Slashdot Mirror
Medical Errors Are Number 3 Cause of US Deaths, Researchers Say (npr.org)
An anonymous reader quotes a report from NPR: A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third-leading cause of death in the United States -- and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye. The authors, led by Johns Hopkins surgeon Dr. Martin Makary, call for changes in death certificates to better tabulate fatal lapses in care. In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death. Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. On the CDC's official list, that would rank just behind heart disease and cancer, which each took about 600,000 lives in 2014, and in front of respiratory disease, which caused about 150,000 deaths. Medical mistakes that can lead to death range from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive. The study was published Tuesday in The BMJ, formerly the British Medical Journal.
We spend so much money for so little.
Is the worst in the world. Cuba is the best, by far.
"250,000 Americans die each year from medical errors"
Fuck fighting terrorism. This deserves more attention.
After eliminating deaths from diseases and occupational situations, it stands to reason that something else would then be ranked number one.
Health nuts are going to feel stupid someday, lying in hospitals dying of nothing.
This issue is a bit more complicated than you think.
When you look up the rates for problems, you see huge % of the staff have problems.
The non-stop pressure from management to work faster coupled with major decisions being made with often not enough diagnostics or time means burnout is high and part of that is the recognition they make mistakes.
A friend who works the ED noted he had an inconclusive diagnosis of a new patient and took extra time to get other tests done. He got the results and the patient was moved into the hospital and he was on to his next patient when a 'bean counter' shows up and says "We noticed you took an extra 20 minutes on your last patient. You are slowing down. etc. etc."
Then to counter the stress and sometimes double shifts, they start taking drugs.
DD vs RPS Prediction
People vastly overestimate how infallible people are (especially themselves). The rate at which humans make errors is about 0.5%. Which if you think about all the things you do in the course of a day, is a really big number.
About 7.3% of the population were hospitalized overnight or longer (23 million people).
If 250,000 of them died, then fatality rate due to medical errors is about 1.1%. Which is in line with the average error rate compounded over multiple ways in which errors could kill a hospital patient.
If you want to reduce the fatality rate, you either need to get people out of the system (e.g. autonomous cars - but they make people uncomfortable even though they're statistically safer), or implement automated checks to supplement people's work. We're already doing the latter with prescriptions - computers now automatically check for dangerous interactions between medications prescribed to the same person. More operating rooms scan all equipment used during surgery, and re-scans at the end to make sure it's all accounted for, and nothing has accidentally been left inside the patient. And some hospitals are starting to use barcode and RFID scanners to double-check that the medication being administered is the proper one for that particular patient.
Anyone who's tried to get a doctor to admit a medical mistake knows how difficult that can be. It's nearly impossible to find someone else in the medical community that will stand with you to acknowledge that there was a problem in the first place - the appearance being that they all have a "gentlemans' agreement" to cover each others asses. I'd wager that if the number of unproven complaints were taken into account it would be the #1 cause.
When Bernie is elected, he'll disrupt the medical cartel.
I was almost one of these statistics.
A 'pain physician' providing after-care for a skull fracture prescribed me 80 mg of straight oxycodone every three to four hours, as needed. That is over HALF A GRAM of oxycodone per day! Talk about a pain roller-coaster... My fiancee would spend the entire day watching me, just to make sure that my chest was moving. It was a deadly dose.
I went back to this bad MD, once, and she tried to place all the blame on me. "You follow what's on the label". I replied, "YOU wrote the scrip, which determined what was on the label!" This idiot was blaming me for her near-deadly error, trying to escape the risk of losing her medical license. Well, she soon got fired from a third institution within a year...
I immediately found an actual Pain Management Physician. He prescribed a 24-hour time-release oxycodone, plus a few on the side for pain-spikes. I got off of that crap in less than three months with no withdrawal issues at all.
This is just an example of how physician errors kill people.
$15 an hour?
The expert researchers did an expert study that determined that all the 'evidence based' medicine that all the expert researchers have been promoting the last 20 years is garbage, and they have scientific evidence to back it up. Is that correct?
I have no idea why anyone would ever question an expert.
No one listened when I called for shutting down all of the hospitals.
Maybe because that's a very stupid idea. The worst idea I've ever heard.
No one listened when I called for shutting down all of the hospitals.
Maybe because that's a very stupid idea. The worst idea I've ever heard.
It's not stupid. If hospital are closed, the number of death due to medical error will decrease, and the number of death from other cause will increase. So the problem of medical errors being 3rd cause of death should be fixed rapidly!
When you are near death a mistake that would be trivial if you are healthy is enough to kill you. That's not excusing the mistakes just explaining some of the statistics.
I had three doctors misdiagnose a systemic infection I had that could have lead to serious complications if untreated, and due to the circumstances, it would have went untreated without dubious research on my behalf. One doctor even prescribed a medication that exacerbated the infection. The third doctor I informed of my theory, concern for medication, and the evidence for diagnosis which they brushed away. I had laboratory testing ordered myself from labcorp which confirmed the case.
I discussed the issue with future doctors and they covered the ass of the other doctors involved. As someone relatively young with a fairly strong science background, ability to research, and logical reasoning skills now encountering the medical world... I have lost faith with the majority of physicians and specialists. Their knowledge sets are often dated and they discount edge/corner cases in diagnostics. Several of the physians even provided incorrect information about laboratory test capabilities, treatment options, and progression yet they gave their answers with confidence in the face of reasonable alternatives.
I went over that digit few years ago. It appears, that percentage-vise even countries like Cuba and People Republic of China are close to 14 and 21 times better than US at this.
I believe that too much bydlo thinks of acquiring an MD to be a ticket to carefree life
Until patient outcome has as much influence on medical practitioner compensation as mere throughput there will be no incentive for clinicians to up their game. While I've been out of the medical industry for nearly a decade I've heard of no changes that would lead me to believe that there has been any appreciable change to this situation in the US. Obviously there are societal factors such as obesity that the clinical industry cannot tackle alone it seems they do bear some responsibility as they disproportionally profit from the outcomes caused by such conditions.
they're everywhere, they don't know english from klingon, and when they do, their accent and enunciation is absolutely horrid; they routinely fuck shit up.. simple stuff even a first year resident wouldn't.. dosages, units, standard abbreviations, incomprehensible dictation, you name it. h1-b will kill us yet. i could cite countless examples just from our work in medical records -- we see it all.
The Peter principle shows that all systems tend toward maximum incompetence. To correct this, it must be recognized but the system exists to deny, deny, deny, since there is so much profit in it. So doctors can diagnose cancer and declare you cured after taking $50,000 from you. It's a con, you never had cancer.
I work for the single payer health care system of Finland on the administrative side (IT & stats related) and partly because of that, health care has always been one of my favorite subjects to discuss. However something I've noticed when talking with Americans about it is a certain type of illusion/fallacy that many seem to be under, which is that because you pay so much for it, it must be the best system out there.
Just yesterday I had a lengthy conversation on fb about the problems with a purely insurance based model, and even though I tried linking a couple of studies as to the amount of deaths caused by lack of access due to costs, I was labeled a liar because apparently 'everyone in the US now has the opportunity to get health insurance" (a direct quote from him) despite the fact that it's known that there are people who do not meet the criteria under the ACA to qualify for the cheaper/low income insurances whilist also not being able to afford a private one AND that there are also still issues with insurances not covering certain operations. Don't get me wrong, the ACA was a small step in a better direction but the gutting of the public option for all sort of killed the best potential about it. Yet my counterpart in said discussion was adamantly of the opinion that anyone who dies in the US for not getting treatment dies purely because he/she didn't bother to get insurance and hence the system is not to blame.
You've plenty of things where you lead the world, and the medical R & D and high level expertise in the US is unparalleled. However I do wish that more Americans would realize how much you're paying for simple base level health care. I've seen hospital invoices from the states where simple over the counter ibuprofen pills are billed at several dollars a piece. That's a a margin of several thousand percentages. The fact that this is allowed is unfathomable to me. Even if one is of the opinion that a life-saving basic service should be allowed to remain a profit-driven business, having no controls on pricing combined with the insurance lobby has created a gigantic price bubble. This is why the US spends combined (private and tax spending) the most money on the planet per capita on health care, and still the results are far from the top. (Source (wiki))
The profit motive needs to be either removed or curtailed heavily, so that more of the money that's spent can actually be used to improve the level of care and oversight, instead of just increasing the profits of the insurance giants and private hospitals.
We get comparable treatment results and universal coverage (at about 3500 dollars a year per capita) than the US does when it comes to life expectancy, cancer survival rates (in fact, with certain types of cancers we're ahead of the US even) and so on. You spend more than DOUBLE that (8700 dollars according to OECD when totaling private and public spending, though interestingly, the CDC puts this figure even higher at 9500) and the massive increase in spending doesn't get you the kind of results that such an investment should.
You could and should easily be able to arrange for the hands down best universal health care system without spending a dime more than you already are. Don't spend more, spend smarter.
Just my 2 cents, feel free to mod me down for being a socialist scum now.
"It is the business of the future to be dangerous" -Alfred North Whitehead
Maybe on the part of the front-line physicians.
Does no guilt lie with the designers of protocols? Can not the possibility be acknowledged that protocols were designed to cull people who "aren't worth saving"?
There is no accountability. The tone of the article proves it. Where accountability is lacking morality is exceeded. This is not some irrelevant generalization. This is natural law, provable by induction.
As though such thoughts would never cross the mind of every ordinary person, let alone one who acts as society's interface to life and death: "If they have lived a full life, have been productive in their career and the raising of their family, what else could they offer? Their days of productivity are at an end, and it would perhaps be cruel to make them go on hobbled or lame."
I'm sure that we can get from number 3 to number 1 in just a few years!
I can only imagine how bad it is where I live, in the Czech Republic. Doctor errors must be our number one cause of death.
I can only imagine how bad it is in the Czech Republic, where I live. Doctor errors must the number one cause of death. Especially when it comes to diagnosis. Who has the time or will to listen when you are expected to see 8-10 patients per hour? When your training was incomplete anyway, because the medical schools don't have the resources (try training a class of 20 students in anatomy when they only have a single cadaver between them. And it's often the head professor!) I would like to move to America to lower my chances of premature death at the hands of the half-skilled.
And you know it...
Bernie wants to make all of US health care as efficient as the VA and Medicare, meaning he will about triple the cost per patient. And doctors and hospitals will love him for it.
Boy, the stupid is really out in full force today.
the purpose of health insurance is to -prevent- people from receiving healthcare.
And the insurance companies have become very skilled at this purpose.
1) eliminate the health care companies. We need direct pay!
The costs are too large to not have either insurance companies or the government involved. The majority of Americans would be bankrupted by a single major surgery and that would be true even if healthcare costs weren't completely out of hand.
2) eliminate the AMA. There are not enough doctors. Patients are dying in the emergency room waiting to be seen.
First off, the AMA has nothing to do with the quantity of doctors. They do not directly control the supply of doctors and in fact the number of medical schools has been increasing in the last decade. Second, there is no epidemic of patients "dying in the ER waiting to be seen". Emergency Departments (they aren't typically called Emergency Rooms because - well, they're not a room) are actually quite good at triaging patients and taking care of those in greatest need first. There is however the problem of people coming to the Emergency Department for conditions that clearly are NOT emergencies because our screwed up system gives them no other options.
3) kill all malpractice lawyers. A doctor practising in good faith should never ever be sued
And exactly how do you plan to distinguish between doctors acting in good faith and those that aren't? While the vast majority of doctors are good, hard working people who care greatly about their patients, there are exceptions. Furthermore there sometimes are doctors of questionable competence. An incompetent person acting in good faith is just as dangerous as a competent person acting in bad faith. Either one is dangerous and there has to be a mechanism for dealing with them.
4) curtail the power of the FDA. The FDA does more harm than good.
Spare me. While nobody would argue that the FDA is without problems, the FDA is one of the most successful and vital government organizations we have. Their prime directive is to actually make sure that medical treatments actually work before they can be sold to the public. Without the FDA you would have absurd levels of quackery and fake "treatments" being sold to people who don't know any better. One merely has to look at the market for "alternative medicine" (particularly homeopathy) to see what would happen. You know what they call alternative medicine that is proven to work? Medicine.
There is no difference between big government and big corporations. You do not want you health care being run by the insurance companies or the government.
If you think there is no difference between government and business you don't understand either one adequately. There are no other payment options available without involving either insurance or government. Most countries have (sensibly) picked the government option since EVERYONE needs health care at some point but insurance can be made to work. But unless you are privately wealthy there aren't any third options. Your notion of everyone paying directly is pure fantasy because the costs are and will remain too high to be feasible.
And hey, they're right, but they're not infallible.
Neither are computers, but they're closer.
Right now, expert systems are ALREADY better than doctors at making diagnoses. The only part they can't handle is doing the actual inspection and questioning of the patient, and that part is coming fast.
What will prevent us from using them? The AMA. They lobby to make it harder to become a doctor, in order to keep down the supply of health care professionals. The AMA is evil, and must be destroyed.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
As long we're not treated by intelligent roboters, this seems unavoidable. Humans will always err. If treatment of cancer and heart diseases further improves, medical errors will be (in all likelihood) number 1 cause. So this seemingly shocking news might be a sign of advancement in medicine. Just playing devil's advocate.
A modern day modest proposal. I like it.
Argh. The laws of science be a harsh mistress.
Medical errors leading to death is just another line item to our insurance industry. Being as it doesn't cost the industry anything for you to die (in fact they come out even further ahead at that point), there is no reason for them to do anything to prevent it. The insurance industry, far more than anyone else, dictates how much work a hospital or clinic needs to do in order to keep the lights on; they could bring down medical errors by lowering that threshold. Doing so would of course eat in to profits so they'll keep it right where it is.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
Perhaps on a list of all causes it might rank 3, but as a preventable cause of death (murder, pool drownings, etc) it ranks 1 by leaps and bounds (250k vs 42k for suicide). I suspect what we have here is a similar situation to that of law enforcement, those making the "mistakes" are often those making the determination.
I've seen them post before. They're not that stupid so that's surely their attempt at humor. I do pay a bit of attention to the names of who posts (I wasn't doing anything better) and they're not usually exclaiming any zealous political opinions at either end of the spectrum. So, I'm pretty sure it's a joke.
Are they grouping inherent risks with medical errors?
Medicine definitely falls into the Rocket Science category of difficult.
When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
So your are roughly 20 times more likely to be killed by a medical professional than by a firearm.
Medicare controls costs and has better outcomes than any other public or private institution in the US.
I very much wish our entire health care system was run by them.
Switch to Canada's model where our insurance doesn't dictate which specialists we can see, and when we can see them. People aren't taking care of their problems because of the cost of doing so makes them put it off until it's serious. My aunt died from stomach cancer because she thought it was just stomach cramps or a food allergy that she could put up with and she didn't have the cash to spend on a visit just for that.
Also please let's get job protection for people with medical problems. My mother in law is going to be fired from her job, and has been in the past, because of polycystic kidney disease preventing her from being able to walk or move. She has 20% kidney function but can only get a new kidney when it's at 10%, and in the meantime she has to try to be at work enough to not get laid off.
Medical system in the US just doesn't work for the average person, we can't even people in to be diagnosed, or get proper care without risking their employment.
If medicine could treat any condition (including anything age-related), then the only thing people would die from are medical errors.
One of the authors of the article is, in fact, the guy out promoting the use of checklists in surgery.
So statistically speaking, I'm safer around guns than doctors?
Stop signs are only Suggestions
A friend's wife is senior management with a hospital system and we were talking about some of the impossible challenges of medical care and cost.
I kind of wondered if more opiates, doled out in small doses & quantities, wasn't actually partly the answer.
1) Pacifies the hypochondriacs and people with vague and poorly defined "symptoms" who end up getting a bunch of expensive tests to rule out rare conditions they don't have. They go home, feel better from the opiates and maybe find something else to be distracted about because they feel better. Eliminates a lot of doctor time, lab time and expensive time on limited access equipment like MRIs.
2) Masks symptoms in people who have chronic conditions and have no actual cure. These people may have expensive and marginally effective therapies for what actually ails them, but quite often these are expensive drugs, demanding physical therapies or other treatments that don't much improve their actual condition or how they feel and won't cure them anyway. A lot of the time is strikes me that these people are on expensive medications with weird side effects and marginal primary effects whose principal value seems to be they aren't opiates.
OK, there would be downsides, some of these people would develop low-level habits, but that's where the small doses and quantities part comes in. Given opiates under managed conditions, most would not spiral into raging junkies and many may actually experience an improved quality of life because they *feel* better. Even if they did have low-level, maintenance habits they could be on opiates for years without any significant side effects, and as drugs they are dirt cheap.
The up side is that a lot of people who clog the medical system with non-problems and conditions that mainly need to be managed to keep them living functional lives, probably saving a bunch of money and resources for people with treatable or more life-threatening conditions.
In a way, it's kind of a rationing of medical resources but with potential state-of-mind improvement for those rationed out of the system.
we do have the worlds best doctors.. we just happen to have some of the worlds worst too :D
Stop signs are only Suggestions
So much this. Doctors are just juggling knives; the more diseases and treatment, the more knives; the better the doctor, the more knives. Eventually the best docs create a system where it's a medical error as likely as anything that terminates this recursive "complex system" catastrophically.
Due to government's licensing-requirements, an immigrating doctor effectively has to go through Medical School again in the US — however accomplished and acclaimed he may be in his home country. I know some permanent residents who have done this (and one, who settled for becoming a nurse instead), but holders of temporary visas understandably would not.
In Soviet Washington the swamp drains you.
2) The wide usage of insurance shifts the bulk of the medical market into an insurance focused market, Rather than having an interest in having a patient with a positive and improved outcome, the physician has the two incentives of 1) not being sued (see above) and 2) placating the beancounters at the insurance company. The actual happiness of the patient ranks a distant third.
The focus on the ACA and the nominal dollars being thrown around is one of the examples of mass naivete that harm most Americans medically. see: http://sti2.blogspot.com/
In the United States, the attitude is that doctors are among the highest paid occupations, and medical stuff is very expensive, so it had better work, unless you are trying to be cheap. I wonder what the error rate is for the European nations, especially the NHS.
It looks like the /. readers don't have access to much information about this other than personal anecdotes and popular press. Clearly the best way to start fixing this is to go youtube ZDogg M.D.
From the makers of the milli-Helen (the amount of beauty required to launch one ship) comes the fabulous milli-why (unit m?).
5 ?
The amount of directed inquiry necessary to fully explicate root cause.
1 m?
The least amount of brain-cell electrical exchange required to ascribe blame.
.....that the US model is held up all over tje world as an example of what NOT to do ?
"Mr Speaker, if we continue down this path to ruin we will end up with American style healthcare, and no one wants that. So I would ask the honourable member, why does he want to destroy the healthcare system and turn it into a facsimile of the US system?" .
US healthcare is used to frighten small children into eating their greens.
More communication between doctors could probably help. Medicine seems to be (in my non-doctor's perspective) a relatively solo practice. Online doctor-only communities like SERMO (http://www.sermo.com/what-is-sermo/overview) could help there. There are also patient-run communities (like MD Junction http://www.mdjunction.com/) that might be useful for patients who want to take a more active role in their treatment.
We have more than we have ever had this shouldn't be on the rise. Influx of low quality foreign doctors with low quality standards.