7,000 deaths a year due to bad handwriting? Save yours!

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.

January 19, 2007 · cyn · 11 Comments
Posted in: From the news

11 Responses

  1. Kate Gladstone - January 19, 2007

    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

  2. cyn - January 20, 2007

    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!

  3. Rachel - January 28, 2007

    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.

  4. Fighting Fatigue - April 1, 2007

    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.

  5. niku@yahoo.com - July 19, 2007

    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 ?

  6. softer1313@yahoo.com - August 17, 2007

    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.

  7. alin360@gmail.com - August 30, 2007

    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.

  8. sabina.buruiana@gmail.com - October 3, 2007

    It would be a shame for a per­fect per­son to die because of a stu­pid pre­scrip­tion.

  9. buga.daniel@gmail.com - November 22, 2007

    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..

  10. glamorD23@gmail.com - March 26, 2008

    Yeah, it hap­pened to me too. Even doc­tors make mis­takes.

  11. sandboxjoe@yahoo.com - March 30, 2008

    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.