Researchers at Johns Hopkins reported this week that 9.7% of all deaths in the United States are due to medical error, making it the third leading cause of death after heart disease and cancer.
What Does Medical Error Look Like?
Medical errors can happen when individuals make mistakes (a surgeon accidentally punctures a patient’s liver), when there are system-wide problems (proper checks and balances for medication dispensing aren’t in place), and sometimes both. These types of deaths may be shrouded in vague explanations: "there were complications;" "by the time we caught the cancer, it was too late"; "she had an adverse reaction to the medication."
Medical error also looks like this: A beloved aunt who lives in an assisted living facility succumbs to pneumonia—and they don’t tell you that she didn’t get the right antibiotic. Or when a sibling dies after his cancer surgery, but the family doesn't know that he had his operation in a hospital that didn’t have the volume and expertise to properly anticipate and prevent complications.
Even at the best hospitals, with the most skilled caregivers, the smallest of coordination and communication errors can easily become fatal if patients and their loved ones are not paying attention and proactively working to avoid errors.
“We spend a lot of money on heart disease, we spend a lot of money on cancer. We have not even begun to recognize the third leading cause of death, and we believe that this high prevalence rate of medical error is not unique to U.S. hospitals—it is likely a high-ranking cause of death throughout the world,” said Dr. Martin A. Makary, a professor of surgery at Johns Hopkins and lead author of the study.
In a review of the literature, Makary and his team estimated that 251,454 Americans die every year due to preventable medical errors.
“And that’s not even a liberal estimate,” said Makary. “That’s using some of the most conservative numbers in the literature.”
In fact, the study only counts in-patient hospital deaths. A 2013 Journal of Patient Safety study estimated that about 400,000 Americans die every year from inpatient and outpatient preventable errors.
Currently, the Centers for Disease Control and Prevention (CDC) doesn’t even tally deaths due to medical error in its annual statistics.
In an open letter to the director of the CDC, the study authors asked that the organization change the way it collects health statistics, arguing that better tracking of medical error would improve public awareness.
But in an interview with ProPublica this week, the chief of the mortality statistics branch for the CDC defended their approach, saying that it was consistent with international guidelines and would be difficult to change “unless we had a really compelling reason to do so.”
Frankly, I can't imagine a more compelling reason than a quarter of a million lives at stake.
Here's the harsh reality: This new report is not breaking new ground. I've seen this story told again and again over the years, beginning with the 1999 Institute of Medicine’s “To Err Is Human” report, which cited 98,000 lives lost a year from medical error.
And yet, the needle continues to move in the wrong direction.
3 Proactive Things You Can Do Now
1. Collect and manage your own medical records—under HIPAA laws, you have a right to ask for them and request that any mistakes in your file be corrected.
2. Keep an inventory in your wallet that lists your prescriptions, allergies, and conditions, as well as who to contact in an emergency. This piece of paper can become a lifesaver for you if you’re ever in an emergency situation where you cannot speak for yourself.
3. Got an appointment coming up for a problem that’s been bothering you? Write up a medical summary for your physician that includes your symptoms, what treatments you've tried, any prescriptions, supplements, and over-the-counter pills you’re taking, any related health problems in your past, and relevant family health histories. Give your doctor the clues he or she needs to help solve your problem.
• For more, see Chapter 3: "Three Things You Can Do Right Now to Be Better Prepared" in The Patient's Playbook.
Consider some recent numbers: 1 in 25 patients will contract an infection from the very hospital that is trying to help them; 1 in 10 people will die because of diagnostic mistakes; and about 80 times a week, surgical patients are victim to “never events”—things like, sponges and tools being left behind in their bodies, or, even worse, getting surgery on the wrong body part.
As a patient, you can wait for the system to get better—and there’s no guarantee that it will—or you can take charge of your own care. I wrote The Patient’s Playbook to give you the guidance and decision-making tools you need to do it right.
In Section I, I show you how to identify and interview the best primary care physicians, how to be prepared for a lifetime of better health, and ways to ask someone to be your health care quarterback.
In Section II, you'll learn how to avoid the most common mistakes people make in a medical emergency, how to find the best specialists for any medical problem, and how to avoid dangerous over-treatment errors.
In Section III, we turn to serious illnesses and I give you the very best of my insider knowledge and the wisdom of some of the top doctors in America, so that you know the right steps and decision-making frameworks to use in order to get to the no-mistake zone in every medical situation.
Medical errors will continue to plague our slow-to-change, complex health care system. And the majority of doctors are doing the best they can to avoid complications and save patient's lives. But they can't do it alone. We have to proactively partner with them in order to save our own lives.
I urge you to read The Patient's Playbook and share it with those you love.