By Don Vaughan

Medical errors now are the third leading cause of death in the U.S., behind cancer and heart disease, according to a recent article in the medical journal The BMJ . It’s a sobering thought, but patients can protect themselves, consumer advocates say.

Researchers at Johns Hopkins University School of Medicine in Baltimore report the number of deaths due to medical errors has risen from an estimated 100,000 patient fatalities a year to around 250,000 and possibly more.

“One of the things that led to our study was we wanted to increase funding at a policy level for patient safety,” notes lead analyst Dr. Martin Makary, who holds a master of public health (M.P.H.) and is professor of surgery at Johns Hopkins School of Medicine and author of Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care (Bloomsbury, 2013). “We’ve spent a lot of time and money on heart disease and cancer but have not fully appreciated the role of medical care gone wrong as the third leading cause of death.”

Makary defines a medical error as anything that goes wrong over the course of a patient’s medical care. This includes preventable complications such as hospital-acquired infections, medication errors, diagnostic errors, and issues resulting from poor communication when a patient is transferred from one medical unit to another.

A variety of factors can lead to medical errors, says Erica Mobley, director of communications and development for The Leapfrog Group, a nonprofit organization that collects and reports information about hospital safety and quality. “Hospitals are very complex places and it is really easy for an error to occur,” she explains. “Hospitals are staffed by doctors and nurses, who are human, and humans make mistakes. We can’t expect our doctors and nurses to be absolutely perfect.”

However, institutions can take steps to reduce medical errors, Mobley says. “Medical facilities with low rates of medical errors typically have protocols and systems in place to catch errors before they happen,” she notes. One way to prevent medication errors, for example, is the use of computerized prescriber order entry, an electronic system that issues an alert if a prescriber tries to enter a medication that could harm a patient.

And on the surgical side, Makary developed a detailed checklist that ensures everyone is on the same page throughout a surgical procedure. The checklist was later adopted by the World Health Organization and now is used worldwide.

Health care professionals play their role, but patients also should be engaged and active members of their care team. “Patients have a very important role in their health care, sometimes the most important role,” says Rear Adm. Jeffrey Brady, USPHS, M.D., M.P.H., director of the Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality (AHRQ).

Consider the following tips to help protect yourself:

  • If possible, come prepared with questions to ask before, during, and after a medical appointment. The AHRQ provides an online question-builder tool that can help get you started.
  • Have a family member or close friend at your side. “Having someone there to look out for you and to speak out if there might be something wrong can really help prevent a potential error,” Mobley says.
  • Bring a tape recorder or take notes when interacting with your care team so you later can review information and instructions.
  • Be knowledgeable about the medications you receive while in the hospital, including what they are for, the proper dosage, and potential side effects. In addition, bring a list of all drugs, vitamins, and supplements you’re taking at home to help reduce the risk of a dangerous drug interaction. “A heightened sense of awareness regarding medications is vital,” Brady confirms. “It’s critically important that patients be engaged and ask questions if necessary.”
  • Don’t be afraid to say something if you don’t understand what your health care team is telling you or if you sense that something might be amiss. “Patients should never feel that they can’t speak up,” Mobley says. “They should feel empowered and able to ask questions of their providers.”