lastpointe
Trillium Health Care Scandal
Posted on: 09/13/2013 13:38
These past few days have seen another health care scandal related to misread scans and mammograms. To date 3500 people have gotten letters that their results are being reassessed.
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A radiologist is suspended.
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It seems like this happens somewhere every year or so.
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Radiology is such an important part of the health care system and yet b all accounts they are vastly overworked.
.what is the answer to how to correct this problem? Each scan reviewed by two people? Double the cost?
And what do you say to the woman who got a clear result from her mammogram last year and now has stage for lung cancer after it was misread.
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chemgal
Posted on: 09/13/2013 13:56
The wait lists seem to be longer in ON, but this sort of thing also seems to happen more often there. I don't know if the system there is more prone, or if it's just coincindental.
Maybe a quick review of each person would be the solution? Aren't scans often already seen by more than one person? I had a CT scan, and I assume a radiologist looked at it, I know my ENT saw it and my GP has likely seen it too. I'm unsure of the regulations about non-radiologist MDs interpretting the results, but if there's something abnormal they should pick up on it if it isn't minor.
Mendalla
Posted on: 09/13/2013 15:06
The problem is that some things show up fairly subtly on X-Rays and it is radiologists who are trained to look at an X-Ray (or CT or MRI) with full knowledge of how things are supposed to look on an X-Ray or CT or MRI. Yes, a GP or ENT might pick up some things but without the training and experience of the radiologist, there would probably be more, not fewer, diagnostic errors.
Our health care system is stressed and one of the stresses is a lack of specialists like radiologists. The problem is not necessarily pay, either, or so I've heard. They may not make more (but often do) in the US private system but they aren't as stressed. They aren't the only specialist of their type in their hospital, let alone in their region or province as sometimes happens here. If you're the only one (or at least one of only a few) and all the cases come to you, then inevitably you're going to overload and make mistakes.
The shortage increases our costs, too. I know at least one specialist personally who can pretty much write his own ticket because his specialty is so rare in Canada. If the hospital he's at won't pay him what he's worth, there will be several more knocking on his door with cheques in hand (and London has almost lost him at least once since I've known him).
I support public health care but not the system as it stands now. We need to find a way to run it efficiently and safely or it is going to collapse and give the Conservatives (or even, to be honest, the Liberals) the excuse they need to go to a European two-tier system (no European countries that I know of have a purely public system anymore) or the American fully privatized model.
Mendalla
stardust
Posted on: 09/13/2013 15:10
Hi lastpointe
These mistakes are just dreadful, horrendous.
There are a lot of problems with mammograms in any event. I've been reading and hearing about them. Not that its any excuse for what has happened at this hospital but its possibly informative for women to learn about the pros and cons of mammograms as in these articles below.
I've never had a mammogram. I've had a number of cat scans (also high radiation) regarding surgery in 2011 and in 2013.
Quote from website:
chemgal
Posted on: 09/13/2013 15:37
The problem is that some things show up fairly subtly on X-Rays and it is radiologists who are trained to look at an X-Ray (or CT or MRI) with full knowledge of how things are supposed to look on an X-Ray or CT or MRI. Yes, a GP or ENT might pick up some things but without the training and experience of the radiologist, there would probably be more, not fewer, diagnostic errors.
I should clarify, when I said minor, I did mean minor as it appears visually. Those minor, subtle changes on the scan can be a major medical problem.
If an obvious abnormality somehow gets through the radiologist, someone after the fact should be noticing, even if they can't determine specifically what it is.
chemgal
Posted on: 09/13/2013 15:49
I do feel really badly for anyone going through the stress of getting the call back and something should be done to prevent it.
I've been through it with an injury, so the same type of stress wasn't there. One radiologist told me I was good to go. Days later, another radiologist saw a break. I have no Idea why there was a second look. I went back in for a cast. A few weeks after and they wanted more xrays because of a disagreement or something. They tried through the cast and it didn't work. Old cast off, new on. A hassle, but I don't think it affected my healing.
ninjafaery
Posted on: 09/13/2013 17:04
Mendella-I'm really surprised that London has a shortage of specialists, considering Western is there (has a med school). Here in Kitchener there was one psychiatrist. I don't even know if that doctor is still around. I've also heard stories of fractures going untreated for ages, and needing to be broken again to put on a cast. Too few orthopedic surgeons.
carolla
Posted on: 09/13/2013 18:02
I can't imagine being a radiologist - sitting in a darkened room all day, rapidly reviewing results & dictating reports. No actual patient contact. Takes a particular sort of personality I think.
Beloved
Posted on: 09/13/2013 18:22
It is very sad for those who have been misdiagnosed . . . or not diagnosed - when given a clean report on a diagnostic test.
If I remember correctly it takes years and lots of education to become a radiologist . . . and I would think they are in short supply.
Human error has tragic results . . . unfortunately it does happen. Who would argue with a report, unless you really felt something was wrong. I've learned a lot about the medical profession these last months. I've learned that there are a lot of wonderful people in the medical field - people who are caring and conscientious and dedicated. But mistakes are made. Who would argue with a normal MRI or CT scan . . . you would be so thankful it was normal! But if you are having symptoms of something not right, how do you convince your doctor to keep looking?
stardust
Posted on: 09/15/2013 14:03
I
One may assume that the Ont. radiologist who had bowel cancer surgery himself in 2011 (and was suspended in 2013) may have been suffering mentally and emotionally as well as physically himself which may explain in part his poor performance on the job.
Toronto Star Update:
Slezic, who had worked at Trillium hospitals for 33 years, had his privileges restricted on April 1 and subsequently stopped working.
The Star has learned that in late 2011, he was diagnosed with bowel cancer, for which he was treated with surgery and chemotherapy.
The controversy has resulted in calls for province-wide radiology standards to root out such errors.
NDP Leader Andrea Horwath accused the premier of “running for cover” by saying quality control was a hospital responsibility and that the problem appears to be isolated to Trillium.
Horwath noted that other provinces such as British Columbia and Alberta have run into similar problems with diagnostic imaging, resulting in patients being misdiagnosed. They have since started to introduce quality assurance programs that require a portion of a radiologist’s work to be reviewed by another radiologist, and Ontario should do the same, she said.
“The implementation of that kind of quality assurance would happen through the hospital, but the mandate should come from the province,” Horwath said.
The Canadian Cancer Survivor Network has also weighed in on the controversy and is calling for more training and oversight of radiologists across the country.
Health Minister Deb Matthews said she is receptive to looking at suggestions on how to improve radiology.
“Are there ways to make (quality assurance) stronger? I will always look to improve quality, and if there are steps that need to be taken, I have an open mind,” she said.
Matthews said the situation at Trillium actually shows Ontario hospitals are diligent: “We do have strong quality assurance in our hospitals, and getting stronger. That is how this case was caught. It was caught internally.”
Meantime, Rafle says she learned last week that problems at Trillium extend beyond her, when she got a call letting her know about the 3,500-scan review.
http://www.thestar.com/life/health_wellness/2013/09/13/trillium_radiologist_misread_ct_scan_in_march_now_woman_is_fighting_for_her_life.html
CTV News Sept. 12/13
This isn't the first time there were mistakes in cancer tests and other diagnostic procedures in Canada.
In 2012, a sweeping medical study of thousands of mammograms in Quebec found 109 cases of breast cancer that had not been previously diagnosed.
Alberta conducted a system-wide review of medical testing in 2011 following reports about 325 patients were misdiagnosed at three hospitals.
Also in 2011, a report in British Columbia found that poor oversight, among other factors, was to blame in the deaths of three patients and the harming of nine more after they were misdiagnosed by three unqualified radiologists.
And in 2009, a public inquiry in Newfoundland and Labrador determined there had been more than 400 cases of misdiagnosed breast cancer from 1997 to 2005, with some of the patients dying as a result of lack of proper care.