Hospitals and Doctors’ Offices Can Be Hazardous to Your Health
By John C. Goodman • Wednesday November 14, 2012 11:35 AM PDT • 2 Comments
Hospitals are dangerous places to be. Doctors’ offices aren’t very safe either. By one estimate, as many as 187,000 patients die every year for some reason other than the medical condition that caused them to seek care. By another estimate, there are 6.1 million injuries caused by the healthcare system, including hospital-acquired infections that afflict one in every twenty hospital patients.
Although some have questioned whether these estimates err on the high side, even the most optimistic estimates of hospital safety are unacceptably high.
Adverse medical events (also known as iatrogenic events) are typically divided into three categories: preventable and negligent; preventable but not negligent; and other adverse events. Events in the first category, also called malpractice errors, are injuries or deaths resulting from medical misconduct or lack of adherence to minimum standards of care. Examples are performing surgery on the wrong site, or leaving a sponge in a patient after an operation. Events in the second category are considered avoidable, although they are not the result of negligence. Most hospital-acquired infections are examples of this sort of medical error. The third category is “other” events. These are events that we do not know how to prevent with our current knowledge and technology.
As it stands, malpractice lawsuits are the only recourse patients have to adverse events. Yet only about one in four adverse events falls into the category of malpractice. Even if the malpractice system worked perfectly—and even if patients are prepared to go forward with the expense and stress of a lawsuit—we are basically unprotected against three-fourths of all the things that can go wrong in hospitals.
Our system for dealing with these events is highly imperfect. Only 2 percent of victims of malpractice ever file a lawsuit,[1] and fewer still ever receive any compensation. On the other hand, 37 percent of lawsuits filed involve no real malpractice.[2] To add insult to injury, more than half the money spent on malpractice litigation goes to someone other than the victims and their families.[3]
What can be done to make the healthcare system safer for patients? We will examine this topic in future installments. For more details, please consult my book Priceless: Curing the Healthcare Crisis.
Notes:
- A. Russell Localio et al., “Relation between Malpractice and Adverse Medical Events Due to Negligence,” New England Journal of Medicine 325 (1991): 245–251.
- David M. Studdert et al., “Claims, Errors, and Compensation Payments in Medical Malpractice Litigation,” New England Journal of Medicine 354 (2006): 2024–2033.
- Studdert et al., “Claims, Errors, and Compensation Payments in Medical Malpractice Litigation.”
[Cross-posted at Psychology Today]
Tags: Healthcare, Malpractice, Tort Reform 
The situation is worse than reported because one of the commonest types of errors, misdiagnosis, often is not detected. Patients usually get misdiagnosed because of incompetent or lazy physicians. (A small percentage of misdiagnoses occur due to atypical symptoms or erroneous diagnostic tests.) The misdiagnosed patients usually get sicker because they aren’t receiving proper treatment and because they may be receiving inappropriate drugs that have side effects. If the physician doesn’t refer the patient to someone else, and if the patient doesn’t get a second opinion, then the misdiagnosis will not be detected. (I’ve seen misdiagnosis cases in which the patient received inappropriate treatment for decades.)
Since no one performs quality reviews of outpatient medical care, the high rate of misdiagnoses will continue.
MingoV | Nov 14, 2012 | Reply
I have been misdiagnosed twice in my life. The first time was due to an ER doctor who made a quick diagnosis without asking the questions he should have made. I ended up in isolation for several days until blood tests verified that I didn’t have the disease I was diagnosed with... The second time was by both my primary care physician and a specialist, neither of whom bothered to check upon the side effects of the medication I was on for ulcerative colitis. This resulted in considerable costs doing wasted expensive tests (the specialist charged my insurance $5,000 for these tests), and when the next referral was to a cancer specialist, I used the Internet to determine the side effects of the colitis medication at the dosage level I was on. I found this dosage level was the cause of the reduced red cell count and that there really wasn’t a reason to be concerned. So the medical profession can make mistakes, expensive mistakes for the patient, although for the doctor, the more they do, the more money they earn regardless. Nice deal for them, not so good for the rest of us.
Jerome Bigge | Nov 15, 2012 | Reply