69 ms·

Medical error is third biggest cause of death in the US, experts say

• viraptor 10y ago
  Does anyone know the actual paper/study link? Pubmed knows nothing, researchgate has some interesting safety-related articles (https://www.researchgate.net/publication/301685868_Surgeon-Level_Variation_in_Postoperative_Complications https://www.researchgate.net/publication/301685868_Surgeon-L...) but nothing about errors/deaths that I could find. NVM, it's here: http://www.bmj.com/content/353/bmj.i2139 http://www.bmj.com/content/353/bmj.i2139
• amalag 10y ago
  Just an anecdote: Our friend in New Orleans had his wife's second baby delivery. They went to the same hospital and doctor as the first normal delivery. She was given the wrong medicine in the epidural. She went into a coma, the hospital flew her to a specialty hospital in Denver to recover. Almost a year later she is still paralyzed from the waist down. Her life is ruined, her husband has two babies to take care of and an infirm wife. The amazing thing is that the state of Louisiana has a $500k limit on malpractice! (Set in the 1970's) Plus he will not get the full $500k. In spite of their clear error the hospital will not just settle out of court. Instead if they pay out through the court system they only have to pay $100k, the rest comes from the state patient compensation fund which has $900 million dollars stored up. So my friend will get $350k and medical care for his wife. This is called keeping costs down in the state of Louisiana. And this was affirmed in 2012 by their supreme court.
  • pen2l 10y ago
    A lot of errors do seem to be this type: wrong medicine being given. The error can originate from any step of the way (doctor ordering the wrong medicine, pharmacist failing to confirm medicine being given is good or not, the nurse mistaking it, the drug-dispensing machinery involved failing, etc.). Do any HN users have thoughts on what sort of system could be put in place to minimize mistakes like this in the field?
    • progressive_dad 10y ago
      There was a definitive study done that showed you can reduce malpractice mistakes by some insanely HUGE amount by changing 1 variable: Leave nurses alone while they're administering medicine. In the study they gave nurses "Do Not Distrub" vests where doctors (no matter how important or urgent) may not disturb the nurses while they are wearing them. Can't find the original study but here is a related piece on hospitals initiating the practice with related resources: https://www.amsn.org/practice-resources/care-term-reference/care-issues/question-do-not-disturb-vest-while-administering https://www.amsn.org/practice-resources/care-term-reference/...
    • deleted 10y ago
      [deleted]
    • flarg 10y ago
      I am a former pharmacist who has moved into technology consulting. I'm in the UK so forgive the UK focus of my response. It is in fact the role of a pharmacist to reduce medication errors - and this is achieved through a series of checks - largely focussed on asking 'is this the right medicine and dosage for this patient and the condition to be treated?' and 'has the correct medicine, dosage and dosage form been dispensed?' Errors tended to occur outside of pharmacy's area of control; in theatres to where pharmacists often have little access, in ward settings where medicines are administered in sometimes noisy and chaotic environments, in clinical teams where pharmacists are not allowed to have a presence, and indeed in the modern NHS where pharmacy staffing levels are severely reduced. A technological solution is possible - based on the concept of checklistbundles, patient medical and medication record systems and image scanning technology - but it is usually hard to sell clinicians on the idea of a check-list never mind anything else. Until there is a true incentive to change practices around medication administration (i.e. unlimited fines) this will always be a hard thing to change.
      • noir_lord 10y ago
        The tragedy here is that checklists where invented for dealing with complex common situations under stress (iirc they where popularised not sure if invented in the modern form as a way to allow pilots to fly a much more complex aircraft than preceeding models[1]). http://www.atchistory.org/History/checklst.htm http://www.atchistory.org/History/checklst.htm
  • deleted 10y ago
    [deleted]
  • NotHereNotThere 10y ago
    I'm sorry for your friend, this is a terrible situation to be in. And it's exactly why many people think pregnancies and births are over medicalized, especially in the US. Women have given birth for a long time without medical intervention, using competent mid-wives, and now were at a point where every pregnant woman wants an epidural, a scheduled C-section (!!), inducing labor via medicine, etc. It's pretty insane.. The movie "Business of being born" (http://www.imdb.com/title/tt0995061/ http://www.imdb.com/title/tt0995061/) goes into detail of how the mindset of handling pregnancies shifted over the last decade, and how pregnancies are almost a "disease" to be treated. Edit: Since I'm getting downvoted for this, I simply wanted to correlate that more interventions = more risk. No other intent, and definitely not trying to "victim blame" given I have no knowledge of the specific situation above.
    • rayiner 10y ago
      > Women have given birth for a long time without medical intervention And they were dying in droves: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm (Figure 2); http://www.cdc.gov/mmwr/preview/mmwrhtml/00054602.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/00054602.htm (Figure 1). Maternal mortality decreased from 700-800 deaths per 100k live births at the turn of the century to less than 30 in 1967, and 5-10 by 1996. Hospitalized births is one of the, if not the most astonishing triumph of modern medicine. It's bigger than the advances in cancer treatment and HIV put together.
      • Florin_Andrei 10y ago
        Plenty of medical care, and therefore quite a few medical errors: live until 85. No medical care, and therefore zero medical errors: live until 62, die of something trivial.
        • cloverich 10y ago
          A more correct interpretation would be "Much higher chance of dying of something trivial at any time before 85."
  • maxxxxx 10y ago
    The US needs a system where victims of malpractice get compensated but the doctors or hospitals are not necessarily held liable (unless it's gross negligence). US doctors spend a lot of time, energy and legal maneuvering denying and covering up mistakes instead of being able to admit them and improve procedures if necessary. In my view there should be a nationwide malpractice insurance pool and the medical associations should push for better quality standards within their ranks.
    • wskinner 10y ago
      That seems like it would raise a serious issue of moral hazard.
      • toomuchtodo 10y ago
        Not if you pull the license of repeat offenders. F* up once? It happens, medicine is hard (EDIT: Document what went wrong, put a process in place so it doesn't happen again, issue a notice to all other medical facilities offering related procedures). F* up again? You're out of a job. No different then how the FAA and the NTSB operate. EDIT: Medicine can be made safer through the same processes used to ensure air travel is the safest transport method in the world. It can't be as safe, but we can do better.
        • rplst8 10y ago
          I disagree entirely. People are known to be fallible. Processes prevent things from accidentally happening. In areas where the life of someone or a large organizational failure hangs in the balance of an action, that action should be wrapped in process to ensure it's correct execution, with fail-safe mechanisms put in place. Further, these systems should be audited on a regular basis to ensure compliance. Only in the case of purposeful or willful action or absolute gross negligence or being found unfit for duty (mentally or physically) should someone have their life ruined by removing their status/job/career path.
          • deleted 10y ago
            [deleted]
  • cmdrfred 10y ago
    I wish I could just set an arbitrary cap on my liability. I'm sorry I totaled your car, here's 50 bucks.
    • dllthomas 10y ago
      Talk to your state senator...
    • forgetsusername 10y ago
      Provided nobody was hurt, your liability would be limited to the value of the car.
  • refurb 10y ago
    That's how it works in Canada. You keep the malpractice insurance rates low by limiting payouts.[1] [1]In 1978, the Canadian Supreme Court limited damages for pain and suffering. Adjusted for inflation, the cap now is just over $300,000. The United States has no federal cap on damages, though a few states, including Florida, have imposed them.
    • LoSboccacc 10y ago
      So you get five year worth of money for lifetime impairment? Sounds fair.
      • refurb 10y ago
        I guess that's what disability insurance is for? You also get a pretty good safety net in Canada in terms of health insurance coverage and disability payments.
        • iends 10y ago
          Long term disability insurance is crazy expensive in the USA. My wife got multiple quotes around $15,000 a year for a perfectly healthy 28 year old woman. It excluded back issues because she went to a chiropractor a few times. This was for like 60% income replacement too.
          • twoodfin 10y ago
            I would guess that there's a serious adverse selection problem in personal disability insurance.
          • nommm-nommm 10y ago
            The strange thing is long term disability insurance for a group plan is really cheap. My work provides it as an option and I only pay $300/year or so for the premiums, work doesn't pay any percent of the premiums.
            • 10y ago
  • tn13 10y ago
    I am unable to why the state must pay compensation here. It should be the Hospital. It looks to me that State and Hospitals have colluded to create this $900M fund while reducing risk for Hospitals and not giving anything to the patients. Can I have the link for SC affirmation ?
  • melling 10y ago
    Shouldn't we be discussing ways to eliminate problems rather than increasing malpractice? What we want is for there to be a system where one person making a mistake is caught by enough redundancy. Maybe it's a cultural issue too? Remember the problem with pilots? http://blogs.wsj.com/middleseat/2008/12/04/malcolm-gladwell-on-culture-cockpit-communication-and-plane-crashes/#:xNCkaXp4D4D8FA http://blogs.wsj.com/middleseat/2008/12/04/malcolm-gladwell-...
  • usaar333 10y ago
    When my wife received an epidural, I noticed a warning label on the connector that said "Epidural, do not connect IV". The only thing stopping such a horrible error is this label. IV and Epidural connectors are fully compatible even though they should never be used interchangeably. I can only imagine how many other simple medical failsafes are missing.
    • pak 10y ago
      This is a very interesting little point, that consumer electronics (especially ports) have little physical safeguards to prevent errors—e.g., you can plug USB2 into USB3 for backward compatibility, but not vice versa, for the B plug; ungrounded extension cords try to prevent you from plugging in grounded plugs. Medical equipment generally doesn't do this. I think the problem is that there is a tradeoff between safeguards and allowing improvisation in a time of shortage or emergency; for example, I've seen blood draw lines repurposed as external irrigators (not as catheters) and that's totally safe as long as you dispose of the needle in a sharps bin.
      • eru 10y ago
        That's a good point. I guess one problem is that the failures of the `can't improvise' case are really easy to see and imagine. Whereas the other failure of mixing up connectors could always be blamed on human error. Someone should figure out which scenario causes more damage. With enough stocking, we should be able to avoid the need for improvisation? As a technical solution, medical connectors could come with bits that prevent mistakes (and clearly different colours and perhaps even outside textures to use sense of touch, too); but with the safety bits simple to break off on both sides, so that you can still plug them together. So you can still plug together arbitrary things, but you get a short moment where you have to consciously use some force.
    • mortenjorck 10y ago
      Indeed, while the anesthesiologist was ultimately at fault, this story made me wonder about the design parameters around the mistake. Are the vials the same color? Do they have the same size and shape? Was this anesthesiologist near the end of a 16-hour shift and had to differentiate two very similar objects? Your comment about the physically compatible, deadly-if-switched connectors was an eye opener: It's almost like if the USB standards group settled on a two-prong design that was physically compatible with a North American 110V AC outlet, and every USB cable shipped with a label saying "DO NOT PLUG INTO WALL OUTLETS".
  • knz 10y ago
    At least they were able to recover some cost. My wife was nearly killed due to the negligence of an ER doctor during the pregnancy of my first child. Every doctor and nurse we dealt with could not understand how it happened and several told us that it was clear negligence but we were told by several lawyers that because there was no immediate and obvious long term harm we were unable to recover any of the additional costs associated with a six week stay in the ICU and hospital. We filed a complaint with the hospital in the hope that the doctor would at least be held professionally accountable but I'm skeptical that it amounted to anything. Pregnancy comes with some inherent risks but it's ridiculous that it's so hard to recover costs associated with gross negligence by an ER doctor (longer hospital stay, counselling for the trauma, related procedures because the doctor messed up so badly etc).
  • knz 10y ago
    At least they were able to recover some cost. My wife was nearly killed due to the negligence of an ER doctor during the pregnancy of my first child. Every doctor and nurse we dealt with could not understand how it happened and several told us that it was clear negligence but we were told by several lawyers that because there was no immediate and obvious long term harm we were unable to recover any of the additional costs associated with a six week stay in the ICU and hospital. We filed a complaint with the hospital in the hope that the doctor would at least be held professionally accountable but I'm skeptical that it amounted to anything. Pregnancy comes with some inherent risks but it's ridiculous that it's so hard to recover costs associated with gross negligence by an ER doctor (longer hospital stay, counselling for the trauma, related procedures because the doctor messed up so badly etc).
  • sjg007 10y ago
    Since the care transferred across state lines can he make a federal case?
    • bduerst 10y ago
      AFAIK, it's based on where the malpractice happened. Plus, that would set a terrible precedence if one hospital couldn't airlift someone out to another hospital that could provide adequate care, because they were afraid of a federal case.
  • rms_returns 10y ago
    Can you please state the name of the hospital and the doctor? The least we can do is blacklist that hospital in our friend circles and defame it on FB, twitter, etc.
  • Dr_tldr 10y ago
    Anytime someone talks about the need for tort reform and capping non-economic medical malpractice damages, this is what they're advocating for. The idea that a "cap on damages" number could be found to cover lifetime expenses incurred for all malpractice cases would be difficult to swallow even if the number was backed up by a fairly large data-set. It's totally absurd when you consider that these numbers are usually arbitrarily set by uninformed politicians and highly biased lobbyists.
  • goodJobWalrus 10y ago
    Wow, I am about to have a baby any day now, this is scary. I really hope they are better in Canada with these things.
  • nugget 10y ago
    Do you know whether an anesthesiologist or CRNA provided the epidural? There's a huge push to replace MDs with nurses for anesthesia (to keep costs down) and I've heard of cases like this as a result. Like Nabisco shrinking a package of oreos from 6 cookies to 4 (for the same price) it's part of the slow dilution of service that we aren't supposed to notice.
    • Scoundreller 10y ago
      Is there evidence to suggest that CRNAs provide poorer care? Someone that is paid less or has less education does not automatically result in poorer outcomes.
      • nugget 10y ago
        Pay has nothing to do with it but I don't think it's a stretch to believe that the average MD with 4 years of med school + 4-5 years of 60 hr/week residency would outperform the average CRNA (nursing + 18 months of 40 hr/week residency). The studies done are usually political submarines motivated by one side or the other in the fight against mid level independent practice rights.
  • ams6110 10y ago
    As my brother the surgeon says, the last place you want to be when you're sick is in hospital.
  • peterwwillis 10y ago
    I am very sorry for your friend's wife. That's.... it really really sucks. It occurs to me that if all the medical malpractice deaths (250,000) were paid out at that cap ($500k), that would cost 125 billion dollars. We don't have a lot of extra room in our budget right now, so that's going to be tough to pay out, even though it's not even enough. But clearly the even bigger problem is the 250,000 unnecessary dead people. If we took a part of that money and used it to fund an agency that just works to fine-tune and eliminate medical malpractice deaths, that would save almost double the amount of people that die from guns and automobiles each year. But that wouldn't help your friend's wife, who didn't die. What would have helped her would have been avoiding medicine that was not necessary, like the epidural. Of course it would have been an excruciating delivery that nobody should have to endure - but I think a risk assessment would conclude that the risk (death) is not worth the benefit (lack of pain). At the same time, having better drugs would also help, but we don't necessarily have that as an option today. So perhaps a campaign to avoid unnecessary medical procedures, and literature to help educate and give agency to those who would be going through those procedures, would be helpful.
  • peter303 10y ago
    Colorados limit is $250K. Lawyers wont take a case unless it is slam dunk.
  • fencepost 10y ago
    Replying since you don't have contact info... If they had life insurance it may be worth looking at that policy as well - depending on the policy it may also cover disability or loss of (use of) limbs. Sounds like every little bit may help.
  • xahrepap 10y ago
    Another anecdote: a close loved one lost their leg due to malpractice. Staff infection. He went in and told the doctor he thought he had an infection. The doctor said it was fine even after running other tests. He's has multiple doctors and nurses look at the test since and say that it's pretty obvious that he had an infection. The greatest part? Their lawyer could not get any doctor to testify as an expert witness, which is required under Utah state law for malpractice (which makes sense, I suppose). Even if they could've, the lawsuit would've only covered $400k since it's capped. Which might've covered the doctor bills, but not the damages to his life... He was between jobs, then ended up in and out of the hospital for a couple years due to the infection getting out of control (lost his leg, had his shoulder replaced, physical therapy, ended up falling and having pretty sever damage and having to start over again). By the time he was on his feet again, he was worn out and past retirement age. Whose going to hire a "gimped old man"? It was a mess. Still is... But things worked them selves out as best as possible. But it's incredible to me that that doctor is still practicing and possibly destroying other people's lives because no other doctor was willing to "out" a "colleague". Frustrating.
  • StanislavPetrov 10y ago
    >The amazing thing is that the state of Louisiana has a $500k limit on malpractice! This is what politicians are referring to when they talk about "tort reform" (rather then the egregious legal nonsense they decry when trying to get it passed).
  • wolframarnold 10y ago
    It's heart-wrenching stories like these that prompted my wife and me to have our daughter at home. It was a beautiful birth. Birth is not a medical emergency, but hospital economic incentives are such that they're always trying to make it one.
    • et2o 10y ago
      The only reason it is no longer a medical emergency is because of modern medicine and hospitals. Women and children used to die frequently during childbirth.
      • wolframarnold 10y ago
        The entire mammalian animal kingdom is fully capable of giving birth, autonomously and unassisted (if necessary). Human females, too, can tap into that part of their brains, if you let them, and don't distract or scare them with bright lights, beeping machines, cramped rooms, force them to make complex decisions that require cognitive function. Birth is operating from the mammalian part of the brain, not the pre-frontal cortex. If this wasn't true, mammals wouldn't exist. Think about it. As a male, however, you'd have to have seen it to believe it. I'm a male, and I saw it. It blew my mind.
        • et2o 10y ago
          I have seen many more than one birth. Your statement is a little ridiculous and I hardly know where to begin. I don't especially care where in the brain things originate (and I think you don't know much about the brain). If I get heart block, I want a pacemaker, even if it's not a part of the "mammalian brain". By the way, a mouse has a prefrontal cortex. Continue your appeal to nature while I remind you that no one weeps when most mammals lose an infant. For a lot of biological reasons, it's hard to compare human reproduction to mammalian reproduction at large, and there are even more differences during childbirth. I'm really glad that your decision worked out for you, but it's dangerous to encourage others to engage in dangerous behavior. If something goes wrong during childbirth without medical attention, people can and do die needlessly. You seem like someone who might not, but please consider vaccinations for your child. http://www.hrsa.gov/healthit/images/mchb_infantmortality_pub.pdf http://www.hrsa.gov/healthit/images/mchb_infantmortality_pub...
  • WalterBright 10y ago
    One way to deal with the wrong drug problem is to use different colors and shapes of bottles to represent different categories and dangerousness of drugs. Coloring can be added to the drug itself, such as using a red for more toxic medications, and green for more benign ones. A deeper shade of the color can represent an increased concentration. Just like different shapes and colors of wine bottles are used for different wine categories. I saw a show once which traced a medicine overdose to the bottles for the different strengths of the same drug being identical. The doctor just picked up the wrong one.
  • jgrowl 10y ago
    Another anecdote... My step sister went in to have a growth removed from her arm. Was just supposed to be a simple outpatient procedure. They put a cuff on her arm and injected lidocaine. Their first mistake was loosening up the cuff which shot lidocaine into her heart and stopped it. The second mistake was that no one noticed for 5 minutes. She was literally sitting there dead for 5 minutes. They somehow revived her but the had brain damage. She acts like a completely different person now. She got diagnosed as bipolar afterwards and the hospital claimed that she just always was like that. They offered a small amount that they ended up having to take it after a whole horrible legal process. It was like maybe 50k for completely disabling her. She has 4 kids, one disabled, and is too incompetent to take care of them. She lost them all. She now is off and on homeless after she started breaking all the windows in the house and lost her fiance because he couldn't take it anymore. She hordes trash and thinks she's going to be a famous singer. If I remember right, the anesthesiologist got in trouble for previously watching porn on his phone during procedures.
  • Fuxy 10y ago
    This mechanism is completely broken considering medical care in the US is ridiculously expensive. The hospital should be held responsible financially for the patient until she dies or their mistake gets fixed. No lawsuit just a simple if you break it you own it philosophy so the hospital is responsible for the medical bill and any loss in financial earnings incurred because of their mistake payed monthly to the patient or its immediate family.
  • speby 10y ago
    That is terrible, truly terrible. If given a blank slate to work with and dealt with all over again, what would be a better way of dealing with the liability? More monetary compensation? Or something else?
• bradleyjg 10y ago
  If someone has terminal cancer, gets palliative surgery, the surgeon makes a medical error, and the patient dies on the table has he died of medical error or cancer? For this reason deaths caused isn't the best metric. It would be better to use QALY (quality of life adjusted years).
  • nihonde 10y ago
    If the error is a 'but-for' cause of death, then I think it ought to be counted. All treatments are aimed at addressing an underlying problem. Just because that problem is terminal doesn't change the fact that a mistake killed the patient. As someone who just watched up close a loved one die from cancer over a seven-year period, you really come to appreciate every minute that they're still breathing (with some allowance for the final, vegetative stages).
    • _yosefk 10y ago
      It still matters if the error occurred when the life expectancy was 7 years or 7 months, so ideally you'd want to count that.
      • ars 10y ago
        It doesn't matter as far as errors go though. There should not be any errors, period. Yes, you can find mitigating factors, whatever. But that the end of the day we want to reduce all errors.
        • PeterisP 10y ago
          Any process with people is going to have mistakes. At the end of the day we have to accept that the errors will be there, no matter what you or doctors do, period. And as in all other industries where errors have a high impact, you have to design your process / systems / procedures so that you get an acceptable result even if people make mistakes, and it takes a combination of multiple errors (or an error combined also with negligence) to kill someone.
      • deleted 10y ago
• Alex3917 10y ago
  For what it's worth, I have a lot of stats here that put this into context and also provide some good additional reading: http://www.alexkrupp.com/Citevault.html#iatrogenic http://www.alexkrupp.com/Citevault.html#iatrogenic (And yes, I know this could be made much more readable with some basic CSS, I'll get around to it eventually.)
  • DINKDINK 10y ago
    Iatrogenics needs to be discussed more, thank you for your contribution regarding this topic
• jobu 10y ago
  Often the medical errors happen on very common procedures like central-line catheters or IV insertions. Staff are overworked and tired, or they get distracted and miss one step and it results in a patient blood infection and often death. John's Hopkins came up with a five-step checklist for central-lines that reduced overall hospital deaths by 10% http://www.hopkinsmedicine.org/news/media/releases/safety_checklist_use_yields_10_percent_drop_in_hospital_deaths http://www.hopkinsmedicine.org/news/media/releases/safety_ch...
  • maxerickson 10y ago
    A key aspect of that checklist program was that nurses were empowered to make sure doctors followed the checklist. Doctors are resistant to adopting such programs. https://en.wikipedia.org/wiki/Peter_Pronovost#Work https://en.wikipedia.org/wiki/Peter_Pronovost#Work
    • Eric_WVGG 10y ago
      There’s a related bit regarding pilots and copilots. http://www.publicspeakingtoolkit.com/ethnic-theory-of-plane-crashes.html http://www.publicspeakingtoolkit.com/ethnic-theory-of-plane-... (take w/ the usual Gladwell-grain-of-salt)
  • jdudek 10y ago
    The story of this checklist has been covered in “The Checklist Manifesto” by Atul Gawande. It’s a great read on how diligence in work can literally save lives. We can advance medicine by breakthrough discoveries that push our knowledge further, but improving how we apply the existing knowledge is just as (or even more) important.
    • mariodiana 10y ago
      Gawande's essay (and book) on the subject came up just recently in discussion on Hacker News. What it all boils down to is that the medical profession in hierarchical and conservative: doctors don't want to change and don't want anybody telling them what to do.
• rayiner 10y ago
  Estimates peg the cost of preventable medical errors at $100 billion-$1 trillion per year: http://www.wolterskluwerlb.com/health/resource-center/articles/2012/10/economics-health-care-quality-and-medical-errors http://www.wolterskluwerlb.com/health/resource-center/articl.... Applying the methodology of this article to the estimate (250,000 deaths per year) in the Guardian piece, yields an economic cost of death due to medical error of about $250 billion. Ironically, the recent debate has centered on "defensive medicine" which posits that doctors are too careful because of malpractice claims. But the estimated costs of premature death due to medical error dwarf the estimated costs of defensive medicine, about $50 billion per year: http://medicaleconomics.modernmedicine.com/medical-economics/news/defensive-medicine-balancing-act?page=full http://medicaleconomics.modernmedicine.com/medical-economics.... In fact, the data suggests that doctors and hospitals are not careful enough.
  • maxerickson 10y ago
    Defensive medicine isn't just about being careful though, it's about ignoring the medical necessity/utility of tests and ordering them because they might be useful against a liability claim. In the extreme, complications from tests ordered due to a defensive mindset could drive both costs. I like this quote from Peter Pronovost, from the wikipedia article I linked in another comment: The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine.
  • snowwrestler 10y ago
    The question is whether the costs that lead to defensive medicine--specifically lawsuits and malpractice insurance to cover lawsuits--actually make doctors more careful. In my limited experience, the medical professionals I know in private practice feel that exorbitant malpractice coverage costs force them to manage a higher volume of patients than they would prefer. Insurance is a fixed cost so they can make it up on volume. But that gives them less time with each patient, and puts more patient care into the hands of nurses, PAs, and residents. Edit--should have said the costs that lead to defensive medicine
• jonwachob91 10y ago
  So... No mention of the different errors that occur and lead to these deaths? A quick look on the CDC site indicates about 70k a year deaths from infections acquired in the hospital (HAIs), but other very reputable sources point towards 100k deaths a year. What medical error committed is not trivial, and should be listed. Not all procedures carry the same risk.
• schizoidboy 10y ago
  It would be fascinating to work towards reducing this problem. Any thoughts on how to get into this field or how software could be applied?
  • itg 10y ago
    If we couldn't get surgeons to use a simple checklist procedure which was shown to reduce the number of errors, I don't know what will.
  • ashearer 10y ago
    A major aspect is miscommunication. According to the Joint Commission: "Ineffective hand-off communication is recognized as a critical patient safety problem in health care; in fact, an estimated 80% of serious medical errors involve miscommunication between caregivers during the transfer of patients." [1] I co-founded Care Thread [2] to help address the communication problems I saw working in hospitals. Electronic medical records systems weren't designed around real-time communication, and mobile secure messaging systems tend to replicate the original alpha pager workflow, without directing the improved technology at improving collaboration. The project involves removing points of communication friction, keeping track of the patient's care team, injecting relevant EMR data into the communications stream and pushing it to the right care team members as soon as it's available, and keeping everything visible to the interested parties. If you're interested in something like this, I'd love to talk. Please contact me through my profile or on our web site. [1] http://www.jointcommission.org/assets/1/6/tst_hoc_persp_08_12.pdf http://www.jointcommission.org/assets/1/6/tst_hoc_persp_08_1... [2] http://www.carethread.com http://www.carethread.com
    • alon44 10y ago
      Hi ashearer, I work with the Patient Safety Movement Foundation and just sent you an email through your demo@ email address. Looking forward to connecting with you.
  • good_sir_ant 10y ago
    Enabling free(er) competition into the medical marketplace for doctors would probably be the single most effective maneuver. That and letting machines begin replacing human doctors...
• Shivetya 10y ago
  I learned this lesson through my boss who passed away awhile back after years of liver problems. If you want to survive complicate or life threatening health issues you need to learn as much as you can about what your treatment options are, which medicines are safe, at what dosage, and in what combinations. My favorite story was his stopping a nurse from administering 700 units of a medicine that in that volume would have killed him. The doctor had written 200 but the bottom of the two landed on the line of the form near perfectly. Fortunately the nurse went to verify and he made it out that time
  • Unklejoe 10y ago
    It's amazing that prescriptions are still being hand written these days.
    • mariodiana 10y ago
      It's amazing that my bank asks me to write amounts both longhand and in numerals when writing a check, even in amounts as small as a dollar, but that doctors scribbling out dosages of medications that can easily kill people has been standard operating procedure since the whole thing started.
    • uslic001 10y ago
      Most hospitals now have computerized order entry now so they are not written by hand. Most prescriptions in private practice are also now computerized and sent electronically per federal mandates.
• davidw 10y ago
  How does this compare to other countries?
• deleted 10y ago
  [deleted]
• nxzero 10y ago
  This isn't news, nor is the fact that people refuse to except that medical professionals are not prefect. Both the patient and medical communities are responsible for fixing the issue. Until that's the case, this will always be an issue.
• shivpat 10y ago
  This is a weak analysis. "To determine the medical error death rate, the researchers analyzed data collected by the government and compared it with hospital admission rates from 2013. They extrapolated that information and found that 251,454 deaths in the US were caused by medical error that year."
  • uslic001 10y ago
    The way they guessed this completely made up number and the fact that it is being reported as real is sad. I can count on one hand the number of deaths caused by medical errors I have seen in my 25 years in medicine. Most errors do not lead to any morbidity or mortality. If this was a real number every person would have numerous relatives that had died due to medical errors. This is not the case. These fanciful fear mongering reports do nothing to reduce medical errors.
• phogel 10y ago
  I've spent years building systems that validate human action/decision in a clinical context (giving meds, transfusing blood, etc.). The environment is error prone and the technology in place is disparate and often operates on incomplete information. It's ripe for automation/optimization. It was scary to see how quickly a new safety feature stopped a potentially catastrophic error. http://www.patientsafesolutions.com/patienttouch-clinical-workflows http://www.patientsafesolutions.com/patienttouch-clinical-wo...
• gshulegaard 10y ago
  Possibly a horrible finding, but this line makes me skeptical: > They extrapolated that information and found that 251,454 deaths in the US were caused by medical error that year. I would be interested to see their methodology, but it sounds tenuous.
  • TallGuyShort 10y ago
    My first thought was the likelihood of dying from something that was misdiagnosed or not caught in time. That could be considered medical error but is a whole different ballgame from, "they accidentally prescribed cyanide."
    • TallGuyShort 10y ago
      However, their point is not about assigning blame, it's about tracking how many deaths could possibly have been prevented by improving the system rather than ignoring everything but diseases that put people in the system. So now that I think about it, it makes just as much sense to track and improve misdiagnosis just as much as mistakes in the pharmacy...
      • cfmcdonald 10y ago
        Surely then it should not be framed as people "killed by medical errors", but rather people who could be saved by improving medicine. The way this is framed in the media is especially absurd, calling it the #3 cause of death after heart disease and cancer. Many of the deaths in question certainly were from heart disease and cancer. They are not disjoint categorizations.
• mikestew 10y ago
  Every time someone in the medical field tells me about how dangerous motorcycles are, I remind them of the woman I knew (world-class rider in some aspects of the sport) who was in a motorcycle crash. The crash didn't kill her, the people giving her the wrong drugs did. Years later I read _The Checklist Manifesto_, only to be horrified that not only did medical personnel need to be told to use checklists, many resisted the idea. It's one thing to kill people because of a mistake, we all make them and thankfully the ones I make usually don't get anyone hurt. But it's quite another to kill someone because your industry is one step ahead of using leeches. I mean, suppose I make a commit that rolls into production and takes out production data. Someone asks, "did you follow the checklist?" If I say, "yes", it's unlikely that heads will roll and we'll update the list when we find out what went wrong. But if my answer is, "no. In fact, I don't even have a checklist/documented procedure, I just make sure my commit message is informative and hope I remembered everything", I'm likely to get fired. A doctor does it, shrugs it off with "we did everything we could", and a lot of time we all just go on about our day.
  • smileysteve 10y ago
    > But if my answer is, "no. In fact, I don't even have a checklist/documented procedure, I just make sure my commit message is informative and hope I remembered everything", I'm likely to get fired. Or even, the nurse has a checklist, but I don't need checklists, I'm a professional.
  • sopooneo 10y ago
    I can not think of a single good reason to avoid check-lists in the medical field. And the doctors who resist them may very well just be arrogant and elitist. But there may also be some other reason. I don't know because I'm not a doctor, but I do know there are always things I don't know to consider in unfamiliar fields. Do we have any doctors on the board who could explain a defensible resistance on the part of doctors to using checklists?
    • 794CD01 10y ago
      Not a doctor, but familiar with some of the arguments. Visible use of checklists damages patient trust. You may (correctly) argue that patients who see their doctors following checklists should trust them MORE rather than less, but most data shows otherwise. Patient trust is very important not just for improving outcomes (they need to follow your instructions after discharge) but also in selecting a physician. That's why checklist use is higher in the OR, when the patient is unconscious. Checklist use is slower. Virtually all physicians are already overscheduled. Lengthening every visit by 30-50% so that the doctor can go over a checklist that only ends up mattering a tiny percentage of the time means fewer patients get seen.
• ndesaulniers 10y ago
  > There is no US system for coding these deaths Because admitting to malpractice would be admitting guilt.
• good_sir_ant 10y ago
  Good to know medical licensing is there to ensure our well-being, in addition to streamlining the entire medical marketplace. /s
• twoarray 10y ago
  In other places, it's even worse: http://gawker.com/5954179/when-oopsies-leads-to-death-student-nurse-who-injected-patient-with-coffee-argues-anyone-can-get-confused http://gawker.com/5954179/when-oopsies-leads-to-death-studen...
• kazinator 10y ago
  What is the algorithm for deciding, in every case of death, whether it was "medical error" or something else?
• kiloreux 10y ago
  I lost my father at a very young age (I was 14) because of a medical error, and we had to go through a lot of things to keep food on the table, now as much as I think the US system might has more justice than my country, where the doctor is still working and we never got compensated 1$ for such death, I wish that never someone goes through the things we have passed through because of a horrible medical error.
  • fiatjaf 10y ago
    I'm sorry.
• djyaz1200 10y ago
  This is a problem technology could dramatically reduce if each of us had a complete medical/medication history that was immediately accessible to the physicians/institutions treating us. That doesn't exist now unless you're getting all your treatment/meds from one company/hospital system (Ex: Kaiser). Right now if you (or your spouse/kid) are brought to the ER unresponsive the doc isn't going to know shit about what meds you are on, what you're allergic to or perhaps even why you're unresponsive in the first place... in the case that they do have information it is likely incomplete. It's not the slightest bit surprising this routinely leads to bad outcomes because doctors are guessing. Dr. William Yasnoff (MD & PhD Computer Science) has suggested the concept of "Health Record Banking." Similar to financial banking institutions would compete for the right to host your health data and providers could "withdraw" records and "deposit" records. Your smartphone would be a key portal to access this information securely. I'm not sure what the perfect solution is here but the Hacker News crowd is going to have to be the folks to fix this because government, doctors and insurance companies are not.
  • akerro 10y ago
    >This is a problem technology could dramatically reduce if e This problem doesn't exist in 2nd and 3rd world countries and didn't exist in US two decades ago.
    • djyaz1200 10y ago
      I'd say this issue gets more severe as the complexity of care delivered increases. The more providers, docs, meds are thrown in the mix the more likely it is that there will be an error. If each of us had realtime records when the doc ordered a medicine we are allergic to their computer system could have a fun little pop up like the Microsoft paperclip guy that said "Hey, looks like you're trying to kill this patient by administering a drug they are allergic to press ok to proceed or X to cancel.
  • iak8god 10y ago
    > This is a problem technology could dramatically reduce if each of us had a complete medical/medication history that was immediately accessible to the physicians/institutions treating us. That doesn't exist now unless you're getting all your treatment/meds from one company/hospital system Local / regional Health Information Exchanges and efforts to combine them at the State level are now chipping way at this problem. An example is the Statewide Health Information Network for New York (SHIN-NY): http://www.nyehealth.org/shin-ny/what-is-the-shin-ny/ http://www.nyehealth.org/shin-ny/what-is-the-shin-ny/ The main challenges are not technical (though data integration must be a nightmare and is almost certainly being done in a wrong and mostly useless way), but social.
• felix_thursday 10y ago
  So, does this mean people are more okay with giving Google all that NHS data now?
  • brent_noorda 10y ago
    So "googling" our personal health data would serve the doctor 40% google ads, 50% bait, 9% invalid information put there by some crackpot, and 1% (buried in there somewhere) of actual valid data?
• hotpockets 10y ago
  Makes me wonder why there's no war on medical errors. Humans are weird. We've evolved to fear most our prehistorical number one threat: other humans. This leads us to waste so much money and to continue sacrificing our own children, spouses, and relatives.
  • rictic 10y ago
    Interesting blog post on the subject: https://blog.jaibot.com/foes-without-faces/ https://blog.jaibot.com/foes-without-faces/
    • hotpockets 10y ago
      Very apropos link. Thanks for digging it up.
• BurningFrog 10y ago
  I'll just point out that what is the "Nth biggest cause of X" is entirely dependent on what classification scheme you've chosen for causes of X. The article is better than most in pointing out that it's 9.5% of all deaths in the subheadline.
• ilamont 10y ago
  The older I get, the more stories I hear involving friends or relatives subjected to poor medical care or advice. The case that leaves me shaking my head involves a friend who had a surgical sponge left inside his leg during a procedure which almost led to his death some months later. When it comes to errors resulting from misdiagonses: An experienced doc/med school professor once told me that they are unable to diagnose 10% of cases that come to his hospital (i.e., don’t know the cause of the ailment/symptoms).
• et2o 10y ago
  In this thread: people who have literally no idea what they're talking about spouting off. I hope it isn't this bad when I read things about other fields.
  • therobot24 10y ago
    what do you mean, i bet some of these guys launched a landing page about a medical startup app that got at least a series A...
  • josephpmay 10y ago
    It's called the Gell-Mann Amnesia Effect
  • mej10 10y ago
    That is a basic tenet of the computer career personality. They've been rewarded for how smart they are their entire lives, so they think they can understand things completely by reading a few paragraphs about it. Even worse if they have one life experience that somehow totally justifies their view of an entire field that varies _dramatically_ from provider to provider. It is the same reason every software person living around SF thinks they are economic geniuses because they got rich by being lucky. The anecdote about a motorcyclist bringing up a medical error causing a fellow motorcyclist to die -- as if this somehow makes riding a motorcycle safer? What the actual fuck. Spend a few days observing a large trauma ICU and they will rethink their story about motorcycles. People have no fucking idea.
• timmytokyo 10y ago
  One way to improve the situation is awareness. The Leapfrog group has established the "Hospital Safety Score" web site to check a hospital's safety "grade" based on publicly available information. Punch in your zip code and examine all the hospitals near you. The next time you or a loved one needs to go to a hospital, only choose among those that received an A. If enough people start doing this, the hospitals with lousy safety practices will start to get the message. http://www.hospitalsafetyscore.org/ http://www.hospitalsafetyscore.org/
• et2o 10y ago
  Honestly I can't imagine this being possible. They must use an extremely broad definition of medical error.
• CodeWriter23 10y ago
  Cops kill about 1500 people per year. So why don't medical professionals wear body cams too?
  • downeveryroad 10y ago
    If anyone should be required to wear body cams it should be surgeons. Alas, we can't even get our own medical records. Could it be that the medical profession isn't designed to benefit patients, but is designed to benefit medical professionals?
• tn13 10y ago
  Shallow journalism by Guardian. More access to medical care means more people go to hospitals and live longer and hence there is a good chunk of deaths that were preventable if doctors or hospitals did better. This is not same as saying 'Doctors are killing people'. The correct way to judge this number would be to see what % of people have access to medical care.
• givan 10y ago
  I don't understand why there is no good rating system for doctors, we have it for restaurants, hotels etc but not for doctors? Yes doctors are more complex but the rating system can be improved over time by feedback and observation and this system can help filter out the doctors that became doctors mostly for financial reasons.
  • uslic001 10y ago
    Because most patients rate doctors based on whether they were given what they wanted rather than if what they did was medically correct. If you fail to give a patient a pain medication or an antibiotic you get a bad review even though it was the right thing to do.
• 0xdeadbeefbabe 10y ago
  I ate too much. Is that the first cause of death in the US?
• bawana 10y ago
  You mean the health care sector has gotten so good at fixing all the other causes of death that what we see is the 'noise in the system'? I think not. You cannot legislate good care on the backs of physicians. Or physicians will go on strike just as they did in the UK last week. In 3 days, 40,000 surgeries were cancelled. 80,000 office visits cancelled. But the PR people were quick to get on the tube and with their constipated smiles reassure the public that there were no problems. How many of those people died? We'll never know. In the US, as long as insurance executives cut physician payment in favor of hospital bureaucracies and executive compensation, HMOs pile on the regulations to reduce utilization, physicians are slammed left and right to guess what's right instead of doing the necessary tests- there will be progressively LESS quality care. Checklists do slow down care delivery AND they are insufficient. Errors snowball because a sick patient is like a set of dominoes ready to topple. Just because the surgical site was properly marked and the type of operation was verified, does not mean that the patient will not fall off the stretcher when 5 people have to struggle to move an inanimate pile of flesh from the operating table to the gurney. The more people involved in a given endeavor, then the likelihood of error increases. We need to strive to simplify care, not complexify it. We have already shipped many of our manufacturing jobs overseas. At this rate, much of our medical care will go the same way. The upper echelons of the the insurance companies and the HMOs will enjoy their views of the New York skyline while they figure out how to outsource health care to Cuba. We also need transparency on costs. Once we get the REAL data, improvements will inevitably follow. We also need REAL data sharing. There are 453 electronic medical record systems now in the US and they don't talk to each other. 453 versions of 'microsoft-like behavior' obscuring the flow of information. It's too funny to think of HIPAA in an era when the NSA already knows everything. And people are always blabbing about their health problems anyway. Just stand in line at Panera, Starbuck's.
• AzzieElbab 10y ago
  Having worked in health care IT in the US and Canada, all I can recommend is 'do not get sick'. Even if the data is right, there is a 50/50 chance medical practitioner will misread or ignore it
  • greedo 10y ago
    My GP blew a diagnosis that should have resulted in my early demise. He took down my symptoms without doing an exam (duh) and then a year later decided, yeah, maybe that colon cancer isn't a hemorrhoid... Only reason I'm still here is pure luck and the grace of God.
• droopybuns 10y ago
  These kind of stories make me feel like the medical & insurance industry has a strong undercurrent of corruption that people are reluctant to address.
• desireco42 10y ago
  I think we need WAR ON MEDICAL ERRORS ! ! ! :) Joking of course. But anything else would require us to address the problem.
• nwah1 10y ago
  Robotic surgery has way lower error rates, but people are so scared of anything new.
  • haldujai 10y ago
    This is blatantly incorrect. All of the latest evidence suggests that robotic surgery is not associated with clinically (or even statistical in many cases) significant improvements in patient outcomes when compared with other minimally invasive techniques (laparoscopy), currently the only field where robotics may have some benefit is in urology and even then, it isn't all that clear. Robotics have clinically significant improved outcomes only when compared to open procedures. No one is scared of robotics but it costs the hospital a lot more money to run the DaVinci system and it requires significantly more OR downtime to prep between cases reducing OR utilization and the number of cases you can do. Robotics may one day be the answer but not yet. 1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254844/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254844/ 2. http://link.springer.com/article/10.1007/s00384-016-2516-7 http://link.springer.com/article/10.1007/s00384-016-2516-7
    • nwah1 10y ago
      But that's just it. For instance, the FDA just the other week denied approval to a hopeful competitor to DaVinci, called SurgiBot. This is preventing competition from driving costs down. Hopefully the big new entrants, Johnson & Johnson in partnership with Google, will have enough clout to shake things up. It is not only difficult to bring new products to market, but also difficult to improve existing products. The 510k application process is claimed to be getting less onerous, but yet it still takes over a year to get a decision after submission. It's just hard to get anything out there in our highly regulated, litigious, and fearful society. The rapid iteration that we like to see in tech can't do its magic in this environment.
• noam87 10y ago
  As someone who's experienced the medical system for the past 6 years (family and personal illness) and know many medical professionals, the level of arrogance, ignorance and lack of professional integrity frankly borders on criminal. It is long overdue to shed light on this issue. Good doctors are few and far between. Stories of mind-boggling ineptitude are so common that my only advice is: if you ever find yourself in need of medical care for anything major, your number one priority is to do your own research and micromanage your physician at every step to ensure he doesn't fuck up. Or he will. Big time. From the diagnosis stage to the treatment stage. Question his every decision because your life depends on it. Trust me when I say this advice could save you from so much pain and sorrow many times over. I speak from experience. No not just one occurrence that left me bitter, but seeing it happen over and over. Being in a position where your life or the life of a loved one depends on people whose judgement you don't trust can be really emotionally taxing. I would go into specifics, but this is not an anonymous account. I can only say in the medical profession, ineptitude and arrogance are the norm. The stories you read in these threads, they are common enough that I've seen these things happen again and again with my own eyes.
  • 6stringmerc 10y ago
    As much as somebody might read the above and say, "Oh wow, it can't possibly be that bad! This sounds like an axe to grind!" - hold that thought. There's a lot of truth to what's been listed above, and the message that your #1 priority should be to micro-manage your care is actually good advice for above-average intelligent people. I can't stress this enough. As with the parent comment, I shy away from sharing too much personal information about my own health battles. They are from birth, ongoing, and likely to stick around until I die. Want to hear something that would shock you? My parents were advocates for my care and our insurance would pay for an innovative, proven type of new corrective surgery. The "Team" of a Head Doc and a couple others on his staff said over and over that my parents were being too pushy and that they would be the ones to decide when I would be a candidate for that surgery. My parents questioned their integrity, because it was obvious that I was a candidate. The Head Doc got very arrogant. My parents got legal. What did they find? In the Head Doc's own notes, and agreed upon by his team in private, that I was an excellent candidate for the type of surgery being mentioned. They were lying to us, and for what? We got a different Specialist after that. I'll never forget that lesson though, and later, having seen that Head Doc at an industry event later in life - he noticed I was doing well - to which I replied that indeed I was and no thanks to him either. Glad that asshole has retired.
• ythl 10y ago
  It doesn't mention what #2 and #1 are, but based on the amount of attention gun control gets, I'm assuming guns are either the #1 or #2 killers.
  • cpncrunch 10y ago
    The article itself says cancer and heart disease are #1 and 2.
    • ythl 10y ago
      Yeah but america has a huge gun problem so I'm assuming it's in at least the top 5.
• briantakita 10y ago
  Iatrogenesis - https://www.wikiwand.com/en/Iatrogenesis https://www.wikiwand.com/en/Iatrogenesis I learned about this concept in http://www.amazon.com/Antifragile-Things-That-Disorder-Incerto/dp/0812979680 http://www.amazon.com/Antifragile-Things-That-Disorder-Incer...
• PerfectElement 10y ago
  A while ago I was watching a great talk by Dr. Greger [1] where he listed the top 10 causes of death and how to prevent them. I remember being surprised when I saw "doctors" listed as a leading cause of death. I don't remember what his advice was on how to prevent doctors, so I'll have to watch it again. [1] https://youtu.be/30gEiweaAVQ https://youtu.be/30gEiweaAVQ
• erikb 10y ago
  I hope it becomes first one day. Think about a world where our medicine is so good that most other causes of death aren't as severe. Then the only serious thing left is some margin of human error. And even that may decrease as the technological support improves.
• joesmo 10y ago
  Considering how often healthcare professionals work without sleep is this surprising? Nothing short of ordering sleep and preventing professionals who haven't slept from working will really put a dent in this problem. And the only thing that will get this done is regulations. Until then, people will continue to die and others will continue to push against regulation killing people in the process.
• hermannj314 10y ago
  Wasn't a major premise of the Affordable Care Act that it was the lack of access to medical care that was killing so many people? Glad to know the situation is better now.
• pascalxus 10y ago
  Another side effect of Medicare and Medicaid overfunding. According to AARP, people are getting way too much medical care - to many surgical diagnostics and procedures putting people at increased risks.
  • maxerickson 10y ago
    Medicare pays less than any private insurer. Medicaid pays less than Medicare.
• musha68k 10y ago
  "Never touch a running system." Complexity kills!
• soufron 10y ago
  After the food ?!?
• soufron 10y ago
  After the food ?!?
• Roboprog 10y ago
  #include std_disclaimer.h I work on the team that maintains the CA Electronic Death Certificate System. Yesterday, our supervisor sent this out among the team. The certificates have spots for immediate and contributing cause of death. We are working on a system for doctors to enter this information (tie in our system to the hospital's) while it is fresh in mind for the staff, and to gather the info in near real time for NIH after finalization. However, even as a programmer, I think it is harsh to expect a doctor to self critique himself/herself in that position (assuming he/she were so inclined). As one of the commenters on one of the articles about this study pointed out, it used to be automatic that a death in the hospital went to the coroner. This would allow a somewhat neutral, educated, third party to asses for procedural errors and the like. Are we, in the continuing age of Reaganism in the US, ready to budget for that sort of backstop to find, analyze and correct these kind of problems?
• Gatsky 10y ago
  Lot of sad stories here, along with understandable mistrust of doctors. However, the most outrageous point thst emerges from the article is that in the US nobody is even measuring the rate of medical error. That is a criminal failure at the government level.
• fiatjaf 10y ago
  Well, this is a problem created by the State and its medical licenses. At the time anyone with a medical license is just a doctor as anyone else, because they all have the same license, disappears the need to show your potential patients that you are indeed a doctor that cares about quality.
• wodenokoto 10y ago
  Something has to be the biggest, second and third cause of death. In a perfect society,what is the number one cause of death?
• alyx 10y ago
  Anybody know of any good self-help/research communities or forums? Search engines are filled with clickbait these days.
• jayess 10y ago
  250,000 people a year are killed by medical mistakes. 11,000 are killed by guns. So you're 22 times more likely to be killed by a medical professional than someone with a gun. In fact, since there 19,000,000 medical industry employees in the United States, and 300,000,000 guns (and probably somewhere around 100,000,000 gun owners), you have a 1.3% chance of a medical professional killing you and a 0.01% chance of a gun owner killing you.
  • bainsfather 10y ago
    I think you mean: "A medic has a 1.3% chance of killing someone this year".
• deleted 10y ago
  [deleted]
• hNewsLover99 10y ago
  Interestingly, but not surprisingly: 1) Like the hundreds of comments attached to this post (or at least the ones that I have read) today's mainstream media coverage of the Johns-Hopkins study (or at least the reports that I have seen) omits the study's admission that it understates the total "medical error homicide rate" (SEE NOTE 1 BELOW) (by not including similar fatalities at nursing homes, outpatient clinics and other non-hospital settings). 2) As a result, most people who viewed that coverage now incorrectly believe that annual medical error homicide rate is a paltry 250,000, when in fact it has previously been estimated to be nearly twice that number. See, e.g., the 2013 study reported by HuffPo, in which the total figure was estimated in 2013 to be over 440,000. (SEE NOTE 2 BELOW.) That's like losing the 50,000 U.S. soldiers lost during the ten-year long Viet Nam War every six weeks, month after month, year after year, decade after decade. 3) A condition imposed by the hospitals submitting to studies of this sort is that findings of error cannot be disclosed to the victims' surviving families or legal representatives (who, of course, are legally authorized to access the victims' patient records, and to assert claims on behalf of their estates). Stated differently, the medical profession can be induced to examine its inadequacies only if it is first favored (bribed?) with perpetual immunity, anonymity and concealment. 4) It is unknown (or at least unreported) what percentage of medical error homicides: - Are ever disclosed to surviving families, - Lead to professional conduct investigations, and to sanctions, - Lead to claims or suits, - Go uncompensated, or unfairly under-compensated, or - Are fairly compensated, both before and after legal fees and expenses. 5) As a result we cannot know the size of the economic windfall enjoyed by the perpetrators of these homicides, their stockholders, and their liability insurers. 6) But we can make some rough hypothetical calculations. If, for the sake of argument, half of the families of the 250,000 (or more likely 440,000) annual victims of medical error homicide were reasonably entitled to a $2 million (gross) recovery, but received nothing, then the annual saved-liability windfall would be $250 billion (or, more likely, $440 billion). Year in, and year out... 7) If the true economic costs of medical error homicide, of fraudulently-evaded civil compensation for victims' families were ever known, perhaps a different light would be cast on the ceaseless whining by the medical profession, insurance industry and political conservatives about "too many" medical malpractice suits. 8) Medical and support staff who withhold or misstate the actual facts of a patient death or injury caused by medical error can (and should) be, but rarely are, prosecuted for violating state and federal wire, mail and other anti-fraud statutes. 9) All citizens can and should do what they can to reduce medical error homicide rate. For example, when victims' families can identify staff who commit, fail to report or attempt to conceal such errors, they should demand civil and criminal justice and professional conduct investigations and discipline. 10) And in cases of extreme recalcitrance by medical professionals and staff, a little public shaming should not be out of the question. NOTE 1: As used in this comment: "Medical error homicide" refers to an erroneous, and therefore negligent iatrogenic event that causes the patient to die. This term and its definition reflect the fact that intent to kill is not a required element of a homicide. "Medical Error Homicide Rate" is the number of medical error homicides committed in a calendar year. NOTE 2: Sources: http://www.huffingtonpost.com/allen-frances/why-are-medical-.. http://www.huffingtonpost.com/allen-frances/why-are-medical-.... http://www.hospitalsafetyscore.org/newsroom/display/hospital.. http://www.hospitalsafetyscore.org/newsroom/display/hospital....
• slr555 10y ago
  This statistic gets bandied about every now and then and is completely indefensible. Extrapolation is hardly proof and the CDC statistics don't begin to validate this nonsense. If it were true it would mean that for essentially every person you had ever heard of dying from any type of accident or pneumonia there would be one resulting from medical error. Every fatal car wreck you ever read about. Every drowning. Every fatal accidental shooting or fall AND every person you had ever heard of dying from lower respiratory tract infection would have an approximately equal number of deaths CAUSED by medical errors. In other words people who would have lived instead died because a medical professional made a mistake. If you believe that's true I have a wonderful bridge here in Brooklyn I would be happy to sell you for a very reasonable price.
• known 10y ago
  https://en.wikipedia.org/wiki/Second_opinion https://en.wikipedia.org/wiki/Second_opinion should be made compulsory
• deleted 10y ago
  [deleted]
• throwaway049 10y ago
  I recommend this lecture "Designing IT to make Healthcare safer" by Professor Harold Thimbleby as being of interest to people on here. There's a video and a transcript. http://www.gresham.ac.uk/lectures-and-events/designing-it-to-make-healthcare-safer http://www.gresham.ac.uk/lectures-and-events/designing-it-to...
• shirro 10y ago
  Medicine and road transport are two areas where I hope AI can save us from ourselves because both produce a huge public benefit but they are both hopelessly prone to errors with deadly consequences.
• perilunar 10y ago
  The comparison between Medicine and Aviation has been discussed here before: How mistakes can save lives: one man’s mission to revolutionise the NHS (newstatesman.com) https://news.ycombinator.com/item?id=7865917 https://news.ycombinator.com/item?id=7865917
• spectrum1234 10y ago
  Didn't read the article but this could be a very good thing. It could mean that health care is extremely good at saving lives so the only thing left is error.
• DyslexicAtheist 10y ago
  Nassim N. Taleb touched on this in Black Swan and even more aggressively in Antifragile[1]. [...] Overtreatment of illness or physical problems, he suggests, can lead to medical error, much the way that American support of dictatorial regimes “for the sake of stability” abroad can lead to “chaos after a revolution.” [...] [1] http://www.nytimes.com/2012/12/17/books/antifragile-by-nassim-nicholas-taleb.html http://www.nytimes.com/2012/12/17/books/antifragile-by-nassi...
• bitL 10y ago
  An opportunity for automation and for MDs to take more rest...
• ransom1538 10y ago
  Doctors routinely avoid questions: "How many times have you performed this procedure." This question COULD save your life. Always ask. Experienced doctors will give you a hint through body language. Younger doctors will become nervous and avoid any questioning. If you are told there will be another doctor assisting: AVOID. Shameless plug: I am committed to fixing this. IF you want to join me let me know. https://www.opendoctor.io https://www.opendoctor.io
• MaPaAbCa 10y ago
  Does anybody has world breakdown figures for medical error, please?