Actually, Medical Errors are the Leading Cause of Death

By SAURABH JHA, MD Josef Stalin famously said: one death is a tragedy; one million is a statistic. Perhaps 250, 000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin. The problem with Makary’s analysis, which also concluded that medical errors are the third leading cause of death, isn’t the method. Yes, the method is shaky. It projects medical errors from a series of thirty five patients to a country of 320 million, which is like deciding national spice tolerance on what my family eats for dinner. The problem with Makary’s analysis isn’t that it is full of assumptions. Assumptions are inevitable in biomedical research, and abundant in health services research. Researchers of medical errors must determine whether a bad patient outcome, such as death, was avoidable. Bad outcomes lie in a spectrum between inevitability and preventability. If every death is inevitable doctors are rendered impotent, and if every death is avoidable doctors are rendered omnipotent (FWIW, I prefer omnipotence). Researchers of medical errors don’t have perfect information. They don’t know the clinical context. How can they? They were not there. They must assume and set their default assumption – which means that the researchers must choose between erring towards calling a bad medical outcome avoidable or inevitable. Err they will. But if they must err in their adjudicating error they must err systematically, because the sci...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: THCB Source Type: blogs