Tuesday, September 24, 2013

I Call Bullshit

I am hard on myself. I'm the first one to point the finger inward. Every patient that dies, every adverse outcome, I study my decisions in excruciating detail. I have high standards. I don't sugar-coat the abilities of myself or my colleagues.

As the owner of my own medical practice, director of a nursing home, expert witness, and associate director for a hospice and palliative care company, I have vast experience dealing with the pitfalls of our medical system. After seeing thousands of patients, in almost every setting over the last seventeen years, I strongly question what I have been recently reading on my twitter feed.

According to a new study in The Journal of Patient Safety, preventable adverse events (PAEs) account for over 440,000 deaths a year in hospitals making medical error the third leading cause of mortality in the United States.

I call bullshit!

In my experience patients die of metastatic cancer, end stage dementia, coronary artery disease, stroke, and sepsis. Of the thousands of patients I have watched die, only a handful, at most, were complicated by preventable adverse events. And most of these happened in patients with highly involved, already terminal diseases, where the pure number of physicians and treatments multiplied the complexity.

I'm not saying that medical error doesn't occur. I'm not saying that we shouldn't have a robust bevy of researchers and experts studying the issue. None of us should rest knowing that our patients lives are at risk.

But I have to think that the extrapolations that led to this data set are faulty.

It just doesn't match what most of us are seeing in the trenches.

5 comments:

Anonymous said...

Unfortunately, I'm on the end where I see a number of mistakes and people are too afraid of the retaliation, blacklisting, and the like to do anything.

tracy said...

You are the most amazing Doctor ever. I don't know what else to say, except i wish you were my Doctor.

james gaulte said...

I agree.That number is of the same type of BS as was the number that IOM fabricated about the number of patients who die each year in hospitals due to medical mistakes.2

james gaulte said...

I agree.That number is of the same type of BS as was the number that IOM fabricated about the number of hospitals deaths due to errors.

john james said...

I think that a soldier in a foxhole who cannot see the whole battle would think that the battle was "bullshit." The doctor has no concept of the number of medical errors that take place each day in our nation. My estimate (440,000/34,000,000) essentially asserts that just over 1.3% of the patients hospitalized each year have their lives significantly shortened by a lethal medical error. No one is asserting that many of these patients don't already have serious illnesses, but the end cause is a mistake in care.