By Nancy Franklin, Special to the Los Angeles Times
February 27, 2012
"You have malignant melanoma," the dermatologist told me. But that wasn't the worst of it. The worst part was that thepathologist's report had been in my chart for over a year and my dermatologist had never told me.
As I sat there absorbing the news, I kept thinking, "How could this happen?" I've spent my career in healthcare; I'd like to think I know how to navigate the system. I'm the one who never puts off a Pap test or mammogram; who had a colonoscopy at age 50; who gets flu shots and regular checkups. I research my doctors, and my dermatologist is one of the best. And yet here I was, on only my second visit, learning that he had made a critical error.
I felt like I had just joined a macabre horse race. I could hear the trumpet blaring out "Call to the Post" and the announcer starting his introductions: "In the post position, Malignant Melanoma. In the No. 2 position, Unlucky Lady, followed by God's Plan, Bucket List, Affairs in Order and, rounding out the field, How Will I Tell My Elderly Mother?" But Malignant Melanoma was already several furlongs down the track. The race had begun more than a year ago, and I was just getting to the starting gate.
The lesion was on my lower back. "We'll need to excise the rest of the area," my dermatologist said. "When would be a good time to come in for that?" I thought he must be joking. "Now," I said firmly. "I'm here now."
He recommended a chest X-ray and blood work-up as a precaution. Both were clear. The pathology report came back several days later showing that the excision was complete and no further surgery or procedures would be required; just regular, diligent follow-up. I got a second, confirming opinion from a melanoma specialist.
Several people have suggested that I sue the dermatologist for malpractice. But I don't want to add to the increasing costs of healthcare. Maybe I'd feel differently if things hadn't turned out all right. But there will always be the risk of human error in medicine, and I believe most doctors genuinely worry about missing a diagnosis or making a mistake with a patient's life.
I was extremely lucky — and extremely grateful that I kept my yearly appointment. I don't know what breakdown in office protocol caused my dermatologist to miss calling me. I do know he has been responsive to me since then and has made changes in his practice.
But it's not all up to him; I'm doing one more thing too.
The next time a physician runs some tests and says, "I'll call you if there's anything abnormal," I'm going to smile and say, "If you don't mind, doctor, I'm going to call you."
Nancy Franklin has worked in healthcare for 30 years and is currently the regional director of marketing and communications for a large health services organization. She lives in the South Bay and can be reached at email@example.com.
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