Are There Really That Many Medical Error Deaths?
You may have seen the headlines that medical errors are now the third leading cause of death in this country. If you are like me, who does not trust the media, your immediate thoughts were “bullshit”. Luckily I found this site which broke down the nonsense. Read this article in detail but here are the highlights for you:
- To get their estimate that medical errors cause 251,454 deaths a year among hospitalized patients in the United States, the authors essentially averaged error-related death rates from four prior studies and then extrapolated it to the number of hospitalized patients today.
- If the researchers had really wanted to update the estimate for the modern age, they should have dug into patient records and made tough decisions about which deaths were truly due to errors — in other words, they should have done their own analysis.
- The authors of the BMJ report define “medical error” as any action “that does not achieve its intended outcome” or any planned action that, for whatever reason, is not done “that may or may not cause harm to the patient.” This definition is uselessly broad.
- By any decent definition, some errors are obvious, such as when a doctor or nurse gives a patient a wrong and deadly dose of a drug. But many “errors” exist in a gray zone. Say a doctor delays sending a patient to the intensive care unit and she later dies. Would she have died had she been transferred to the ICU 45 minutes sooner?
- The BMJ article, and the subsequent reporting about it, continue a trend where the public is wrongly told that all deaths are the same. They aren’t.
- The new estimate of 251,454 deaths matters because the sensational figure is imprecise and may be wrong by a large magnitude. The renewed attention on medical errors in hospitals might be good, prompting doctors to take it more seriously. But it could be harmful if it scares some people away from getting the care they need.
- Here’s how I would summarize the BMJ report: The authors made a number of reasonable proposals so we can better understand medical errors, which probably happen often but honestly aren’t something we have a good definition for and don’t do a good job of measuring or tracking.
So why did I know this study was BS? Because of the headline. C’mom, does anyone really think our doctors are that bad? It is a covert mission for insurers, hospitals and administrators to make the public believe that doctors are bad and need to be controlled and watched. I clipped the above image from the original NPR article and when I saved it I realized the pic was save under the name “doctor-failure_custom-0640e06948eeb7143273ab9f2902979b128f7c08-s800-c85”.
Doctor failure? No one else, just doctors?
Child, please.
Guys, don’t get so defensive/reactionary. You don’t get it. The finger is not being pointed at doctors making wrong decisions. The issue at hand, based on the very wide-ranging definition the authors give right at the beginning of the article, is a damnation of the entire healthcare System in the United States. Hospitals and doctors do great jobs…initially. But then the horror occurs when the insurance companies and administrators come into play pushing people out the door way, way, way too early. To rehab hospitals/facilities? Replace that with go-to-die facilities. Wholly inadequate oversight by nurses and once-a-week brief visits with fourth-rate physicians. To home care? What home care? No physicians ever. The patient is left to his or her own devices, knowledge, and abilities to keep care going, which is usually none.
Do those initial hospital physicians ever check up on any patient after he or she leaves the hospital to find out what has gone on? You ALL know the answer to that question. It doesn’t matter what the reason is. With no continuity of care, “medical error” occurs, death usually resulting. If you’ve ever been a patient requiring intensive medical care over a long period of time or if you have ever had to be an advocate for a loved one in that situation, you absolutely know how the System has so many mile-wide cracks for people to fall in and disappear forever. Frankly, medical error isn’t the #3 cause of death. It’s probably #1.
Mr. Stein, you don’t know the meaning of “reactionary.”
Are you a physician? If so, then tell us – if not, then damn your arrogance. I know exactly what this study is, and King Doug only beat me to writing about it. This is another propaganda campaign, disguised as caring and compassion, that will lead to theories that quickly become policies, that suddenly become de facto law. How do I know?
The damnable, government-funded (redundancy admitted) Institute of Health published a 1999 report that spooked everyone into believing that doctors were killing their patients in droves. The result was, among other oppressions, the Maintenance of Certification, the dreaded “MOC” that most doc’s have to pass in order to be on a private insurance panel or hospital staff. Since instituting the MOC I am out thousands of dollars, a lot of totally UNCOMPENSATED time, and considerable stress at having to take an irrelevant, strenuous day-long exam for the third time in seventeen years. I am having to squeeze out dollars to pay a CEO earning over $750 K per year by his own admission, and fund lesser levels of parasites who add no benefit to my life. None of this process has in the least altered how I treat patients, and has added considerably to my resentment regarding the lay masses who blindly get behind these initiatives because they were told it was beneficial by those who stand to profit by their enforcement.
“Wholly inadequate” nurses? They are great, but chained down by idiotic government regulations that a self-serving study like this will definitely increase. “Fourth-rate physicians”? That is what this population deserves, for treating them like an enemy. Patients are not followed by care-continuity Marcus Welby, because he started taking Medicare, and soon found out it was an economic drag to see hospital patients. How dare this society this society simultaneously pay less, add more restrictions, and expect more work?
“Reactionary”? “Horror”? You are an obvious hysteric who has bought into the idea that it’s okay to use force on others based on your needs. You sentiments are those of an ignorant bully, or worse, and you need to be called on it. I welcome civil discourse, but not when the first line is a punch in the nose.
(Rather, *Institute of Medicine*… same difference. )
“Be The Change You Want To See In The Healthcare System.” That is the tagline under Authentic Medicine. From your response, I do not know exactly what “change” you wish to see. I, however, would like to see significant improvements. Being unfortunately embedded in the System for too long, I can only hope that the BMJ article can bring some good to reverse a bad slide that has gone on for too long. I would advise that you and everyone else actually read the article closely to understand what the authors actually said. What is obvious is that you completely missed the gist of my comment. Someone did something to you sometime in the past to cause so much anger that you’re blind to…I have no clue. Anyway, if yours is the standard of response in Authentic Medicine then this forum is completely the wrong place to make my efforts.
Authentic Medicine is my baby. I am proud and grateful that Pat gives his input and also blogs once a week for me as well. You two can continue to go at it or you, Paul, can leave. Makes no difference to me. As far as the tagline, I am the change I want to see. I am doing DPC. I do not bill insurance companies. I see patients for 30-60 minutes a day. My fee is nominal. I am proud of that. So, tell me what you have personally done? I mean that sincerely and not in a facetious way.
As Henry David Thoreau said, “Extrapolate, extrapolate.”
I agree with the other comments. This study and the publicity were just fuel for a sad agenda against physicians which is destroying our relationship with patients that is built on trust and professionalism. When I heard this study being gushed about in the press it did make me pause and consider, how common is death by medical error? I am a cardiologist working in a busy Heart Hospital and I see a lot of patients that do die from the number one cause, heart disease. While I am aware of 2 or 3 deaths from heart disease every week, I can’t recall A SINGLE death in the last year that was due to medical error. I have seen people die of sepsis, pneumonia, cancer, and many other causes (even though they were in a specialty Heart Hospital). How could it be possible that medical errors is the third leading cause of death? Because it’s not! This was not an analysis or a study. It was a gross manipulation of previous extrapolation.
If My memory serves me right, the article I read began with the 250,000 deaths due to medical errors and the same article seemed to suggest a ridiculous figure of 39. The latter figure appears reasonable because actual deaths due to medical errors are pretty rare. During my decades of practice I have served in various positions in hospitals of various sizes including Morbidity and Mortality Committees with reasonably strict criteria for accuracy. Whenever a medical error was mentioned as a cause of death all hell broke lose and, needless to say, thorough review ensued and action taken. Comparing the deaths reported from medical errors to the incidence of prostate cancer, let us consider that as a urologist I saw a lot of patients with carcinoma of the prostate with an annual incidence of some 220,000. If deaths due to medical errors were a quarter of a million annually, that would be a killing spree so huge that it would have reflected in the deaths reported to our committees. With people dying like flies I would likely have quit the practice of medicine altogether.
I like how they come up with such a precise number: 251,454. Not 251,453 nor 251,455.
Don’t get me started on the IOM report. That “study” was ludicrous. They actually claim that almost 1% of all outpatient deaths are due to “medication error”. That is just pure nuts
I’ll bet some fancy new levels of MOC exams, mandated for licensure renewal, would make it all better. You can bet the IOM, AMA, ABMS, and AAFP/ABFM are already on board.
And doc’s better not dare complain – its only a little more time and money, and that’s a small price to pay for patient safety, however non-clinicians care to define it.
Wow, if medical care is so harmful to our health, why are we making all these laws to get more people insured? Seems like the safest thing is to avoid doctors and hospitals, and save money while you’re at it.
Don’t forget the first studies they used were also using extrapolation so basically this study is a guess based Orr a previous guess. Also they stretched it so far as to include poor discharge instructions as an error that caused death. This is just a hit piece.
The big word is – Dolchstosse. It’s a German word with massive historical meaning. “The “stab in the back” legend asserted that Germany’s fate (in WW 1) was caused, not an overwhelming military defeat, but by treacherous internal forces.” http://www.globalsecurity.org/military/world/europe/de-back-stab.htm
There. The first lie should go down smoothly, matter-of-fact, with one’s morning coffee and newspaper. The IOM report in 1999 talked about medical errors, and if you read it, it’s not at all what it was made out to be. The press seized upon the “deaths from medical errors” theme, and the ‘reformers’ found that they had a blank check for their agenda to ‘reform the medical system!’
This time, they’re doing it again, but on purpose. Surely, EVERYONE knows that the wicked doctors have stabbed the American people in the back, the way that the you-know-whos stabbed Germany in the back during WW 1. It’s only natural not to stand for being stabbed in the back, no?
The progression of the lie in Germany went from – I wonder whether we were betrayed at home by hidden enemies? to Who are the hidden enemies who betrayed us at home? to How badly did the hidden enemies damage us at home?
Once the hidden enemies are “unearthed,” the system roots them out and administers swift justice to them. This is classic totalitarian mindset. We’re trying it on the medical system. Await final victory.