
In 1999, the Institute of Medicine reported that 98,000 people are killed by preventable medical errors in American hospitals every year. That scary number did not include persons severely disabled by medical errors or those injured or killed by preventable medical mistakes outside of a hospital, i.e., physician's office. The top recommendation by the authors of this report was to implement procedures for the mandatory reporting of medical errors by physicians and hospitals. This never happened.
Now, 11 years later, a new report by the Department of Health and Human Services estimates medical errors contribute to the deaths of an estimated 180,000 patients every year. This new report has findings that are virtually identical to those contained in the shocking report of the Institute of Medicine in 1999 and the recommendations of the authors of both studies are the same: INSTITUTE MANDATORY REPORTING OF MEDICAL ERRORS!
Disclosure of medical errors will help medical consumers select physicians and hospitals based upon knowledge of their prior mistakes. As reported in an editorial of the USA Today, "It's a problem crying out for a fix" and disclosure of medical mistakes is the number one step that can be taken to remedy this problem.
When the American Hospital Association's President was asked to comment about the disclosure of medical errors, the response was that "there is no magic solution to this challenge. If there were practices that would avoid every bad outcome, hospitals and clinicians would adopt them." He's right in one respect, there is no magic potion to fix the US's mess with poor medical care. However, mandatory reporting of medical errors is a step that is long overdue and still resisted by physicians and medical societies.
The President of the American Hospital Association claims that "hospitals willingly report performance data on key measures that demonstrate how care provided is affecting patient outcomes." Even better, the President states that such disclosure of medical mistakes by hospitals "also report adverse events to patient safety organizations, where they are analyzed by safety experts so everyone can learn from what occurred at a single hospital." Sounds good, but it's total crap!
What "patient safety organizations" is the President of the American Hospital Associations referring to? Where do hospitals report performance data to demonstrate how patient care is being provided? There are no specifics provided by the President of the American Hospital Association. The generalizations are not, unfortunately, substantiated by any shred of evidence and in fact, the President's claims are bogus.
Hospitals and physicians continue to cover up medical mistakes just as they have always been doing. Medical consumers are forced to make decisions about hospitals and physicians based on their gut feelings without any actual knowledge of the medical mistakes in the background of their medical provider.
Let's give an example of the coverup: the National Practitioner's Data Bank was created in 1986 by the federal government as a databank for the reporting of payments by physicians in medical malpractice lawsuits and claims. For those physicians who do not report malpractice settlements to the National Practitioners Data Bank, there have been no consequences. Even worse, consumers have no access to the National Practitioners Data Bank. You might be treated by a physician who has made ten malpractice payments in the last five years, but unfortunately, you have no way of finding out because the National Practitioners Data Bank is not accessible to you.
The sad fact is that the continued obstruction by physicians and hospitals to mandatory reporting of medical mistakes has resulted in death and injury for patients and a heavy dose of medical malpractice lawsuits against negligent physicians. Perhaps physicians like the status quo, but you shouldn't. Consumers are as poorly informed about medical mistakes as they were in 1999, when 98,000 deaths were first reported by the Institute of Medicine.
A new study suggests that 40% of women who take medications that can cause birth defects misuse or skip taking their oral contraception pills despite the risk involved. Medications that have been deemed unsafe to take during pregnancy are known as Category X drugs. Examples of these drugs include certain types of statins, acne medications, sedatives, and sleep aids. Scientists from the Medco Research Institute looked at prescription records of 26,136 of its female enrollees, between the ages of 18 and 44 who were prescribed both an oral contraceptive and a Category X drug.
About 60% of the enrollees took the oral contraceptive reliably, filling their prescriptions regularly and having enough on hand to take it 95% of the time. However, 22% only filled their prescriptions often enough to have enough available 80 to 94% of the time and the other 19% appeared to have enough filled to have the contraception less than 80% of the time. Medco stated that it received permission from its clients to use to use the data and analyzed the data without names included.
According to the study, which was published in the October issue of the American Journal of Medicine, 6 percent of U.S. pregnancies occur among women taking Category X medications that are known to cause birth defects. The authors of the study assert that women taking these medications may not be aware of the risks involved in becoming pregnant. The study's data showed that certain group of women, such as women taking large number of different prescription medications, those in certain minority groups, and women with lower levels of education were less likely to properly take their contraception on a regular basis.
According to lead author, Amy Steinkeller, these women may not understand that birth control must be taken "on a nearly perfect, consistent basis" and may not be being effectively counseled by their physician or pharmacist. Steinkeller suggested in a recent press release that physicians and pharmacists may feel "awkward" or uncomfortable discussing the topic with those being prescribed both an oral contraceptive and a Category X medication.
Medco's research findings are extremely important and show that women taking Category X medications and oral contraceptives must be better educated as to the risks involved in becoming pregnant while on these medications. Doctors and pharmacists must do their jobs and counsel these patients adequately, and not allow any "awkward" feelings they may have about the subject matter get in the way of doing their job. All women taking oral contraception should try take the medication as prescribed; I have a feeling that the most difficult part of oral contraception is remembering to take it. If you are taking an oral contraceptive, try setting an alarm on your cell phone for the same time every day to remind you to take your medication or post a note somewhere you will notice such as by your front door or on the refrigerator. If you have been prescribed any type of medication by your doctor, but are not sure if it is a Category X drug, consult him or her immediately and find out whether you should start taking oral contraception.

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John H. Fisher
130 North Front Street
Kingston, New York 12402-3058
Phone: 518.265.9131
Toll Free: 866.889.6882