Transcript: Dr. Philip Hebert On The Incidence of Medical Errors | May 21, 2003

Allan is in his mid fifties and has light brown hair, and a greying goatee. He wears a black blazer and a white button up shirt.
Allan and Philip sit in a living room with a circular table between them.

Allan says NOW, WE'VE ALL HEARD HORROR
STORIES ABOUT PEOPLE GETTING
THE WRONG LEG AMPUTATED, OR
DYING OF AN OVERDOSE OF THE
WRONG KIND OF MEDICATION.
I WANT TO START OUR TALK
TODAY JUST UNDERSTANDING THE
MAGNITUDE OF MEDICAL ERRORS
THAT WE MIGHT BE DEALING
WITH IN CANADA.
HOW FREQUENT IS THIS?
WHAT KIND OF NUMBERS
ARE WE TALKING ABOUT?

The caption appears. It reads “Dr. Philip Herbert. Medical Ethicist.”
Dr. Philip is in his fifties and has grey hair and is clean-shaven. He wears glasses, a brown suit, white shirt, and brown tie.

Dr. Philip says WELL; I'M GOING TO HAVE TO
BACK UP A LITTLE AND SAY WE
DON'T HAVE GOOD FIGURES,
AS YET, FOR CANADA.
THERE'S A LARGE STUDY GOING
ON, SO THE WORK THAT'S BEEN
DONE IS MAINLY IN OTHER
COUNTRIES, SUCH AS THE U.K.,
THE U.S., AND AUSTRALIA.
AND THE MAGNITUDE IS
SURPRISINGLY LARGE.
APPROXIMATELY 10 PERCENT
OF PATIENTS ARE HARMED,
PATIENTS ADMITTED TO HOSPITAL
THE AVERAGE ADMITTED TO HOSPITAL ARE HARMED ON ACCOUNT OF
THE CARE THEY RECEIVE.

Allan says DO WE HAVE AN
ESTIMATE OF DEATHS?

Dr. Philip says WE HAVE AN
ESTIMATE OF DEATHS.
ABOUT 1 IN 200 TO 250
ADMISSIONS, PATIENTS DIE ON
ACCOUNT OF WHAT WE DO TO THEM.

Allan says COULD THIS BE AS MANY AS
5,000 TO 10,000 DEATHS
A YEAR IN CANADA?

Allan says THIS, IT'S BEEN ESTIMATED IN
THE STATES, 50,000 TO 100,000,
SO IN CANADA, THAT WOULD
BE A REASONABLE ESTIMATE.
NOW, IT'S NOT TO SAY ALL THESE
PATIENTS WOULD BE ALIVE TODAY
HAD IT NOT BEEN
FOR THIS ERROR.
THESE ARE TYPICALLY VERY
SICK PATIENTS RECEIVING A
MULTITUDE OF MEDICATIONS.
SO IT'S NOT TO SAY THEY
WOULD ALL BE ALIVE TODAY.
BUT STATISTICS SHOW THAT AN
ADVERSE EVENT, OR MEDICAL
ACCIDENT, WAS INVOLVED IN THEIR
CARE, AND THEIR POOR OUTCOME.

Allan says OKAY, NOW WHAT ARE
WE TALKING ABOUT?
I MEAN, WHAT IS A MEDICAL
ERROR, FIRST AND FOREMOST?

Dr. Philip says WELL, A MEDICAL ERROR CAN BE
DEFINED AS FAILURE TO ACHIEVE
A DESIRED OUTCOME.
AND SOMETIMES PREVENTABLE,
SOMETIMES NOT.
BUT A VERY TYPICAL EXAMPLE
WOULD BE PATIENT IS ALLERGIC
TO A MEDICATION.
THEY RECEIVE IT ANYWAY BECAUSE
SOMEONE MISSED THE FACT THAT
THEY WERE ALLERGIC.

Allan says DIDN’T SEE IT ON THEIR CHART.

Dr. Philip says RIGHT.
IN FACT, THAT KIND OF MISTAKE,
A DRUGA-RELATED MISTAKE, IS
THE COMMONEST KIND
OF MISTAKE WE SEE.

Allan says THAT IS THE MOST COMMON?

Dr. Philip says ONE IN FIVE ERRORS IN
HOSPITALS ARE CAUSED BY SOME
DRUG RELATED EVENT.
WRONG PATIENT, WRONG
DRUG, WRONG TIME.
COMPLICATION, SIDE
EFFECT OF THE MEDICATION.
THAT'S A VERY LARGE PROPORTION
OF EVENTS THAT HAPPEN
IN HOSPITAL.

Allan says MISDIAGNOSES.
DOES THAT HAPPEN FREQUENTLY?
AND HOW WOULD IT OCCUR?

Dr. Philip says VERY COMMONLY.
PNEUMONIA MISTAKEN
FOR HEART FAILURE.
HEART FAILURE MISTAKEN
FOR PNEUMONIA.
CAN GO EITHER WAY.
AND MEDICINE IS A
COMPLEX ENTERPRISE.
I MEAN, FUNDAMENTALLY,
MEDICINE IS, PEOPLE AREN'T
LIKE MACHINES.
IT'S NOT LIKE TAKING YOUR
BODY, YOUR CAR INTO AN
AUTO MECHANIC AND
HAVING IT DIAGNOSED.
IT'S NOT THAT SIMPLE.
MEDICINE IS
FUNDAMENTALLY COMPLEX.
SIMPLE THINGS CAN TURN
OUT TO BE COMPLICATED.
COMPLICATED THINGS CAN
APPEAR IN SIMPLE WAYS.
SO MEDICINE IS A VERY HARD
THING TO PRACTICE, EVEN TODAY.

Allan says ONE OF THE ARTICLES I WAS
READING IN PREPARATION FOR
THIS TALK, I WAS SURPRISED TO
SEE THAT FILING WAS LISTED
IN THE TOP FIVE CAUSES
OF MEDICAL ERROR.
SIMPLY HAVING THE WRONG
THINGS IN THE FILES.

Dr. Philip says YEAH.
OR THINGS NOT BEING IN FILES
THAT SHOULD BE IN FILES.
HERE'S AN EXAMPLE.
A PATIENT COMES BACK TO SEE
THEIR PHYSICIAN FOR A PROBLEM
UNRELATED TO THE
PREVIOUS VISIT.
AND THE PATIENT SAYS, OH,
I DIDN'T HEAR FROM YOU, I
PRESUME MY CHEST X-RAY WAS
NORMAL FROM THE LAST TIME.
PHYSICIAN LOOKS IN HIS CHART AND
THE CHEST X-RAY IS NOT THERE.
THIS IS SIX MONTHS EARLIER.
CALLS UP TO RADIOLOGY, AND
RADIOLOGIST SAYS, OH,
THERE'S A MASS ON THAT CHEST
X-RAY, DIDN'T YOU KNOW?
THE PHYSICIAN NEVER
RECEIVED THAT REPORT BACK.

Allan says NEVER CAME FROM THE LAB.

Dr. Philip says NEVER CAME FROM THE
LAB BECAUSE THERE WAS
A CHANGEOVER IN
COMPUTERS IN RADIOLOGY.
AND RATHER THAN GOING BACK
TO THE ORDERING DOCTOR, SOMEHOW
IT GOT MISFILED AND ENDED
UP IN DEAD SPACE SOMEWHERE.
THIS IS A VERY, VERY
COMMON PROBLEM IN MEDICINE.
COMPLEXITY.
WE ORDER TOO MANY TESTS,
WE DO TOO MANY THINGS,
THINGS GET LOST.

Allan says EVERYONE, I THINK, HAS
EXPERIENCED THIS, TOO.
FAILURE TO MONITOR PATIENTS.
HOW MUCH MEDICAL ERROR
IS A FUNCTION OF SIMPLY
BENIGN NEGLECT?
THE INABILITY TO KEEP ON TOP
OF THE PATIENT'S PROGRESS WHILE
THEY ARE IN THE HOSPITAL?

Dr. Philip says AND IT MAY BE SOMETHING AS
SIMPLE AS NOT MONITORING
SOMEBODY'S VITAL SIGNS.
THERE WAS A DEATH AT A
LARGE HOSPITAL IN TORONTO
NOT LONG AGO, AND THIS
MADE FRONT-PAGE HEADLINES.
AND THE SURGEON INVOLVED SAID I
DIDN'T LOOK AT HER VITAL SIGNS.
I THOUGHT THE NURSES DID.
AND THE NURSES SAID, WE DIDN'T
LOOK AT IT BECAUSE WE THOUGHT
THE DOCTOR DID.
HE CAME BY TO LOOK
AT THE PATIENT.
AND ADMITTED IN THE FRONT
PAGE OF A TORONTO PAPER,
THE PHYSICIAN FAILED TO DO
WHAT HE COULD HAVE DONE.
VERY SIMPLE THING.
AND THIS FAILURE TO DO ROUTINE
CHECKS BECAUSE YOU THINK
SOMEBODY ELSE HAS DONE IT, IS
A VERY COMMON SOURCE OF ERROR
IN MEDICINE.
I CAN'T SAY IT'S THE
BIGGEST SOURCE, BUT IT IS
A COMMON SOURCE.

Allan says THE ONES THAT ALMOST ALWAYS
GET THE BIGGEST HEADLINES ARE
SURGICAL ERRORS.
THE WOMAN WHO GETS THE WRONG
BREAST REMOVED IN A MASTECTOMY
FOR BREAST CANCER.
I MEAN, AGAIN, DOES
THIS HAPPEN FREQUENTLY,
AND IF IT DOES, HOW
WOULD THAT EVER OCCUR?

Dr. Philip says WELL, ONE WAY IN WHICH IT
OCCURS IS WRONG SIDE OF THE
BODY YOU OPERATE
ON THE WRONG SIDE.
FAMOUS CASE IN THE STATES WAS
A CASE WHERE A MAN HAD THE
WRONG LEG AMPUTATED.
PEOPLE WERE HORRIFIED.
BUT, IN FACT, BOTH HIS LEGS
WERE TERRIBLY DISEASED BY
PERIPHERAL VASCULAR DISEASE,
SO HE HAD A PROBLEM
WITH BOTH LEGS.
ONE LEG LOOKED ALMOST AS BAD
AS THE OTHER, AND I GUESS THAT
LED THE SURGEON TO
OPERATE ON THE WRONG LEG.
SOME PEOPLE SAY YOU SHOULD PUT
X ON THE LEG YOU ARE GOING
TO OPERATE ON.
BUT MAYBE X MEANS THAT'S THE
LEG YOU DON'T OPERATE ON.
SO THERE HAVE BEEN VARIOUS
SOLUTIONS PROPOSED FOR THIS,
NONE OF WHICH SEEM
TO HAVE WORKED.
IT MAY BE AN X-RAY
FLIPPED THE WRONG WAY.
SOMEONE PUTTING THE SYMBOL FOR
LEFT WHEN IT SHOULD HAVE BEEN
THE RIGHT SIDE.
SO THERE'S A WHOLE COMBINATION
OF THINGS THAT CAN HAPPEN.

Allan says ONE OF THE MOST DISTURBING
ONES THAT I READ ABOUT WAS,
AGAIN, AN ONTARIO HOSPITAL
WHERE THERE WAS A MISTAKE
INJECTION OF POTASSIUM
CHLORIDE THAT, WHAT MADE IT
DISTURBING IS THAT IT HAPPENED
TWICE IN THE SAME HOSPITAL.
HOW DOES THAT OCCUR?
WHY ARE THESE
THINGS NOT CAUGHT?

Dr. Philip says WELL, THIS IS A VERY
DISTURBING EVENT.
CONCENTRATED POTASSIUM
CHLORIDE HAS ABSOLUTELY NO
BUSINESS BEING ON ANY FLOOR
IN ANY HOSPITAL ANYWAY.

Allan says THAT'S WHAT THEY USE FOR
LETHAL INJECTIONS IN DEATH ROW.

Dr. Philip says THAT'S WHAT THEY USE
FOR LETHAL INJECTIONS.
AND THAT'S INDEED
WHAT WILL HAPPEN.
IF IT'S INJECTED INTO YOUR
VEINS YOU'LL DIE WITHIN
MINUTES BECAUSE IT LEADS
TO CARDIAC STANDSTILL.
NOW, WE HAVE IT OUT OF
TRADITION, PEOPLE LIKE HAVING
POTASSIUM AROUND TO PUT
IN INTRAVENOUS BAGS.
WE GIVE PEOPLE ELECTROLYTE
SOLUTIONS, WE LIKE A LITTLE
POTASSIUM IN THERE.
SO TYPICALLY A NURSE WILL TAKE
A LITTLE BIT OF CONCENTRATED
POTASSIUM, PUT IT IN THE
SOLUTION, GIVE IT TO THE
PATIENT.
THE PROBLEM IS, IN THE HEAT OF
THE MOMENT, YOU MAY, WHEN YOU
WANT TO GIVE A PATIENT A
DIRECT INJECTION INTO THEIR
VEIN, YOU MAY PICK THAT VIAL UP
THINKING IT'S SOMETHING ELSE.
AND THIS IS WHAT'S HAPPENED.

Allan says HOW WOULD IT HAVE
HAPPENED TWICE?
ONE TIME, YOU COULD SAY,
THAT'S AWFUL AND TRAGIC.

Dr. Philip says WELL, THE HOSPITAL DIDN'T
TAKE IT OFF THE SHELVES WHEN
THEY SHOULD HAVE TAKEN
IT OFF THE SHELVES.
THAT'S A SIMPLE WAY.
YOU DO NOT NEED POTASSIUM
CHLORIDE ON THE WARD.
AND HOSPITALS ARE
TRYING TO REMOVE IT.
THEY HAVEN'T ALL DONE SO.
AND PEOPLE WILL SAY THINGS
LIKE, WELL, WE'VE NEVER HAD
A PROBLEM HERE WITH
POTASSIUM CHLORIDE.
WELL, IT'S AN ACCIDENT
WAITING TO HAPPEN.
THERE'S NO REASON WHY YOU HAVE
TO HAVE POTASSIUM CHLORIDE
ON THE WARD.
YOU CAN PREMIX THE BAGS WITH
POTASSIUM IN THE PHARMACY AND
SEND THEM UP TO THE FLOOR.

Allan says NOW, WE ARE ALL FAMILIAR WITH
CUTBACKS THAT HOSPITALS HAVE
UNDERGONE IN RECENT TIMES,
ESPECIALLY THE
SHORTAGE OF NURSES.
DOES THAT REALLY COMPOUND
THE SYSTEM PROBLEMS
THAT IS ALREADY THERE?

Dr. Philip says THERE'S NO QUESTION ABOUT IT.
AND THERE HAVE BEEN MANY
STUDIES TO BACK THAT UP.
JUST A VERY SIMPLE ONE, FOR
EXAMPLE, THERE HAVE BEEN
SEVERAL STUDIES LOOKING
AT INTENSIVE CARE.
INTENSIVE CARE, OF COURSE,
MANY, MANY THINGS ARE DONE TO
PATIENTS, AND THERE IS A
DIRECT CORRELATION BETWEEN THE
STAFFING AND THE ADEQUACY
OF THE STAFFING, AND THE
OCCURRENCE OF ADVERSE EVENTS
OR MEDICAL ACCIDENTS.

Allan says RIGHT.

Dr. Philip says THERE WAS ALSO ANOTHER
STUDY A COUPLE OF YEARS AGO
OUT OF ONTARIO.
THIS WASN'T VERY GOOD
EVIDENCE, SUGGESTING THAT THE
RATE OF ERROR HAD GONE UP
AS THERE HAVE BEEN CUTBACKS
IN HEALTHCARE.
NOW, ON THE OTHER HAND, YOU
COULD SAY MAYBE WE'RE MORE
VIGILANT ABOUT ERROR,
PICKING IT UP MORE.
SO IT'S HARD TO KNOW HOW
MUCH RELIABILITY TO PUT
IN THOSE STATISTICS.
BUT THERE DOES SEEM
TO BE A CORRELATION.
AND, CERTAINLY, THAT'S
THE EXPERIENCE OF EVERY
HEALTHCARE PRACTITIONER.
MULTITASKING, DOING THINGS THAT
OTHER PEOPLE WOULD HAVE DONE,
LOOKING AFTER MORE PATIENTS,
SICKER PATIENTS.
THOSE ARE THE SITUATIONS
IN WHICH ERROR HAPPENS.

Allan says NOW, I KNOW BECAUSE IT'S A
RECENT OCCURRENCE THERE'S NO
PROSPECT OF HAVING ANY
RESEARCH AROUND IT, BUT I
WOULD GUESS, ALSO, THAT WHEN
YOU HAVE A MEDICAL EMERGENCY,
LIKE WE HAVE WITH SARS RIGHT
NOW, THAT MUST HAVE A HUGE
COMPLICATING AND COMPOUNDING
EFFECT ON MEDICAL ERRORS.

Dr. Philip says IT DOES BECAUSE IT MAKES,
AGAIN, IT MAKES CERTAINTY
MUCH LESS LIKELY.
YOU DON'T KNOW WHETHER THIS
NEXT PATIENT COMING IN WITH A
COLD HAS, IN FACT, SARS OR A
MORE SERIOUS ILLNESS GOING ON.
ANOTHER EXAMPLE OF THAT IS
RETAINED INSTRUMENTS FOLLOWING
SURGICAL PROCEDURES.
ONE CORRELATE OF THAT IS
EMERGENCY PROCEDURES.
IN OTHER WORDS, IF YOU
HAVE AN EMERGENCY SURGERY,
YOU'RE MORE LIKELY TO HAVE AN
INSTRUMENT OR SOME PACKING
LEFT INSIDE YOU THAN IF IT
WASN'T AN EMERGENCY SITUATION.

Allan says RIGHT.

Dr. Philip says SO EMERGENCIES MAKE ACCIDENTS
MORE LIKELY TO HAPPEN.

Allan says YOU TALK ABOUT THE LACK OF
REPORTING SYSTEM IN CANADA.
UNTIL VERY RECENTLY,
THE LACK OF RECOGNITION.
THIS IS A PROBLEM.

Dr. Philip says YES.

Allan says I MEAN, YOU'VE CITED IN
SOME OF THE ARTICLES YOU'VE
WRITTEN, MANY EXAMPLES WHERE
THE PATIENT'S DESIRE FOR
DISCLOSURE OF MEDICAL ERRORS
IS FAR, FAR GREATER THAN A
DOCTOR'S WILLINGNESS
TO TALK ABOUT ERRORS.
ABOVE AND BEYOND THE FEAR OF
LAWSUIT, WHICH I WANT TO TALK
ABOUT ALSO, WHAT CONTRIBUTES
TO A PHYSICIAN OR CLINICIAN'S
RELUCTANCE TO ACTUALLY
REPORT MEDICAL ERRORS
AND TO ADMIT THEM?

Dr. Philip says I GUESS TWO THINGS.
ONE IS, AT A VERY GUT LEVEL,
THESE ARE WRENCHING EVENTS,
GUT WRENCHING EVENTS
FOR CLINICIANS.
NOBODY, AS YOU SAID
EARLIER, GOES IN WANTING
TO HARM PATIENTS.
SO THE IDEA YOU CAN HARM
PATIENTS IN THE COURSE OF WHAT
YOU DO IS A TERRIBLE EVENT FOR
A CLINICIAN, ESPECIALLY IF
THE DEATH OR SERIOUS
INJURY OF A PATIENT CAN BE
SOUL-DESTROYING.
SO ON A PSYCHOLOGICAL LEVEL,
VERY HARD TO OWN UP TO THESE
EVENTS, TO SAY I'M
RESPONSIBLE, I'M ACCOUNTABLE
FOR THIS EVENT.

Allan says THIS IS PART OF THE
SELF-IMAGE OF THE PHYSICIAN.

Dr. Philip says THAT'S RIGHT.
SO THERE'S THAT WHOLE
PSYCHOLOGICAL OVERLAY
TO THESE EVENTS.
BUT THEN THERE'S ALSO
RECOGNITION MEDICINE IS A
COMPLEX ENTERPRISE.
WHAT IS AN ERROR ANYWAY?
SOMETIMES HINDSIGHT
IS PERFECT, ISN'T IT?
PEOPLE SAY, WELL, YOU
MADE THIS MISTAKE.
BUT, YOU KNOW, WHEN YOU ARE
THE ACTOR IN THAT EVENT, THERE
MAY HAVE BEEN A WHOLE NUMBER
OF THINGS THAT MADE THAT
SITUATION MUCH MORE
COMPLICATED THAN IT APPEARS
IN RETROSPECT.
SO SOMETIMES PHYSICIANS DON'T
KNOW, IS THIS AN ADVERSE EVENT?
IS IT AN ERROR?
IT IS JUST A
DIFFERENCE IN JUDGMENT?

Allan says WE'RE LIVING IN A
LITIGIOUS SOCIETY.
EVERYBODY KNOWS THIS.
THE FEAR OF REPRIMAND, OF
PUNISHMENT, OF LEGAL ACTION
OBVIOUSLY PLAYS, IN PART,
THE RELUCTANCE TO REPORT.
BUT I WAS AMAZED AGAIN, AT ONE
OF YOUR STATISTICS, THAT ONLY
2 PERCENT OF PATIENTS THAT ARE
INVOLVED WITH MEDICAL ERROR SUE.
WHY SO LOW?

Dr. Philip says WELL, THERE ARE
MANY REASONS WHY.
ONE, IT'S A HUGE UPHILL BATTLE
TO SUE AND TO WIN THAT.
SO I THINK THERE'S JUST
ENORMOUS GRAVITATIONAL PULL
AWAY FROM SUING PHYSICIANS,
JUST BECAUSE YOU HAVE TO
GO UPHILL.

Allan says SO THAT FEAR IS OVERBLOWN.

Dr. Philip says YEAH.
OH, IT REALLY IS OVERBLOWN.
AND I THINK ALSO, WHY
DO PEOPLE SUE ANYWAY?
PEOPLE SUE FOR WANT
OF INFORMATION.
AND IF THEY GET THAT
INFORMATION FROM CLINICIANS,
THERE MAY BE A LESS NEED
FOR THEM TO SEEK THAT SUIT
IN THE FIRST PLACE.
SO SOMETIMES PEOPLE SUE
BECAUSE THERE IS A GENUINE
NEED FOR MONETARY RECOMPENSE
FOR AN INJURY SUFFERED,
LOSS SUFFERED.
BUT ON THE OTHER HAND, PEOPLE
SUE BECAUSE THEY DON'T KNOW
WHAT HAPPENED.

Allan says IN FACT, I UNDERSTAND THE
DOCTOR WHO WAS INVOLVED IN THE
TRANSPLANT, THAT CASE OF THE
TRANSPLANT OF THE HEART LUNGS
THAT WERE OF THE WRONG BLOOD
TYPE, IT DID COME FORWARD
AND CONFESS.
WHAT ARE THE
REPERCUSSIONS FOR THAT?

Dr. Philip says WELL IT'S HARD TO SAY.
WE'RE NOT AT THE END OF THAT
PARTICULAR STORY, BUT WHAT WAS
INTERESTING FOR ME ABOUT THAT
WAS THE IMMEDIACY WITH WHICH
THE CLINICIAN
ADMITTED THE MISTAKE.
BUT, ALSO, IT JUST SHOWS YOU
THE BEST PEOPLE CAN MAKE THE
MOST SERIOUS MISTAKES, AT
THE BEST OF INSTITUTIONS,
AT A VERY FUNDAMENTAL LEVEL.
THAT'S WHY YOU THINK ONE WAY
OF ATTACKING ERROR IS YOU TAKE
ALL THE ERRING CLINICIANS AND
THROW THEM ALL INTO THE SEA.
WELL, IF YOU DO THAT, THE SAME
ERRORS WILL HAPPEN TOMORROW,
AND YOU TAKE ALL THOSE
CLINICIANS AND THROW THEM INTO
THE SEA, THE SAME WILL
HAPPEN THE DAY AFTER THAT.
SO THIS ADMISSION, AT THE
OUTSET OF THE EVENT, IS A VERY
POSITIVE, I THINK, STEP
FOR AN INSTITUTION.
AND WILL LEAD MUCH MORE
QUICKLY TO CORRECTIVE ACTION
ON ACCOUNT OF
THAT INSTITUTION.

Allan says I UNDERSTAND THE FINANCIAL
IMPLICATIONS OF MEDICAL
ERRORS ARE ALSO HUGE.

Dr. Philip says OH, IT IS, YEAH.
I MEAN, THE AUSTRALIANS
FIGURED IT COUNTED FOR,
MEDICAL ACCIDENTS AND ADVERSE
EVENTS COUNTED FOR 10 PERCENT
OF HOSPITAL SPENDING.
10 PERCENT.
THAT'S A HUGE AMOUNT OF MONEY.

Allan says YEAH, IS IT EVER.

Dr. Philip says WE'RE TALKING BILLIONS
OF DOLLARS IN THE STATES,
AND I GUESS HUNDREDS OF
MILLIONS IN CANADA.
BUT THE INEFFICIENCY, THE
MISUSE, THE UNDERUSE, THE
OVERUSE OF TREATMENTS, ALL
THESE THINGS, IF ADDRESSED
PROPERLY, COULD LEAD TO VERY,
VERY SIGNIFICANT SAVINGS.

Allan says PATIENT PROACTIVITY.

Dr. Philip says YES.

Allan says WHAT WOULD YOU ADVISE
PATIENTS TO DO TO BE AS
VIGILANT AS THEY CAN TO PLAY
THEIR PART IN THE REDUCTION
OF MEDICAL ERROR?

Dr. Philip says SO HERE'S A SIMPLE ONE,
AND I TELL MY PATIENTS THIS.
IF YOU CAN'T READ YOUR
DOCTOR'S PRESCRIPTION WHEN
YOU'RE LEAVING THE OFFICE,
GET HIM TO REWRITE IT.
I REWRITE A LOT OF
PRESCRIPTIONS THESE DAYS.

Allan says BECAUSE THERE'S A CHANCE THE
PHARMACIST WON'T BE ABLE TO
READ IT EITHER.

Dr. Philip says THAT'S RIGHT.
AND ALSO FOR THE PATIENT
TO KNOW WHAT HE OR SHE IS
SUPPOSED TO BE
TAKING AND WHEN.
SO WHAT DOES THIS
MEAN, DOCTOR?
WHAT DO THESE HIEROGLYPHICS
MEAN YOU'VE WRITTEN HERE?
SO WRITE A LEGIBLE
PRESCRIPTION.
AND IF THE PATIENT CAN'T
READ IT, THE PATIENT SHOULD
SPEAK UP AND ASK THE
DOCTOR TO REWRITE IT.
AND I THINK THAT INVOLVEMENT
OF PATIENTS IN THEIR OWN
CARE IS EXTREMELY IMPORTANT.
IF YOU'RE IN HOSPITAL, IF AT
ALL POSSIBLE, TAKE SOMEBODY
WITH YOU, IF YOU CAN.
JUST TO BE VIGILANT ABOUT
WHAT IS GOING IN THIS BAG?
WHO IS LOOKING AFTER MY
FATHER, MY MOTHER, WHATEVER.

Allan says DON’T HIDE IT UNDER A BUSHEL.
THERE'S NO SIN IN BEING VOCAL.

Dr. Philip says ABSOLUTELY.
IF YOU'RE NOT SURE WHAT'S
GOING ON, I REMEMBER MY OWN
MOTHER, WHEN SHE WAS QUITE
ILL IN HOSPITAL, SHE'D LAPSED
INTO A COMA.
WHEN I WENT TO SPEAK TO THE
NURSE, AND A COUPLE OF MY
SIBLINGS WERE THERE, AND THEY
DIDN'T RECOGNIZE THIS BECAUSE
THEY THOUGHT SHE WAS SLEEPING.
I WENT TO THE NURSE, I
SAID MY MOTHER'S IN A COMA.
SHE SAID, NO, SHE'S
JUST SLEEPING.
I SAID, NO, NO,
SHE'S IN A COMA.
AND THEY HADN'T BEEN AROUND
FOR A COUPLE OF HOURS.
THEY HADN'T CHECKED ON HER.
IF I HADN'T BEEN THERE, IF
I HADN'T BEEN A PHYSICIAN,
WHO KNOWS HOW LONG IT
WOULD HAVE GONE ON.
SO YOU HAVE TO BE VIGILANT.
YOU HAVE TO SPEAK UP.
ASK QUESTIONS ---IN A
NICE WAY, OF COURSE.
BUT IF YOU DON'T DO THAT,
AGAIN, THAT LACK OF VIGILANCE
IS A THING THAT LEADS
MEDICAL MISTAKES TO HAPPEN.

Allan says Dr. PHILIP HEBERT, I WANT
TO THANK YOU VERY MUCH
FOR JOINING ME.
IT'S BEEN A REAL PLEASURE.

Dr. Philip says THANK YOU KINDLY
FOR THE INTEREST.

Watch: Dr. Philip Hebert On The Incidence of Medical Errors