First, do no harm. Doctors get that. They embrace it. It’s nevertheless the conclusion of a major study that medical mistakes kill at least 250,000 Americans a year, trailing only heart disease and cancer as a threat to human life. Here’s an overly hushed horror that needs massive attention, and scurrying loudly to the scene are John Hopkins University and a professor there, Martin Makary.
He’s the lead author of this analytical study, which examined four other national investigations while also searching for relevant data elsewhere. What he points to, one learns along with much else in varied news accounts, are such slip-ups as diagnoses that don’t fit the disease, vital messages never passed on, and gulps of drugs being prescribed when sips would do, or maybe sips when gulps were needed.
To err is human, Makary agrees. What’s worrisome is the complicated, overloaded state of a health care system that, without the necessary remedies, will maintain its role in propagating mishaps now affecting as many as 25 percent of all hospital patients.
With most medical mistakes, the victim can grin and bear it, but there are also grisly incidents and then those quarter of a million instances in which death occurs. That’s just for inpatients. The number could grow greatly if outpatients were added on.
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Cut off the wrong leg — something that has actually happened — and the error will likely get publicity and make eyes pop. Yet, for a variety of reasons, death certificates do not include medical error as a cause of death, and federal agencies issuing statistics refer to underlying health issues even if an errant scalpel was at fault. In one actual case, a woman had a transplant, seemed to be fine, then encountered difficulties that took her life. The reason? Her liver had been accidentally cut by a needle. The death certificate said she died from cardiovascular disease.
For starters, Makary wants to find ways to shine a bright light on the actual facts, getting them openly reported in detailed, standardized fashion. Here will be one step facilitating much deeper, broader research in a “more open and honest conversation.”
We can then turn to systemic adjustment, as in putting better safeguards in place, revising rules of procedure and assuring better team work. We can reach beyond some of the scattered, relatively small efforts going on and do what is done in cancer research — putting statistics in a national registry where they can be constantly probed in great depth and used for the right kind of decision-making.
Here is no small matter.
For context, consider that, in 2014, deaths from accidents of all kinds were something more than 130,000, some 120,000 fewer deaths than those caused by medical error. Then note that accidental, homicidal and suicidal gun deaths over the entire past decade were about 280,000, just 30,000 more than the number of deaths from medical error in one year. The number of Americans lost both in and out of combat in World War II was 407,000. The number of Americans dying from medical error during a similar four-year period today would be a million.
Getting multiple times more serious about this third leading cause of death would not mean the numbers would get to zero overnight, obviously, but research does pay off, and assiduous effort over time does get results.
What’s happening to cancer, for instance? We’ve come a long way and treatments are getting more effective daily. In 1972, we had 54,000 traffic deaths in this country. After determined civic and governmental pushes in many directions, the deaths were down to 32,675 in 2014.
This country can save lives from medical error with the right focus, and no matter what the hindrances and threats, we need politicians and medical practitioners to stand tall. The chief culpability would be doing too little.
Jay Ambrose is an op-ed columnist for Tribune News Service. Readers may email him at firstname.lastname@example.org.