purpose, thereby enters the computerized medical record.
And what happens when disasters knock out a hospital’s network? More than one hospital, during Hurricane Katrina, lost its generator, its electric power — and therefore its computer system — for the duration.
Even the computer-savviest staffers in the disaster zone had to use pens. Let’s hope they wrote legibly.
Kate Gladstone — Handwriting Repair — http://learn.to/handwrite
What a unique business! And obviously, you’re filling a serious need. I’d never thought of teaching people to write better as a way of saving lives before today. But I realized after writing that post that there was nothing in the world that I or my advocate could do to fix things if a doctor’s poor handwriting on my chart had resulted in the wrong medications in my IV or injections this past year when I was hospitalized. The nurses found it shocking enough when I questioned them about the pills they handed me to swallow.
I’m fairly sure that I couldn’t work with a crowd of doctors, and I have abominable handwriting (much worse now than pre-fibromyalgia), so what you do seems like walking on water to me. Thank you for doing it!
I’m a doctor’s daughter, so I’ve seen bad handwriting my entire life. The main cause of the bad handwriting epidemic in medicine is the fact that you have so little time to write it out. You can’t bill the time you spend writing, so they write fast to get it over with. It’s also partly caused by the immense and outrageous paperwork load required by the federal government. It’s ridiculous the amount of paperwork they have to fill out and keep track of! So they write fast to get it over with and out of the way. I was my dad’s right-hand for 3 years and my handwriting suffered too. And this was in spite of the fact that we did ALL notes and Rx’s in our computer system. The only thing written on our Rx’s was his signature.
This was a very enlightening article. I never thought about how a doctor’s handwriting affects patients overall. I have a new forum for CFS and Fibromyalgia patients if you want to check it out. It is http://www.fightingfatigue.org/forum.
How can you avoid this, i mean is there any way you can do it ? work with doctors that are recommended by other people or what ?
I think is not entirely a handwriting problem. It’s about pharmacist’s misinterpretation of doctor’s handwriting. A good way to avoid fatal mistakes is to type all prescriptions on a computer or a typing machine. Anyway, pharmacists should know how to correlate the diagnosis with the proper medication and dosage.
Automation should eliminate many of the errors that occur when pharmacists misunderstand or misrecord medication names or dosages conveyed messily on paper or hurriedly by phone. Given that there are more than 17,000 pharmaceutical brands and generics available, a spoken request for Celebrex, for instance, can be mistaken for Celexa, or a notation requesting 150 milligrams of a drug might be read as 1500. In electronic systems, drugs and dosages are selected from menus to prevent input errors, and pharmacists don’t need to re-enter information.
It would be a shame for a perfect person to die because of a stupid prescription.
When I go to the doctor I always ask what medicines he prescribes me to know for sure if I get the right ones! It’s their fault too..
Yeah, it happened to me too. Even doctors make mistakes.
I have encountered many problems in the past because of the writing on my prescriptions. The pharmacist wouldn’t give me the meds or gave me the wrong ones. I was lucky not to need any intervention or heavy medicine because with that handwriting the doctor would surely mess up.