Doc: Empower patients in decision-making to reduce medical errors

Doctor talking to senior patient and her husband
Patients need to feel empowered to ask questions and be involved in decisions about their care. (Image: Getty/olgachov)

Lawrence Schlachter headshot
Lawrence Schlachter

When a baseball injury ended his surgical career, Lawrence Schlachter, M.D., decided he wanted to continue working for patients. So he went to law school and now represents patients as a medical malpractice attorney.

Over his years both in the operating room as a neurosurgeon and in the courtroom, Schlachter has seen trends emerge in the causes of malpractice and medical error and how they are handled by providers. He’s compiled his experiences both in the field of medicine and the field of law into a book titled Malpractice that’s due out early next year.

Schlachter said he was struck by recent study data from The BMJ that suggests medical errors may be the third leading cause of death in the U.S.—responsible for as many as 250,000 deaths per year—and said that those figures validate what he’s experienced in 15 years of law practice. And, he said, experts suggest that for every medical mistake that is litigated, at least 10 are brushed under the rug and patients never hear about the errors.

One of the key problems, Schlachter said, is poor communication, both between doctors and between doctors and patients. Physicians need to take accurate histories, he said, and ensure that they order correct tests. Patients, meanwhile, need to feel empowered to ask questions and be involved in decisions about their care.

Schlachter described one case in which a patient had a painful infected area on her back, but doctors were more concerned about her gastric symptoms and treated her for gastroenteritis despite her concerns. Within 24 hours, she went into septic shock and surgeons had to amputate all of her limbs, Schlachter said. A case like that, he said, is an example of a doctor failing to examine the patient correctly and failing to communicate effectively with her.

But patients also have to take some responsibility, Schlachter said. For instance, patients must be proactive when selecting doctors and should actively participate in decision-making. Because many patients may be nervous or reluctant to question medical professionals, he suggests providers accommodate them and encourage open discussion. Patients need to have strategies to protect themselves, too, he said.

“(Patients) don’t have to become annoying or inquisitory. All can be done in a normal fashion, and healthcare providers should answer the questions in a normal fashion,” Schlachter said. “I’m not trying to create a war zone between patients and doctors. … If I can start a conversation, if I can make people start questioning things more, I will be happy. I will have succeeded.”