For patients killed or maimed by medical errors, doctors and hospitals still often deny wrongdoing. But newer programs offering prompt disclosure of medical errors, an apology and compensation for them or their families are growing.
The “reps,” who are there to answer any technical questions that arise during surgery, also often cultivate close relationships with the doctors, leading to questions about how much influence they wield.
Fertility specialists say that egg donation is safe and involves the same process as in vitro fertilization, but there are sporadic reports of cancers, some fatal, and subsequent fertility problems among egg donors. Because of a lack of research, it isn’t known whether these problems are linked to the process or are the result of chance.
The prestigious facilities are seeking to improve patient safety by getting surgeons and hospitals to pledge to meet minimum thresholds for 10 high-risk procedures.
CT scans, which are administered more than 85 million times a year, are an important diagnostic tool, but just one can be equivalent to 200 X-rays. Some doctors warn that health providers are not considering possible consequences when ordering the tests.
The nation’s internists urge doctors to quit performing the invasive exam for most women, but gynecologists argue that it is important.
The problem, which is often preventable, is estimated to cost more than $143 billion annually and disproportionately affects people older than 65. It is often misdiagnosed as dementia.
Often considered less important than technical skills, having a good bedside manner is important to helping patients and can lead to better outcomes.
The recent death of Joan Rivers, who suffered cardiac arrest at a center in New York, highlights some of the concerns among consumer advocates.
Medibid, a four-year-old Internet service, can help people get non-emergency medical services outside of costly hospitals, but critics note that the service provides no guarantee of quality or safety.
Reviving bedside medicine is becoming a new priority at some medical schools after technology has hurt some doctors’ abilities to use physical exams to make accurate diagnoses.
The chance to finish medical school early is attracting increased attention from students burdened with six-figure education loans. Medical school administrators and policymakers see it as a way to produce doctors faster and as a response to the looming shortage of primary care physicians.
Most of these patients have multiple chronic illnesses and all too often they wind up in emergency rooms because they have enormous difficulty navigating the increasingly fragmented, complicated and inflexible health-care system.
The work day for doctors in their first year out of medical school was cut to 16 hours to reduce fatigue and medical errors. But recent studies suggest it may be making the situation worse.
Diagnoses that are missed, incorrect or delayed are believed to affect 10 to 20 percent of cases, far exceeding drug errors and surgery on the wrong patient or body part, both of which have received considerably more attention.
For many years, hospitals were reluctant to address physicians who berated nurses, threw scalpels or demeaned co-workers. But increasingly such actions bring discipline.
There are no mandatory retirement ages for doctors or formal evaluations of their skills, but some hospitals are now requiring older physicians to have periodic physical and cognitive exams.
Few doctors have studied alcohol or drug abuse, but the problems can be at the root of more obvious ailments that keep patients cycling through the medical system.
The volunteers, part of a program called Health Leads, help low-income families connect with social service groups providing food, clothes, housing and other services so that children can overcome some of the obstacles contributing to health problems.
The expensive medications, designed for people with schizophrenia or bipolar disorders, are being prescribed regularly for common problems such as anxiety and attention-deficit disorder and are being used on children and the elderly.