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Could it be true that avoidable medical errors by doctors and hospitals are the third leading cause of death in the US? According to a story written by Ariana Eunjung Cha on May 3 for the Washington Post, entitled “Researchers: medical errors now third leading cause of death in United States”, doctors from prestigious medical institutions such as the Johns Hopkins University School of Medicine have concluded this to be a fact. Does 700 deaths a day _ not from injury or illness but from avoidable treatment errors _ shock you!? It does me. Professor Martin Makary from Johns Hopkins said in an interview that this shocking statistic includes “bad doctors”, and “communication breakdowns when patients are handed off from one department to another.”

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” Makary said.

The analysis that is the basis of the Washington Post article comes from the British Medical Journal (BMJ) and is entitled “Medical error—the third leading cause of death in the US“, BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016) Cite this as: BMJ 2016;353:i2139.  

Let’s be clear here. We are talking about people who go to doctors or hospitals and end up dying as a result of substandard treatment. That excludes patients who die without any negligence or cause other than the condition that caused them to seek medical care. Many patients die who are provided excellent medical care but medical science did not have a way to save them, and even the most skilled doctor could not avoid the inevitable outcome. What we’re talking about here, however, is negligence. Negligence is defined in the law as doing something that a reasonably prudent person in a given situation wouldn’t do, or not doing something that a reasonably prudent person would do in that situation. It is a “situational” concept that takes into account that in an emergency situation a reasonably prudent person will be given more latitude given the circumstances. Negligence means that the end result was avoidable through normal practices and standard diligence. The patient should have lived but didn’t. The death could have been avoided if the doctor and hospital followed the rules and provided the treatment that a competent doctor or hospital was supposed to provide.

It has been 17 years since a similar report shocked the medical profession. The Washington Post story above reports that “[I]in 1999, an Institute of Medicine report calling preventable medical errors an “epidemic” shocked the medical establishment and led to significant debate about what could be done.” How “shocked” was the medical profession? What has been done by the medical profession? If anything the situation has gotten worse and patients face great risk of death and injury in US hospitals.

According to Ms. Cha in her story:

The IOM, based on one study, estimated deaths because of medical errors as high as 98,000 a year.  Makary’s research involves a more comprehensive analysis of four large studies, including ones by the Health and Human Services Department’s Office of the Inspector General and the Agency for Healthcare Research and Quality that took place between 2000 to 2008. His calculation of 251,000 deaths equates to nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.

At 700 deaths per day you would think this would be front page news and a part of the debate in the presidential campaigns. But it isn’t and I ask myself “why not?”

The Washington Post story of Ms. Cha sheds light on the problem:

Makary said he and co-author Michael Daniel, also from Johns Hopkins, conducted the analysis to shed more light on a problem that many hospitals and health care facilities try to avoid talking about.

Though all providers extol patient safety and highlight the various safety committees and protocols they have in place, few provide the public with specifics on actual cases of harm due to mistakes. Moreover, the Centers for Disease Control and Prevention doesn’t require reporting of errors in the data it collects about deaths through billing codes, making it hard to see what’s going on at the national level.

The CDC should update its vital statistics reporting requirements so that physicians must report whether there was any error that led to a preventable death, Makary said.

“We all know how common it is,” he said. “We also know how infrequently it’s openly discussed.”

 

I know the doctors are terribly busy and that the economics of medicine have become very difficult with insurance company reimbursements dropping in doctors being asked to do more record-keeping and reporting to the government. But I also know that in the past 30 years I have witnessed doctors and hospitals alongside their insurance companies lobbying at state legislatures and in Congress to change laws making it harder for patients to hold negligent doctors and hospitals accountable for the injuries they cause. For 30 years we have all witnessed doctors and their insurance companies complaining that there really isn’t any medical negligence and that anyone who files a lawsuit against the doctor or hospital is probably bringing a frivolous claim. Along with the many private foundations funded by billionaires like Karl Rove and the Koch brothers, the medical profession has denied that they have a problem with medical negligence at all. What do they have to say about 700 deaths per day? They want to cover it up and they want laws passed that in the end will protect bad doctors and bad hospitals. The data shows that nine out of 10 patients who are victims of these avoidable medical errors cannot find an attorney because the laws have been changed by the doctors who lobby with insurance company money and their own at the legislature in ways that make it impossible to file a lawsuit. The families of these dead and injured patients who suffer immeasurable loss of love and affection, and often incur huge medical expenses all due to the bad doctors and bad hospitals, are left with the insult of no justice and no ability to recover because elected officials caved into the pressure of the well-connected medical profession, their lobbyists and the all-powerful insurance industry. For them it’s all about money. But I think it’s even worse than that.

 

It’s one thing to have some bad doctors, some bad hospitals and some significant problems in communications that all are causing injury and death to patients. If they spent their time getting to work to stop 700 people from dying every day in the country due to their profession we would all applaud them and offer help. It’s completely another thing to cover it up, to deny it even though it’s true and then to try to get laws passed that protect these doctors and hospitals from being accountable for the harm they cause. We are talking about death here. And if there are 700 deaths per day in the United States because of avoidable errors by incompetent doctors and careless hospitals, can you imagine how many people live but have traumatic brain injuries, or paralysis or other lifelong tragic conditions?

We all know that if there is going to be change the first thing that has to happen is for the responsible party to acknowledge the problem. The medical profession was apparently “shocked” by the 1999 report by the Institute of Medicine, but nothing happened to improve patient safety. Perhaps the doctors should stop organizing marches on the state capital or the Congress in Washington DC, and hold seminars identifying how to reduce avoidable medical errors, find and educate the bad doctors, institute quality control measures that would catch the errors that are now killing people and take responsibility for a profession that has lost its way. A leading doctor from Harvard quoted in the Washington Post story shares his dismay at the lack of improvement:

Kenneth Sands, who directs health care quality at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, said that the surprising thing about medical errors is the limited change that has taken place since the IOM report came out. Only hospital-acquired infections have shown improvement. “The overall numbers haven’t changed, and that’s discouraging and alarming,” he said.

Some of my greatest heroes are medical doctors that I have met throughout my life. Most doctors never injure a patient through carelessness. But few doctors will speak up for patients when one of their peers commits malpractice. I know that the good doctors are not offended by the irritation that I express here, because in candid discussions they acknowledge that there are problems of competence and communication that plague the medical profession. They know the bad doctors and bad hospitals are protected by the insurance industry and the “conspiracy of silence” that pressures good doctors from testifying against bad ones.  They have chosen to believe false and unproven statistics created out of thin air by the insurance industry into believing that there is an epidemic of frivolous lawsuits filed against doctors. Just the opposite is true. Suffering families cannot file claims to bring justice to the death of a loved one from medical negligence because of legal roadblocks thrown up by the insurance industry and the medical profession to avoid accountability by doctors and hospitals. One cannot look at this shocking set of facts and not see that the medical profession faces a moral crossroad. Who will speak up for patient safety and injury prevention? Who will apologize to the millions of families who suffered a wrongful death at the hands of a bad doctor or hospital?

One cannot look at this shocking set of facts and not see that the medical profession faces a moral crossroad.

 

One Comment

  1. Gravatar for Deirdre Gilbert
    Deirdre Gilbert

    NEWS

    For Immediate Release

    Contact: Deirdre Dickson-Gilbert

    Phone: (832) 488-5765

    Email: nammv1988@gmail.com

    “They Trust Each Other Lies”

    This is the BUZZ in the Medical Community

    Talk of the Town

    The talk of the town about Medical Malpractice as being the third leading cause of death is true, but there are very limited reasons of why that is occurring. Medical Malpractice has been a silent killer for decades and the ones who are being harmed are never thought about in the process. This issue is bigger than medication errors or complications but is really about the greed of medical establishments that have figured out how to create cash flow from harming patients. Seldom is there talk about the truths of these deaths and who is causing it. It is simply not an error when medical facilities and physicians’ cover-up a death because of fear.

    System of Silence

    Physicians seldom want to discuss or even acknowledge their part in the entire equation. There is a system of SILENCE that does not allow conversation about these deaths and the cover-ups for fear of being sued and losing their livelihoods. Many physicians have stated that they trust each other’s lies and just continue on in the process. There has been a system of manipulation that was well defined and oiled like a machine before many of those who were harmed even knew what hit them. There are protocols set in place of what to do when you hear Code Blue. There are ways to manipulate the records before one can find out what happens. Blame the patient or the family for the death. Just say the patient died of obesity or other underlying conditions, but don't say that the doctor was inebriated, don't say that the doctor left the operating room to view a YouTube video because he/she did not know what they were doing, don't say that the physician had killed before and SILENCE was the word.

    Let’s Talk the Truth

    If we are going to talk about this subject, let's talk the truth. Let's tell about how many physicians have criminal histories with no background checks, let's talk about the falsifying of medical records, let's talk about medical examiners who cover-up for hospitals to keep them from being sued, let's talk about no oversight and no review of medical errors, let's talk about the many people who have committed suicide because they were harmed or because they could never get the truth about their loved one's death, let's really talk about the SILENCE. Blame the attorneys who sue because they are just trying to make money. NO! The truth again is, SILENCE.....It was done and they did again and no one did a thing about it. They can make millions off of your harm and there is nothing you can do about it, so they do it again until it doesn't matter how many people they harm. This cycle becomes like a drug habit that can’t be broken.

    Playing God is not an Option

    Physicians are playing God and there are no legal remedies to stop them......Physicians would have you to believe as it has been sensationalized in the media that people just want to sue and that doctors are leaving states by leaps and bounds, but this is about the value being placed on, exaggerated, malpractice costs over that of human life. The real truth is about the public’s right to know if a hospital or doctor being paid for services has a history of malpractice suits and reprimand for reprehensible behavior which violates the vow and/or oath required of their profession. This issue with all of the necessary elements is about the capability of illustrating the need to reform Tort Reform, the Public Information Act, and other legislation and policy that allow medical negligence and other acts of harm and endangerment to go unanswered or only minimally compensated. This is about the millions of stories that will be un-heard only by legislators, hospital administrators, physicians, nurses, and American citizens who have no heart, and without which, are incapable of hearing, but they are not the majority. The majority are average, ordinary, law-abiding citizens who would not dare think of wasting time and energy on frivolous lawsuits, though we are all, as Tort Reform rhetoric implies, presumed to be.

    It’s Not in Our Favor

    Unfortunately, the majority does not know that the moral cards are not stacked in his or her favor. Should a loved one fall at the hands of a practitioner with a history of malpractice suits and reprimand for reprehensible behavior which violates the vow and/or oath required of their profession or by the practices of a hospital with a history of the same, the chances of attaining justice are nil. The average ordinary citizen, in an emergency situation, is incapable of making an informed decision as to where and to whom he or she should entrust the care of a loved one, because that information is private, protected by the Public Information Act. In the absence of information, life-threatening decisions are left to chance. People should have the right to fight for their lives, and knowledge has always proven to be the most formidable weapon. People have a right to know. People have the right to legal remedies in a court of law. People have the right to the truth and have those who reap havoc on a medical entity and its patients sanctioned and penalized. There are great doctors and there are plenty of BAD APPLES and it is time for change. We must be heard and we must be allowed to have the truth be told. We have been held captive inside of a closed capsule of abuse and these behaviors are dangerous and unacceptable.

    The Alert System

    Deirdre Gilbert, National Director of National Medical Malpractice Advocacy Association and its’ chapter directors says “they are working to alert the public to these truths.” We are petitioning for more accountability and oversight to ensure patient safety. Those of us still reeling from impact of medical negligence and malpractice, trying to regain our footing, came to realize that individually battling such a formidable foe, quietly struggling to climb insurmountable obstacles equates to silence. It ultimately became evident that our silence would not protect us, could not protect us; it is only when we stand up and speak out that this SILENCE would STOP.

    ##End##

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