Dr. Makary, a surgical oncologist, has published an article in the British Medical Journal where the sensationalized clickbait headline is "Medical Errors account for the third leading cause of deaths in the US". There it is, making the rounds on NPR, nightly news talk shows, etc. Patients and politicians are freaking out on those crazy doctors killing us. Read the actual article here.
Just step back for a moment. This man is a researcher whose niche is analyzing medical errors. He's a surgeon specializing in cancer. He wrote the book on implementing checklists in the operating room, like pilots have pre-flight, where the surgical team takes stock of where they are, who they are working on, and why. This is now why whenever you enter the health realm, you're asked 50 times by 50 personnel who you are and why you're there, and patients harrumph back and give bad reviews on HealthGrades on how they were continually asked who they were.
Dr. Makary notably ends his paper bemoaning that there aren't ways to measure medical errors because WE DON"T HAVE THE ICD-10 CODE FOR IT. That's right, we need ANOTHER code for this and every hospital, death certificate, etc has to have a space where the code for what the medical error was that caused the patient death. He tugs at heartstrings, citing I assume from his world, a case of a young woman who was a transplant recipient (soooo, wouldn't she be dead already if not for the transplant?) whose death eventually came from an error in the judgement of a procedure she received when readmitted to the hospital because she fell ill again.
THEN he bemoans the lack of funding for medical errors, his niche area, and hence his dearth of grant money.
OK. Dr. Surgical Oncologist, why aren't you writing about surgical oncology? Not operating anymore, because no patients. So he sat around chewing the fat with a friend, and in the dicussion they figured the way out for them was to analyze the analysis of the analysis (spearheaded by the oft quoted Institute of Medicine 1999 Medical Errors paper) and in so doing, extrapolated their findings to the whole population of hospitalized/sick patients.
I've had enough of being demonized and it being assumed that doctors are making so many errors all the time that it's a wonder anybody is alive.
No question that medical errors happen. No question that there's been a slew of soul searching and action from all of these papers, editorials, CME, safety committees--"pause and stop and think and remember where you are". Use your checklist.
All in the 7 minutes the doctor is allotted to attend to Mrs. Smith. Do it fast AND to perfection, every minute, every day. We are already doing it as fast and as perfect as we can. We have to comply with MACRA, MIPS, MU, EHR mandates, 5-figure malpractice insurance premiums, our corporate bosses telling us speed it up or we're fired, denial of payment for actually rendering a service to the patient, calling them back, imploring them to take their meds, listening and comforting when they're in pain and infected and not doing too well. Overdose.Retire. Walk away. Suicide. We can't do it anymore.
How about the EHR errors? How about the government errors? How about the pharmacy errors? They all get lumped and dumped into medical errors. See what they did here. Medical is the root cause of all evil, and lets' get them out of the way.
I'm not sure who is actually going to be left to do the transplant. I hope when my time comes for real serious medical care, there's someone left who can fix my troubles, not MACRA, MIPS, MU, checklist charlie.
