No i dont think doctors tell you when there have been prior errors. This isnt science we are dealing with its some sort of art and if they start dobbing in their mates then they will open themselves up to criticism.

I spent 9 years in the Army - I had a new posting every 2 years - it gave me quite a unique view on things. My conditions like eczema or knee degeneration didnt change - but every different doctor had a different diagnosis when i changed postings. One doctor was convinced the eczema on my feet was athletes foot when it clearly wasnt. One doctor was convinced my grade 4 cartilage degeneration in my knee was nerve damage when it clearly wasnt - but because i changed doctors every 2 years i got to see how much hand waving actually goes on with a diagnosis.

I can see all this now quite clearly when i read my medical notes that i got a copy of on discharge, but at the time it must have been quite clear to each new doc on posting the discrepancies in the history, but not a one of them dobbed in the previous one, because i assume they hope the next one wont dob them in too for their own hand waving.

lol pressure - pass the Xanax

Agreed. With one notable exception, no physician has ever written a note for me that has even implied misdiagnosis or surgical error; and the notes are so contradicting of one another that there are more red flags for me than not, yet no physician will even begin to answer any questions I raise. The exception being an out-of-state neuro who was so appalled at some prior surgeries that he offered verbally to participate in a deposition should I pursue legal recourse.

It seems that most of us on this board suffer from ignorance/ misinformed physician care than actual malpractice. However, those with untreated but evident pap seem to suffer from inconsistent diagnosis & actual medical error in the worst way.

Ethically, of course physicians should bring these matters to a patient's attention, but it rarely if ever happens.

Additionally, there are hidden detriments to patients who take these physicians and/or colleagues to task. We decided long ago that I had no option to pursue my "bad surgeon" -- my state has tort reform (limiting malpractice awards). But even more insidious is that if one makes a stink about a particular physician, one risks one's access to further care throughout the entire medical community -- a big red sticker in your file that says "litigant". Because our large neuro community actually is quite tied at the hip, no neuro would see me if I implied previous bad care.

So the real question then is Keren, how do you get proper treatment for your cartilage degeneration with so many mis-DX in your file? How do any of us get REAL treatment when hand-waving is now the norm?

yeah, docs protect each other. it has to be pretty blatant and it has to have caused harm, and the doc has to be one that cares. most don't want to get involved or cause trouble.

Something I was surprised to find when I went into nursing was how much of a continuum medical error is on. There is outright medical error - such as administering the wrong medication, wrong surgery, the dramatic, clear stuff - and then there are the judgment calls that could have been done better. Medicine is an art that is based on science. And I think that part of the reason doctors don't always come out and tell you bluntly that another doctor was wrong is that medical opinion is called that for a reason. Plus you have to be careful not to incite lawsuits. That's just a hassle. ;) So I think that even when a second opinion physician disagrees with the first, they learn to do so carefully. Of course I have known doctors who tell it like it is, regardless. They are usually brilliant and confident enough not to care if colleagues are offended.

The trouble is that sometimes the "error" isn't clear until later and depends so much on how an individual person responds to a treatment, etc. We used to use the term "hindsight is 20/20" in the hospital on a near daily basis. I think they are off the hook a lot because of the individuality in health care. What were the chance I would respond to IV steroids with IIH? Had to be pretty darn low! Blech.

So, I guess then we as patients have to rely on finding the good physicians who can tease out the bs and/or error and then set a new baseline for treatment? All within the context of implicit trust and willingness to move forward from a new starting point each time.

It must be terribly hard on the good medical people to have to do this and still stay within the 'lines' most times. Hat tips all 'round to our medical friends here!

- trust - thats the key word

some one who will be up front and honest with you i.e. says: i think it might be this - lets try this treatment and see where this gets us etc -..... then, yes or no that didnt work - i will revise my statement, so it looks like what we are dealing X..... i much prefer that to all the bs

But you asked Pressure, how do i get proper treatment for my cartilage degeneration? well the army sends you to its top rehab facility for war vets- it does an Op which doesnt work then it Discharges you to the national health service who are not interested in your mixed medical history, and often re-defined knee problems and leaves you disabled for the rest of your life at the age of 34. but that's all irrelevant cause then you get IIH that same year and thyroid problems and have more worries then having to walk with sticks.

Golly wizz i am chipper this weekend - not. my GP sneered at me when my bad new neuros letter finally arrived summarizing our appointment and supporting the view of my bad old neuro. i am not feeling the trust and support for the medical profession at the moment and my shingles antivirals have set off my kidneys killing me but I am not fancying going back in a for another sneering at. lol. never mind, you know me. dont stay cranky for long. :)

Hey Keren: sending Xanax right 'way now using my special mental powers. Good grief, did not realize that your GP already got "The Note". Arrrggghhh.

So now you're not allowed any pain meds whatsoever; you don't have IIH because it magically resolved; you DO have migraines of some sort and your GP is to manage those meds for the next 4 mos or so, but those meds haven't been prescribed yet; you can't literally get a sleep study because NHS is so fast & fab; your GP is auditioning for RSC with the constant sneering bit; your thyroid is treated somewhat but basically ignored and deemed irrelevant to all other SX; AND, you're walking with pretty sticks as a "Thank You for Your Service, mum". NICE!

Seriously, it's the trust issues that fetter me so. I have a handful of good MDs I do trust implicitly. I have not had trust success with any of the neuro community except for the one out-state fellow who was unbelievably open & honest. Thing is, that poor dear man was killed in a bike/auto smash job just a week after I saw him the one time. Still makes me cry to think of such a good man & his family ruined by a drunk driver.

I get and appreciate the value of differential DX; what I don't get is the "giving up and walking away" part when a year later after umpteen $40,000 procedures & tests, conclusions don't reveal what the doc was hoping to find, but do reveal signs of IIH that are ignored. That's when my hackles rise as more & more wastebasket DX make it into my file so I can be bounced yet again to more MDs who have to start the process over. Nary a one has ever tried to look at my medical history in a global manner. For instance, more than not I've had neuros tell me that my 3 rounds of CSF leaks had nothing to do with increased ICP (even with scans showing partially empty sella!).

I think I've joined the cranky wagon going on day 3. Please send some sticks so I can wield them wildly in clinic rooms! :)

lol PC i think your Xanax is kicking in - i had a good chuckle at your summary of me -it about fits the bill, then i had a bit of a cry about the poor neuro in the drunk driving incident, then joined you in a rant over bloody stupid doctors who refuse to look at the big picture - especially if god forbid it touches a topic that might be someone else's discipline (which is most of the damn body) - then i had a vivid mental image of us both slightly off our heads raising hell on a ward, wildly waving some walking sticks around and telling the doctors to get their arses in gear. LMAO - that would give them something to complain about on the medical reports - HA!

Bet we'd get a heck of a mental DX for that! :) Destructive Maniacal Conversion Disorder with Imminent Risk to Public Safety (but no IIH ever).

seriously, sometimes I think we need to start our own country. we live in an alternate universe and no one gets it.

Empress SophiasMom of IntraCranalia!

haha. I'm more like the wizard in the ivory tower. do not approach. Mary should be the queen.

the country name could be Hephaestus (an Apollo asteroid discovered in 1978). Hephaestus was the greek god of the Forge, and when Zeus had a bad headache, Hephaestus chopped his head open in order to cure it.

On the note of medical malpractice/errors/misdiagnosis, this is why John Hopkins advocates being open with patients after they lost a pediatric patient to dehydration/overdose. This child was schedule to be discharged in the coming days. The mother did not want to sue, she wanted the world to understand that people make mistakes and there needs to be reform.
Here in Michigan I have not seen this attitude come into full view. I miss Indiana where everything is a learning experience and when a mistake was made they put a committee together and found a way to make sure that mistake was not made again. The attitude of the institution, the doctors and the nursing staff is the real problem. Fix that and you will have better patient outcomes and frankly happier patients.
Here is an article from the Sun about the new safety institute that John Hopkins has put together. The first of its kind: http://articles.baltimoresun.com/2011-05-26/health/bs-hs-hopkins-patient-safety-20110526_1_patient-safety-medical-mistakes-patient-deaths

AimHigh: this is hopeful - thanks for sharing. Better outcomes are tied heavily now to medicare/medicaid reimbursements, so let's all hope that this sort of transparency is well- and broadly adopted!