Why it matters: The medical industry is a leading killer

[nothingshocksmeanymore]

In 1998, reporters Fred Schulte and Jenni Bergal at the Fort Lauderdale Sun-Sentinel wanted to find deaths from cosmetic surgery, but their reporting had hit a dead end.

Doctors hinted at horrendous problems that a colleague was having, then provided no details. And, coroners said they knew of no deaths from liposuction, a supposedly safe cosmetic surgery that makes people thinner.

All that changed when Schulte and Bergal searched records where the bodies were piling up: the county morgue. The slow, painstaking review unearthed striking cases. The reporters identified even more deaths from liposuction when they investigated hundreds of malpractice suits

snip
Two studies in the IOM report estimate that between 44,000 and 98,000 people are killed each year from medical errors.2
Medication errors are thought to cause 7,000 deaths annually – more than the 6,000 deaths that occur each year in the workplace.2 The annual cost of medication errors is at least $2 billion.2
Total costs for preventable medical mistakes, including lost wages and extra health costs, are estimated to be between $17 billion and $29 billion a year.2 Preventable mistakes in hospitals alone are thought to cost from 2 percent to 4 percent of national health expenditures.2
Forty-two percent of randomly selected Americans said they had personal knowledge of a medical error that had happened to themselves, a relative or a friend, according to an October 1997 poll financed by the National Patient Safety Foundation, an independent group established by the American Medical Association

http://www.ahcj.umn.edu/qualityguide/chapter2.html

Note: This is an extremely LONG read about the entire medical system and the way it markets and delivers care. It debunks much of the tort-reform argument by demonstrating how very few cases of malpractice actually see their day in court, let alone get filed. It has every aspect of medical care covered, including reporting of medical care. It goes into great detail about the financial motivation to ignore KILLER medicine. It is a MUST READ!


Main points of the article:

Key Facts: Too many deaths, too much money
Two studies in the IOM report estimate that between 44,000 and 98,000 people are killed each year from medical errors.2
Medication errors are thought to cause 7,000 deaths annually – more than the 6,000 deaths that occur each year in the workplace.2 The annual cost of medication errors is at least $2 billion.2
Total costs for preventable medical mistakes, including lost wages and extra health costs, are estimated to be between $17 billion and $29 billion a year.2 Preventable mistakes in hospitals alone are thought to cost from 2 percent to 4 percent of national health expenditures.2
Forty-two percent of randomly selected Americans said they had personal knowledge of a medical error that had happened to themselves, a relative or a friend, according to an October 1997 poll financed by the National Patient Safety Foundation, an independent group established by the American Medical Association.

[havocmom]

1. Good resource. Thanks NSMA

Medical care as a business as opposed to medical arts practiced by professionals.

Businesses want to increase profits and one way is to do more while cutting costs. Gee, wonder where that busisness plan leads when dealing with human bodies.

[underpants]

2. Does it say anything about ANY deaths from Canadian Rx?

I see the medication deaths so that could include wrong prescriptions from anywhere and everywhere. I have yet to see any report of drugs from Canada being any less safer or killing anyone (as if the Canadians don't test and monitor the drugs THEY PAY FOR).

[skygazer]

3. Just a few days ago

A guy died at a local hospital when he was accidentally given TEN TIMES the amount of chemotherapy meds that he was supposed to receive. The hospital's solution? Hire one new nurse to double check chemo doses! What about other meds? If it can happen with one, it can surely happen with others.

Thanks for the info - thought provoking and frightening.

[underpants]

4. Tie this in with the Americans for Insurance Reform

http://www.insurance-reform.org/

They had a great PDF on how the states (Fla., Okla.,Ohio, Miss., etc) that have actually passed the insurance company written tort reforms have seen malpractice premiums RISE.

I'll see if I can find it.

[underpants]

5. Here you go-check out what they did in Texas

http://www.insurance-reform.org/pr/AIRCaps%20then%20Rate%20Hikes.pdf

Texas: During the 2003 campaign for a “tort reform” referendum, ads promised rate cuts if caps were
passed. After the referendum passed, major insurers requested rate hikes as high as 35 percent for
doctors and 65 percent for hospitals.1 Lawmakers who supported the cap are now expressing anger that
premiums have not gone down.2 In April 2004, after one insurer’s rate hike request was denied, it
announced it was using a legal loophole to avoid state regulation and increase premiums 10 percent
without approval.3

Florida: “When Gov. Jeb Bush and House Speaker Johnnie Byrd pushed through a sweeping medical
malpractice overhaul bill last August, the two Republican leaders vowed in a joint statement that the bill
would ‘reduce ever-increasing insurance premiums for Florida's physicians .��.��. and increase physicians'
access to affordable insurance coverage.’” But, insurers soon followed up with requests to increase
premiums by as much as 45%.4

[Kanary]

6. Thanks for posting this important info

Nominated.

Kanary

[JackDragna]

7. Horse puckey.

I'm not normally one to support the medical industry, but the IOM reports about the number of preventable medical deaths should be the stuff of urban legend. Most of its methodology is flawed, in that widepsread extrapolations of national trends were made from examining a very small subset of patients. The best description of what I'm talking about is here:

http://gasnet.med.yale.edu/societies/apsf/newsletter/2001/fall/03errors.htm

[nothingshocksmeanymore]

13. Well the doctors who attacked the study from JAMA certainly had

no corporate sponsors /SARCASM/ JAMA is hardly independent of corporate insurance industry funds...in the study, their allegations of a 3 month mortality rate on those that would have survived is highly suspect and speculative.

And when it comes to Yale, here's just a small list of Yale researchers on the corporate dole....some for drug companies which were partially the subject of the above article:

http://www.cspinet.org/cgi-bin/integrity.cgi

Of course they would want an adjunct to attempt to debunk it.

[Gwerlain]

65. I think you misread the link you posted...

It isn't about the IOM report, it's about another report attacking the IOM report by some folks named Hayward and Hofer.

I'm sorry, I don't think it's an urban legend. I think it's the truth:

"When we undertook the MPS we had no idea what we would find. Although all reviewers brought their own personal biases into the process, they were not aware that there was a huge problem; 180,000 deaths from medical accidents, 98,000 of them preventable. They had no "axe to grind." They had no reason to find for or against error as a causation of injury. "

The MPS was the Medical Practice Study, conducted by Harvard in 1991. Note that the numbers there are considerably higher than those from the IOM report.

At least it's getting better. But it sure isn't a myth.

[LunaC]

8. The death rate DROPS when Doctors go on strike.

"The June 10, 2000 issue of the British Medical journal reports on an interesting statistic that has occurred in Israel. It seems that three months ago physicians in public hospitals implemented a program of sanctions in response to a labor dispute over a contract proposal by the government. The article stated that the Israel Medical Association began an action in March to protest against the treasury's proposed imposition of a new four year wage contract for doctors. Since then, the medical doctors have cancelled hundreds of thousands of visits to outpatient clinics and have postponed tens of thousands of elective operations.

"To find out whether the industrial action was affecting deaths in the country, the Jerusalem Post interviewed non-profit making Jewish burial societies, which perform funerals for the vast majority of Israelis. Hananya Shahor, the veteran director of Jerusalem's Kehilat Yerushalayim burial society said, "The number of funerals we have performed has fallen drastically." Meir Adler, manager of the Shamgar Funeral Parlour, which buries most other residents of Jerusalem, declared with much more certainty: "There definitely is a connection between the doctors sanctions and fewer deaths. We saw the same thing in 1983 when the Israel Medical Association applied sanctions for four and a half months."

http://www.chiropracticresearch.org/NEWSdeath_rate_drops_during_doctor_s.htm


According to the Journal of the American Medical Association (JAMA), Doctors are the THIRD leading cause of death in the US, causing 250,000 deaths every year.

http://www.mercola.com/2000/jul/30/doctors_death.htm


You may also find this abstract to be of interest:

Death by Medicine
http://www.nutritioninstituteofamerica.net/research/DeathByMedicine/DeathByMedicine1.htm

[Julian English]

14. Sorry, but cite some more objective and accurate sources

The webpages to which you link are every bit as biased as the insurance industry. For example, chiropractic and "natural" or "alternative" health providers make extravagant claims with little or no science to support them.

Certainly, problems exist in the current medical system--but the claims made in the pages you cite are about as reliable as the claims of the Swift Boat Veterans For Truth. Such advocacy groups seek to further their beliefs ("Kerry is bad" or "Medical doctors are bad" rather than to solve the problem. In pursuing their agenda, they offer simplistic answers and inaccurate statements. Such sort of stuff may be fine for Freepers but I like to think DU members are a bit smarter and discerning.

If you are truly concerned about the facts in this complex issue, I suggest you look at data from good journals on Public Health rather than the websites from self-appointed advocacy groups with an axe to grind. Science and statistical evidence, while not as easy as to understand, offers far more reliable results than dogma. After all, scientific method applied health issues has a demonstrated track record of improving public health.

[LunaC]

25. It's disingenuous to comment on links you haven't even read!

That's usually a practice reserved for Repugs, reminiscent of the uproar surrounding F911.

If you had bothered to actually READ the links before your knees reacted spasmodically, you'd have known. for example, that the Mercola site presented an article from the prestigious Journal of the American Medical Association (JAMA) - the most widely circulated medical periodical in the world! The article was written by Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health, Department of Health Policy and Management.

You're more than welcome to track down the original article here:

Journal American Medical Association - July 26, 2000;284(4):483-5
"Is US health really the best in the world?"

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed

Surely JAMA (not to mention the British Medical Journal cited in the first link or the multitude of highly respected Journal
references cited in the last link) meet your standards of "good journals" offering "science and statistical evidence" without an "axe to grind."

I am reminded of Abe Lincoln's quote - "It is better to remain silent and be thought a fool than to speak and remove all doubt."

[Julian English]

31. Um, I read the articles.-which is why I scoffed.

I understand how the articles misinterpret and misquote the data. One or two articles from peer-reviewed journals do not mean damnation, particularly when cited by dogmatic websites. The field is complicated and is an area of considerable study in public health.

Overly simplifying things is what you can get from the National Review of The American Spectator, as well as those websites. Citing articles without context is the sort of tactic upon which Anne Coulter and such dogmatists rely. (And which Al Franken has offered a neat layman's debunking.) Really, you can cite anything you want--but that doesn't mean that you are citing correctly or understanding it.

Consider this crap in the one article, http://www.mercola.com/2000/jul/30/doctors_death.htm:
ALL THESE ARE DEATHS PER YEAR:

* 12,000 -- unnecessary surgery 8
* 7,000 -- medication errors in hospitals 9
* 20,000 -- other errors in hospitals 10
* 80,000 -- infections in hospitals 10
* 106,000 -- non-error, negative effects of drugs 2

These total to 250,000 deaths per year from iatrogenic causes!!

All you have to do is add up the numbers to see that this guy is not interested in facts: 12,000 + 7,000 + 20,000 + 80,000 + 106,000 =225,000 not 250,000. That is an exaggeration, even using his own figures in one paragraph of 11.11%--a rather significant amount.

Further, the references are sloppy. For example, the whole area is of "non-error, negative effects of drugs" is a rather broad category. Consider someone who would die from cancer but has their life extended by 6 months by chemo, yet still dies. They may fell in this category. But given the paucity of the cite to footnote 2, a reader can really not tell what the definition is in the text cited. Indeed, the conclusions of the IOM report, as noted elsewhere has been criticized. A good, readable criticism may be found in the article "The Institute of Medicine Report on Medical Errors - Could It Do Harm?," New England Journal of Medicine, Volume 342(15),13 April 2000, pp 1123-1125.

The level of this article and others analyzing the IOM report and the issue of patient care oare far more sophisticated than dogma you seek to preach. Still, if you are at all interested in the truth (unlikely as that appears from the troll like nature of this thread's heading), you might want to investigate the field. Doctors and other health professionals spend a great deal of time in thoughtful analysis of this. Search Pubmed and Ovid--you'll find more than a few articles on the matter.

(By the way, has anyone noticed how chiropractors seeks to decry trained medical doctors yet seek to misappropriate the title "doctor" for their non-scientific cult? It is the way that we see Bush abusing the term "compassionate" to preach hate.)

I realize such training in analyzing the articles in science journals is probably beyond your ken, hence the need to resort to name calling. That is the problem so much of the political debate--dogma trumps the search for truth. C'est la guerre. Still, if you want to present a statistical argument, go ahead. I would be interested in seeing such whenever (and if) you can do it. You might need a bit more training to do that, though--unless you're a Freeper and have no regard for the truth or for reason. If that's the case, I have I nice piece of Ark in which you may be interested.

[LunaC]

40. Take it up with JAMA

I'm sure they'll quickly change their whole approach now that your Big Brain is on the scene. I mean, everybody knows that Dr. Barbara Starfield is such a crackpot, right? Tell me, how many articles have YOU gotten printed?

[Julian English]

41. Either you don't understand the arguments I made or you don't want to

Either way, replying to you is pointless. I must say that your screen name is quite accurate as to the nature of your post.

[JDPriestly]

9. The number of deaths from a particular procedure tells you nothing.

Some procedures are simply very risky, but also either necessary or in great demand. The doctor's duty is to disclose the dangers of a procedure and let the patient decide whether to proceed. Many people would choose liposuction in spite of a high fatality rate. The issue is whether the patient made an informed decision about undergoing the procedure. Think of the many people who have cosmetic surgery in spite of the risk of anesthesia -- vanity explains it.

Also, with regard to liposuctions, remember obesity is a huge health problem in and of itself and a risk factor. It damages the heart and other vital organs. Doctors have great difficulty operating on obese people. Even diagnosing obese people can be a problem because the doctor cannot adequately feel the parts of the patient's body.

Doctors are human, and medicine is as much an art as a science. Let's face it. Probably the most common cause for the failure of a course of treatment is the patient's failure to follow the doctor's advice.

As for those concerned about malpractice cases. I was a lawyer in a court where I wrote tentative opinions on many, many malpractice summary judgments. Let me tell you that it is very difficult for a plaintiff to win a medical malpractice case. Nevertheless, even bad cases are a hassle and a waste of time for doctors. I believe Edwards has an excellent proposal for getting rid of bogus malpractice cases. Check it out.

[nothingshocksmeanymore]

15. Clinton had an excellent remedy

For each specialty DEFINE what the standard of care is..in other words create a threshold for compensability and if the case does not meet that threshold or the doctor did NOT operate BELOW that standard one has NO case and therefore cannot file. The reason this was wholly rejected no doubt is because MANY cases where carriers want to deny liability do indeed meet whatever the defined threshold would be...it would REMOVE some of the insurance industry's DELAYS on VALID cases.

[REP]

32. Weight and Surgery

The problems with the overweight and surgery isn't due to the cardiac health of the patient, but the dangers of general anesthesia (which usually presents the most risk to any patient during most surgeries). Anesthesia dosage is done by weight; the larger the patient, the more anesthesia.

There is more to these cosmetic procedures than mere vanity; gastric bypass has an absolutely ghastly risk of death (2 out of every 100 patients die within a month of the surgery) but just read the responses to a 'fat' thread on this oh-so-tolerant board and you may come to realize why so many are willing to risk their lives with surgery.

[Ripley]

10. It's irritating they never mention that...

When the media gives out statistics on death in America. They always claim the biggest killers are Heart Disease then Cancer. Yet medical errors kill more. You will never hear that on CNN.

I remember when a woman in Birmingham died after having liposuction a year or so ago. It was so bizarre. She was mid-40's and ran marathons. No one she knew could believe she even had the surgery. But she did and died the next day from complications from it.

Is our society disgusting or what that a healthy athletic woman could be driven to having a vacum cleaner suck out miniscule amounts of fat so she could feel better about her body image?

[demigoddess]

11. I know from personal experience that doctors

rather seldom know what they are talking about. Their preventative measures are probably more dangerous than believed. Chemo is either deadly or ineffective. No doctor really questions 'conventional wisdom'. My mother was treated for a year for a disease that she did not have. I have refused some things that turned out later to be a really bad idea and they were recalled from the market. I have heard that most of the Over the counter medicine is totally worthless or it would not be over the counter. and I know that the last stage of testing new drugs is often done on the maternity ward of a hospital. God, how can you trust medical people after that.??

[sendero]

21. "No doctor really questions 'conventional wisdom'."

This is very true, and one doesn't have to dig very deep to see how astonishingly often medical "conventional wisdom" is pure horseshit.

I don't take any pharmaceuticals without reading the PDR page. I don't get any treatment of any kind until *I* agree with the diagnosis.

I have discovered that doctors are just humans, and many of them really make a lot of bad decisions. I double-check just in case.

With respect to malpractice, my wife had an experience a couple years back. She was going in to have a stint installed in a coronary artery. They use the dye in the processs. This dye is well-known to be very toxic to the kidneys and she has advanced renal disease.

But there is a silver lining. There is a drug that has a completely different purpose that is well known to block the ill effects of the dye on the kidneys. My wife was assured that this drug would be used, (and even put forth effort to facilitate its use) but the dickhead son of a bitch heart surgeon who we had to use (her doctor was on vacation and time was an issue) took it upon himself to NOT use the drug.

Sure enough, 24 hours after she had the surgery, her kidneys SHUT DOWN. She had to go back to the hospital for 2-3 days and HOPE her kidneys restarted, which was apparently not guaranteed. All of the other doctors/nurses on the staff apologized profusely for the error, except of course the dickhead surgeon. We didn't feel we had any legal recourse because of the circumstances of the drug's application.

Long story short, I didn't like this guy from the minute we met him, and he justified my negative instinct. I will never go against that instinct again.

[Eloriel]

44. So true, demigoddess

Herbs, give me herbs.

Of course, there is some good done in Western medicine. They are usually very good at diagnosis (and have a lot of fancy tools to aid that), and heroic measures are another usually great success. As is setting bones and the like.

But they WILL kill you if they get the chance (no, not on purpose -- or at least, not usually). And the scandal of iatragenic deaths have been a not-very-well-kept secret for many years now.

[sangh0]

12. kick

for the medical malpractice fakers

[Snow]

16. Okay, NSMA my friend - you started the thread -

would you be willing to address some of the more egregiously misinformed posts? To wit, in #10, "They always claim the biggest killers are Heart Disease then Cancer. Yet medical errors kill more. You will never hear that on CNN."

or in #11, "doctors rather seldom know what they are talking about. Their preventative measures are probably more dangerous than believed. Chemo is either deadly or ineffective. No doctor really questions 'conventional wisdom'."

While I sympathize with your concern over medical errors, and it is a major area of research within any medical center, medical college, HMO with a research department that I know of, some of it is sensationalized, and some of it is very hard to grasp. One of the commonest things my 'health care system' gets accused of is delays in diagnosis of cancer. This is a tough one because of two knotty problems - many cancers don't give you a whole lot of symptoms to detect - and some of the damn things grow a lot faster than other cancers at the same site. Breast cancers are among the worst for this - some of them just sit there, and some of them are terrifyingly swift. Who knows why. And those are sometimes counted as 'errors'.

[nothingshocksmeanymore]

18. I'm willing to address them in a bit...a little too in depth for what I am

doing right now, but I agree with you that heart disease and cancer kill MORE people..in terms of PREVENTABLE causes of death however, medical errors rate very high on the scale ( as certainly most people would hardly consider heart disease and cancer to be preventable when both often have ideopathic origins.)

As far as post 11 is concerned, the opening sentence was generalized, but what followed was the individual's experience with a family member and that part I can't rebut.

I can understand that not all conditions are easily diagnosed and often because patients don't follow through with testing until the condition becomes catastrophic and unmanageable..HOWEVER...as one who has represented both docs and patients in this arena, I've seen FAR more legitimate cases of malpractice than illegitimate cases. Yes, accidents do happen but so does NEGLIGENCE. State medical quality assurance boards are largely ineffective at weeding out the worst doctors in many states (although California's program is decent) and certainly medical specialty boards could do a better job of policing their own...it is also of note that when doctors RIGHFULLY testify against BAD docs in their own communities, they often end up getting blacklisted...one should not be punished professionally for being a whistle blower when bad medicine is the culprit.

[Snow]

26. Okay, good answer....

and it is indeed a tough nut. You should be aware, though, that if you're someone who's represented docs & patients, the illegitimate cases rarely get to the stage where someone like you would be called in. It's a denominator problem, in that, for example, deaths from prostate cancer don't represent cases of prostate cancer, because prostate cancer rarely advances that far. Probably not a good example, but oh well.

The problem is that often people have the misconception that nothing is being done and that indeed there is massive cover-up. There are many people within the health care industry working on this problem - we are aware of the dimensions, we know there're screw-up docs out there, and we're aware there are other reasons mistakes get made besides incompetent docs, or nurses, or pharmacists or what-have-you. Don't broad-brush paint us all. (I know you wouldn't NMSA, but these sorts of threads often attract that sort).

[nothingshocksmeanymore]

29. Oh I agree. All healthcare professionals don't look alike

:D

For every schmuck, I can point you toward ten or fifteen very dedicated individuals including my ex ( I could teach GWB about OBGYN's who love women :evilgrin: ) She and I have ALMOST come to blows over this situation...but every time I confront her with the Clinton remedy of DEFINING the standard of care in order to protect GOOD doctors while leaving the bad docs vulnerable and , hence, their license to practice at risk..she whole heartedly agrees. I also think we can ALL agree that while bean counters have their rightful place in ANY organization (and for the most part, docs are NOT good business people) their opinions can not have greater weight than those of the patient and the doctor.

Difficult diagnoses are not the same as MISSED diagnoses...I recall the case of the MARLBORO MAN (can't recall his name) the model for MARLBORO commercials. He lived here in Newport Beach...had some shortness of breath...went to his doc...doc got a chest xray but neglected to read it....turned out to be large cell carcinoma which if caught at the time of the chest xray (and it was visible) would have been treatable...he died of lung cancer...yes, he smoked and that's his fault but the doc did INDEED have a duty to read the chest xray and didn't...oops!

[Snow]

30. Okay, tricky problem here.....

I don't know if it's true in the marlboro man's case, but some of these diseases we truly don't treat very effectively. Lung cancer is a case in point, although LCC I'm unsure of. However, here's the problem - it's called lead-time bias. Suppose a disease runs a course of 12 years from inception of disease to death. You diagnose someone at year 9, and they live three more years, regardless of what you do for them. But, a new advanced diagnostic technique comes out, and you can now diagnose them at year 2 of the disease. They still die at year 12, but they've survived for 10 years past diagnosis & treatment, and in most cases 5-year survival is counted as a cure. So, i guess the point I'm making is, a lot of our cures don't do anything more than that - a lot of the time, early detection simply means you have a longer period of time of being aware of the disease. Granted, some cancers - some of the lymphomas, leukemias, some of the solid tumors - really do respond well to treatment. But a lot of the promoters of cancer screening don't understand lead-time bias, and neither do a lot of patients who were diagnosed 'late' and think they could have been cured if only they'd been caught in time.

[nothingshocksmeanymore]

37. Those aren't the situations addressed in this article

but having worked on many many mesothelioma cases, I am aware of what you are asking since mesothelioma is ten years old by the time the cells have divided enough for it to be the size of a pea (and hence detectable on xray)

That someone COULD have been cured with with newer technology is not the same issue as a person that SHOULD have been cured with due diligence (unless, of course, there was plenty of literature on the new technology and the insurance company denied the treatment as "experimental")

[Snow]

43. Well, yes and no......

the poor slob who's diagnosed at year 9 of his cancer doesn't live nearly so long as the guy diagnosed at year 2 - so he gets counted as a late diagnosis at the very least, and probably as a medical error. Or am I off base, here?

[nothingshocksmeanymore]

46. Not in this study

this study pertains to demonstrable clear cut cases of poor medicine without the issue of failure to diagnose...and the litmus test in failure to diagnose is whether reasonable steps were taken to achieve a diagnosis based on the patient's complaints at the time and the standard of care in the community...as with the case I cited above...certainly no one would argue that it is within the standard of care of any medical specialty to order xrays and then NOT READ THEM.

[Ripley]

20. So, I am egregiously misinformed?

Here's what I read to make that statement:

By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD

ABSTRACT

A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.1 Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.2, 2a

The number of unnecessary medical and surgical procedures performed annually is 7.5 million.3 The number of people exposed to unnecessary hospitalization annually is 8.9 million.4 The total number of iatrogenic deaths shown in the following table is 783,936. It is evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.5

TABLES AND FIGURES (see Section on Statistical Tables and Figures, below, for exposition)

ANNUAL PHYSICAL AND ECONOMIC COST OF MEDICAL INTERVENTION
Condition Deaths Cost Author
Adverse Drug Reactions 106,000 $12 billion Lazarou1 Suh49
Medical error 98,000 $2 billion IOM6
Bedsores 115,000 $55 billion Xakellis7 Barczak8
Infection 88,000 $5 billion Weinstein9 MMWR10
Malnutrition 108,800 -------- Nurses Coalition11
Outpatients 199,000 $77 billion Starfield12 Weingart112
Unnecessary Procedures 37,136 $122 billion HCUP3,13
Surgery-Related 32,000 $9 billion AHRQ85

TOTAL
783,936 $282 billion

We could have an even higher death rate by using Dr. Lucien Leape’s 1997 medical and drug error rate of 3 million. 14 Multiplied by the fatality rate of 14% (that Leape used in 199416 we arrive at an annual death rate of 420,000 for drug errors and medical errors combined. If we put this number in place of Lazorou’s 106,000 drug errors and the Institute of Medicine’s (IOM) 98,000 medical errors, we could add another 216,000 deaths making a total of 999,936 deaths annually.

[Snow]

27. Yes, you are

And here's a site that talks about your source:
http://www.geocities.com/healthbase/null_hypothesis_laidler.html

a couple of quick quotes

-snip-

1. Most of the numbers he uses are "chained" - meaning that they are derived by taking a number from one source and
multiplying (or adding, dividing or subtracting) it by a number from another source, often repeating the process again with
a number from yet another source. This does two things: it multiplies the errors of all the individual numbers and it blurs
the connection between the numbers and their source. Let me give an example.

In the second page, he states that there are 32,000 unnecessary surgeries performed each year. This number,
according to his own references, is derived by taking the "most common procedures" numbers from the Agency for
Healthcare Research and Quality 2001 statistics and multiplying those numbers by the findings of a 1976 House (US
Congress) Investigation of unnecessary surgery.

For those not familiar with US Congressional investigations, they are often driven more by politics than by scientific fact,
so the numbers generated are suspect at best. In addition, Mr. Null is using these "estimated" incidences from 1976 and
applying them to numbers from 2001 - a gap of 25 years! I've been in medicine for only 22 years and there have been a
LOT of changes in the practice of surgery in that time. It is not (repeat NOT) valid to assume that surgical practice
patterns in 1976 have continued unchanged to 2001. By "chaining" these numbers, he hides the unreliable and outdated
1976 incidence numbers behind the more reliable and up-to-date 2001 statistics.
-snip

-snip-
As alluded to in 1, some of the references are dated and/or of questionable validity. Many are books and articles written by people with no evident expertise AND an agenda to advance (or axe to grind).


3. In deriving his numbers on "bad outcomes", Mr. Null adds all types of adverse outcomes together without considering
(either through ignorance or intent) that many of these are not due to medical error or other failure but are merely the
natural consequences of the disease or injury. Infection, for instance, is usually not due to medical error but is a natural
risk of surgery, injury and disease. The question NOT asked is this: "How many of these adverse outcomes would have
occurred WITHOUT medical intervention."
-snip-

Further, I notice you comparing total number of iatrogenic deaths to CVD & cancer death rates. Are you sure you have your numbers straight? A death rate is very different from total deaths.

[Gwerlain]

66. Most people die in hospitals, so...

they must be really dangerous places!

[4sanity]

17. medical malpractice

Ten years ago, my daughter who is now 39 yrs old, went in for a "routine" appendectomy. The doctor, and I use the term loosely, decided to use a laproscope to survey her lower bowel area. In doing the procedure he severed her vena cava artery, punctured another major artery and nicked her bowel. She bled out in what was described as a fountain of blood. The hospital used every available unit of blood of her type and then resorted to a crystalin solution to keep a blood supply to her brain. A nuero surgeon was brought in to repair the damage. She gained 26 pounds as a result of the surgery. She has suffered severe brain damage and now has a scar that runs from her pubis to the sternum. She was a model who made a good living from her looks. No more. Her husband left her because of her mental state, took her children from her, and she turned to illicit drugs for solace. The doctor who did this to her continues in his practice and we have subsequently discovered that he has a history of "mistakes" in his surgeries. A law suit was filed, but the insurance company lawyers made mince-meat of our local attorney. Some years later I spoke with the judge who heard the case and he told me that it was the most egregious miscarriage of justice he had seen in his courtroom in over 20 yrs on the bench. You see it was my daughters fault that she was injured, so said the jury. She continues to struggle with her fate and has more problems than I care to relate. As a father I am angry, distraught, and disillusioned with our health care system as well as our legal system. Every day of my life I battle with the urge to seek "justice" on my own terms, and my fear is that I will give in to my baser instincts. God bless my fellow DUers and any advice you can offer.

[nothingshocksmeanymore]

19. I know how you feel

Even though I am in the legal profession, I couldn't help my own father when a negligent retinologist left him blind from a surgery.

He was rushed to surgery because of pressure behind his one good eye (the other eye had been damaged in a work related accident years earlier.) The anesthesiologist knew he was on coumadin because I informed him he was (and I am medically sophisticated) He didn't listen to me, didn't heparnize my father prior to surgery and my father's entire vitreous hemorraged during surgery leaving him blind..after that he fell into a deep depression, lost his mind and simply existed for the next five years until he finally pined himself to death.

I took him to the best specialists including at St Mary's in Long Beach and the Jules Stein Eye Institute at UCLA (one of the top ten in the nation) Both specialists that saw him told me that it was indeed malpractice but that they would deny having said it if subpoena'd since the opthamology community is a very small community of physicians...they all know each other.

For all my hifalutin education..I couldn't help my own father. To this day, if I saw that surgeon on the street, I'd probably punch him in the nose...or maybe the eye. So sorry to hear about your daughter's experience.

[Tsiyu]

64. Here's some advice, 4sanity

having been through the horrors of our judicial system and our medical one: Don't give in to your rage. It will subside with time. And you will see the "mighty" fall. Be a source of peace and acceptance and hope your daughter gets through this.

"When you find yourself going through hell, just keep on walking."

[struggle4progress]

22. PIRG looked over the malpractice issue several years ago ...

... and found that most problems are caused by relatively few doctors.

A national policy enforcing serious sanctions against doctors who repeatedly make serious mistakes wouldn't hurt most doctors, it would make treatment safer, and should (with appropriate regulatory oversight of the industry) permit insurance premium reductions.

[nothingshocksmeanymore]

23. Except that the insurance industry still won't reduce premiums

Even in California where we have caps, rates went UP not down. The only time rates went down and stayed down was when voters voted for INSURANCE REFORM on the ballot, it survived legal challenge, and rates went down 8% across the board for all insurance in the state.

[struggle4progress]

55. Yes, appropriate regulatory oversight is required. eom

[Gwerlain]

67. 80/20.

[hunter]

24. Big Money has polluted medicine in almost every arena...

If it's cheaper for big money to cover up a problem than it is to fix it, that's what big money always does. Death and suffering do not enter into the equation except as a dollar amount.

Big money works for the people who pay the bills, mostly the insurance industry or the government. Doctors, various health care professionals, and patients are merely cogs in the big money harvesting machine.

Doctor-Patient relationships are discouraged. In the big money world there are only "providers" and "consumers" and all are replaceable. If one provider makes too much noise, big money gets another one who doesn't. If a patient makes too much noise, big money pays them off and tells them to go away.

Too bad and so long if you are a health care professional or patient who demands a high standard of care. There are always doctors and patients with very low standards who will gladly take your place in the big money machine.

[Heddi]

28. How many of these deaths are due to overworked staff?

I've heard many nurses that I work with and around complain about times when they've been working for 3 straight days because there is NO one else to do the job and around day 2.5 with minimal sleep they start getting loopy and wonder hmm...did I give the right medicine? Did I read that order right?

The same for surgeons---one of the Gyn Oncology Dr's I work with was on call a few weeks ago and in addition to the 2 back-to-back bilateral salpingo-oophorectomies he had scheudled that day, there was an emergency hysterectomy that had to be done that night (I don't know the particulars) and the next morning another surgery that had to be done---in the interim he had 3 hours sleep. That's alot--no matter how well trained you are---to do in the span of 2 days. Especially when the most routine of these kinds of surgeries are minimum 3 hours---longer if the patient has suspected cancer/metastisis and a pathologist has to do a frozen sample, etc before the procedure can continue.

And I know that Dr's are well trained to work long, hard, and under the not best conditions---but the human body can only be trained so much---

I think the pressure and work performance level would be even more extreme in Trauma/ER situations.

I know that liposuction isn't a life-saving procedure, and I've heard horror stories from nurses who worked in plastic surgery day clinics where the Dr's learned to do liposuction after taking only a weekend-long training class.

I also wonder if the number deaths are linked with the socio-economic status of the hospital in question. I mean, would an overworked, understaffed community hospital that doesn't have the fancy gizmos and gadgets available have a higher death rate due to malpractice? Or would the fancy-schmancy 'private' hospitals have an equal number of deaths as the cheap-o, about-to-be-shut-down community hospitals?

I think the problem is very deep. You have nurses and other hospital staff who are very overworked and very understaffed. THe Nurse:Patient ratio is growing more and more extreme every day. My Supervisor (an Oncology nurse with 25+ years exp. as a nurse) said when she started out, there was one nurse to every 4 patients. When she quit doing 'rounds' and started working in research, it was one nurse to TWENTY patients....of course when you have to work in those conditions, preventable errors will rise. It's just bound to.

So what do we do? ALLLLLL the Dr's and Nurses I work with are very aware of the liability they hold, and there are numerous "Stop/Check" during surgeries.
Just for those who don't know---STOP/CHECK is this:

STOP in the middle of the procedure. Name the patient, the problem, the procedure

CHECK all instruments in the basket against those being used and those that have been returned for sanitation. Check all lap pads and other absorptive towels--how many are in the patient, how many are in the bucket, and how many are in saline waiting to be used.

If there is ANYTHING missing--a lap pad, a hemostat--ANYTHING--the entire procedure stops until the missing instrument can be found.

At the end of the surgery, before the patient is closed up, another stop/check is done and the patient will not be sutured closed until EVERYTHING is accounted for---down to the tiniest thing.

They (we) all want to decrease the number of preventable, hospital-error deaths that occur. That doesn't make ANYONE look good and people already have little faith in the medical establishment as it is.

But it's a systemic problem that can't be solved by tort reform and award caps.

Vacancies MUST be filled and filled quickly with trained, knowledgeable, able individuals. That takes the load off of those already overworked so that small errors that are missed by a Dr or Nurse who's on their 4th day with no sleep can be caught right away and corrected if possible.

[REP]

33. Or Arrogant Assholes?

I've had an ER doctor try to give me repeatedly an injection of a drug that is extremely dangerous for patients with my condition - a condition that isn't that rare (renal failure) and is noted all over my chart, which he had. Not all patients are as willing as I am to question a doctor's actions and prevent them - or to even know that what is about to be done to them could be fatal. (Private hospital during the Killing Season)

Edited to add: not that I'm down on doctors! My regular doctor is terrific, and is a wonderful person as well. He's why I'm in such surprisingly good shape. I believe most are doctors like him, and my equally excellent GYN. Assholes like the one in my example are not the rule, and they screw it up for everyone, especially the patients they harm.

[LynzM]

36. I had a similar experience with having to be your own police...

I'm diabetic. During labor, the OB on call (not my normal OB, who I'd previously discussed this with) told the nurses that he didn't want me monitoring my blood sugar every hour, he only wanted me monitoring it if I was 'symptomatically low' and then they were to call him before I could treat my blood sugar! That is positively absurd, that in the midst of the most stressful thing a woman's body will normally go through, that I should not be monitoring my diabetes on a regular basis. I ended up sneaking the tests in when nurses weren't around, which is equally absurd. In a hospital. And later in the course of the labor, I was given an IV. They were going to put a standard D5 drip in, which contains dextrose, which should not be given to a diabetic unless specifically needed, which it was not. When I told them I would not let them connect that until they got the saline-only drip, minus the sugar, they did indeed get it. But if I had been less informed or willing to speak up about it, I could have had major blood sugar issues going on, and who knows what that would have meant for me, our daughter, and the course of the labor/delivery. But I'm 'just the patient', right? ;) Sorry to get catty, that just really pissed me off.

[SarahB]

34. And most errors are concentrated in the hands of a few doctors.

I wrote this yesterday in regard to malpractice:

"Why don't physicians begin to "police" themselves (for lack of a better term)? If I am correct, I believe about 5% of physicians account for more than 90% of the lawsuits. If the various boards took action with their own members, they could take care of things themselves."

After years spent married to a hospital-based respiratory therapist, being the daughter of an RN (also being a daughter of an attorney), and becoming a RN myself, I have heard far too many direct stories that made me say, "I hope they sue." Not to mention medical errors that while didn't cause me permanent injury or death, sure caused a lot of pain. Anyone know what it feels like to have a paralytic ileus for 3 days? How about a spinal headache for a entire week? Both preventable and not life-threatening, but painful as all hell. Things are worse out there than most laypeople want to believe. Stemming from many things- understaffed nurses, antiquated system of residency for physicians (a big one in my opinion), and an overall arrogance of some (not all) physicians.

[Tsiyu]

35. Work in a hospital if you want the truth

I don't have time to check if any posters on this thread are employed in hospitals, but if you want to know the truth about medical malpractice you must spend time in one - in the ER, in ICU, on the floors.

I have witnessed more people dying than most of you know living. Being part of a code team at one time, I was there at many folks' moment of death. It is true that there are many deaths a doctor or medical worker cannot prevent. But there are many deaths caused by physicians, by nosocomial infections, misread diagnoses, neglect - you name it - and I witnessed more than my fair share.

How about two infants who had their genitals burned off when on OBGyn forgot to ground the laser circumsicion machine? They didn't die, but according to Bush, we should just pat the Ol Doc on the paw and say, "There, There." And tell those babies "TOO BAD."

If you work in fast food and you get get the order wrong, no big deal. If you work at Mercy General and you get the order wrong ( and yes, everyone - including myself- will make a mistake with meds or procedures at some point) you can kill somebody.

Since leaving the medical profession 15 years ago, I haven't been to a regular physician. They scare the hell out of me.
The OP is correct, no matter how much "proof" some doubters need.

[REP]

38. Makes Me Feel Better About Refusing To EVER Go To The ER

I've done all the bitching about my encounters with incompetence I'm going to do in this thread, but reading this post has just reinforced my decision to not return to an ER unless a limb has actually fallen off, and even then, I'd still have to think about it.

[Eloriel]

45. don't say "never" --

There ARE good doctors and certainly many good nurses out there. I myself feel much the same way you do (and in general avoid MDs like the plague, along with all pharmaceuticals).

However, there have been occasions in the last 5 years when I've had to go to my local ER, a small county hospital, and I've been very, very pleased with the care I received.

I think it's important for those who are "doctor-phobic" (for good reason) to remember that there are good ones, and to reamin open to having GOOD experiences if we need to avail ourselves of their services. (But also, to remain vigilant and ask questions. of course that may not make us "popular" with our medical team, but tough.)

[Tsiyu]

49. We have old timey Doctors

If they die, I don't know what we'll do. How about $15 for a 45 minute visit, including antibiotics?

But the ol' Doc would rather work with prevention and herbs- restoring the immune system.

I wouldn't have a baby except in a hospital equipped for the sickest neonate, but other than that, I have no need.

[Name removed]

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[Tsiyu]

56. hey My Puter is weird

sorry, I had to leave the house right after i posted and now it's too late to delete all these silly dupes.

Bad fat fingers!

[nothingshocksmeanymore]

57. you can hit the alert and the mods can take them down when

they get a minute

[Tsiyu]

59. Thanks nsmam

Forgot that option...Hopefully they'll get right on that....sorry i cluttered up your excellent thread!

[nothingshocksmeanymore]

60. you didn't clutter it

thanks for keeping it kicked :D glad you found it useful

[DemExpat]

62. I also avoid medical doctors whenever possible, but last month

my 20 year old son had testicular torsion (twisted testicle with excruciating pain), and without swift diagnosis and emergency treatment he could have become sterile....

This was one medical emergency that was handled excellently at our local hospital, which renewed a little of my faith in medical institutions.

For emergencies like this, my preference for Homeopathy and herbs would have had no answer.

Use both with care is my stance.

DemEx

[REP]

68. And I Had To Pay Money To Become Sterile!

Nothing good comes of going to the ER.

I'm not against medicine or doctors. See my post upthread about one of many experiences I had with incompetent residents at the ER, where the outcome could have been my death or complete loss of renal function. If I'm sick, I'll wait until office hours and see my doctor.

[gratuitous]

39. And what "tort reform" means is . . .

We have a situation in which patients are being butchered by doctors. As a result, some of those patients (or their estates) seek some sort of compensation for their loss. The injured patients get their hired gun, an attorney, to make their case because doctors, hospitals, medical conglomerates and care organizations are unwilling to face up to their mistakes.

The solution proposed by "tort reform" is not to punish the insurance companies, or the hospitals, or the doctors, or anyone else in a position of responsibility for maiming patients. No, "tort reform"'s solution is to further punish the person who was maimed or killed by limiting their rights to due process and a jury trial in court to determine the nature and extent of their injury, and the culpability of a doctor or a clinic in causing that injury.

[Misunderestimator]

42. Well, it took most of the morning to get through the entire article...

what, with the nuisance of working and all. Thanks for posting this! I'm going to send it to my Dad and get his take on it. He was sued unsuccessfully many times during his career... would be interesting to read his reaction to this.

Oh, and by the way... :loveya:

[nothingshocksmeanymore]

47. I'd be real interested in his take

In my experience (legally), pathology is actually loaded with some very poor specialists...the number one diagnosis error in most major hospitals is misread slides....whenever anyone I know is going for a biopsy I always recommend they get more than one pathology opinion. In fact, because of this many hospitals now take the "team" approach to pathology so that slides are read by teams of doctors.

[Snow]

48. Standard practice in cancer epidemiology

is to have all study case subjects (ie, those with cancer) have their slides read by three pathologists. Makes your grant proposal bloody expensive, but, hey, better have the feds spend money on my cancer study than on bombing people somewhere.

[Romulus]

54. kick to the top

:kick:

[jdj]

58. I'm in the 42%. They killed my grandmother.

My Mom didn't find out til years later, the one of her nurses ran into the family while caring for another family member and said that there was a medicine she was on that was supposed to go in at a very slow drip, and there was a new nurse and she let it go in wide open. My grandmother died because of this, but they did not find out til a decade or two after the fact.

And a friend of a fried almost died from lipo; the only reason he's still around is 'cause he was supposed to go to a party and didn't show up, so they went to his house and found him unconscious in the shower, hemorraging.

[nothingshocksmeanymore]

61. 8 times more malpractice actually committed than claims filed

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=104x2326419#2328777

[DoNotRefill]

63. The figures I've seen....

are for 100,000 to 200,000 negligent deaths in this area per year. Compare that to the US firearms homicide rate of 8,000 per year.

There's a reason the medical journals are so anti-gun...it's called "smoke and mirrors", to distract from the fact that they kill 3-6 times as many people each year as are killed by all guns, even if you include the 16,000/yr gun suicide rate, and over 10-20 times the number of gun murders each year.

[nothingshocksmeanymore]

69. You know me...I'm not anti-gun....

just sensible ENFORCED regulations :D (how's the baby..tell me while you kick my thread :evilgrin: )

[DoNotRefill]

70. Kick

Baby is smelly, noisy, and cranky. In other words, just perfect!!! :)

[nothingshocksmeanymore]

71. awww...but she's a daddy's girl too I'll bet

[DoNotRefill]

73. Yup, 8 out of 10 times...

she pukes or pees on me, not my wife. Ahhh...Love.... :)

[nothingshocksmeanymore]

72. kick