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Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

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Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#101

Post by marcus0x62 »

causi wrote: post #89
giantg2 wrote: post #67

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” That's because they're hard to standardize. What qualifies as a medical error? It's easy to go back after the fact and analyze a case where someone has a poor outcome and say 'we should have done this another way'. That doesn't mean there was any indicatio…

I'm a little skeptical that there are legitimately 250k that result in unnecessary death each year From purely anecdotal experience, that number is totally believable. Again anecdotally, the medical field seems to only have two kinds of people, the extraordinarily competent and dedicated, and people who don't give a whiff of a shit. The medical bell curve looks more like a bathtub.

My anecdotal data (which is primarily second-hand from friends who work closely with doctors in a hospital setting) agrees with your anecdotal data, for whatever that is worth. There are some spectacularly bad doctors out there which the medical system provides cover for, mainly, as far as I can tell, because they generate revenue.

It is important to understand that in the American private healthcare system, the doctor is the true “customer” of the hospital, in that, with the exception of services provided by hospital-employed physicians, the things the hospital itself can actually bill for have to be ordered by physicians in private practice who have patients admitted to the hospital.

There is a tremendous power imbalance between physicians and non-physician clinicians and a powerful incentive to cover up bad acts by bad doctors who perform a large number of profitable procedures.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#102

Post by rscho »

q1w2 wrote: post #98
anamexis wrote: post #95

Earlier quoted context omitted.

I don’t see them referring to doctors as such.

Who do you think is making the majority of these diagnostic errors?

Medical errors are not all diagnostic errors, far from it. All kinds of healthcare workers are involved.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#103

Post by chiefalchemist »

causi wrote: post #89
giantg2 wrote: post #67

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” That's because they're hard to standardize. What qualifies as a medical error? It's easy to go back after the fact and analyze a case where someone has a poor outcome and say 'we should have done this another way'. That doesn't mean there was any indicatio…

I'm a little skeptical that there are legitimately 250k that result in unnecessary death each year From purely anecdotal experience, that number is totally believable. Again anecdotally, the medical field seems to only have two kinds of people, the extraordinarily competent and dedicated, and people who don't give a whiff of a shit. The medical bell curve looks more like a bathtub.

Also, anecdotal, but worth adding...

I think the no wiff of shit group can be split in two. Those who never gave a shit, and those who have been beaten down by a system that has normalized profits over patients.

Yes, the treatment runs the gamut, but the overall healthcare system - sans the higher end (naturally) - is more checklist-driver assembly line than patient care. It's not about quality, the system runs on quantity.

Of course things are missed, they were never looked for in the first place. Fwiw, I saw this happen to my father first hand. I dred the day my mother or I have to depend on the healthcare system. It's not all bad. But the odds favor the house.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#104

Post by chiefalchemist »

rscho wrote: post #99
causi wrote: post #89

Earlier quoted context omitted.

I'm a little skeptical that there are legitimately 250k that result in unnecessary death each year From purely anecdotal experience, that number is totally believable. Again anecdotally, the medical field seems to only have two kinds of people, the extraordinarily competent and dedicated, and people who don't give a whiff of a shit. The medical bell curve looks more like a bathtub.

I gather you are not a healthcare professional, hence the artificial dichotomy stemming from your perception as an outsider. Medical competency is very difficult to assess objectively. You're good/bad because people say so. There isn't any form of performance feedback.

How can that be? A patient gets diagnosed. There's treatment. There's an outcome. That can't be measured? And assessed?

There's data flowing all over the place. But perhaps the lawyers and the insurance stand in the way of improvement?

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#105

Post by throwawaylinux »

synu wrote: post #78
throwawaylinux wrote: post #24

Earlier quoted context omitted.

[flagged]

There was a moratorium? It feels like this conversation has been happening endlessly for years now.

Yes there was. Questioning of corporations, their motives, or their claims, was verboten. Maybe it still is, someone just accused me of being "far-right" for the thought-crime of questioning Pfizer's profiteering, lmao.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#106

Post by dTal »

giantg2 wrote: post #49
sschueller wrote: post #46

Earlier quoted context omitted.

This is insane. These device UIs should be standardized and any manufacturer making a significant UI change to their product should not be permitted to sell it under the same name and number. The FDA should be looking at this before approving such devices for use. Don't aircraft have more or less standardized controls and displays?

"Don't aircraft have more or less standardized controls and displays?" Commercial pilots (and military) are required to train and qualify on a particular aircraft before being allowed to fly it. Controls can differ, but it's generally the difference in flight characteristics/handling that is the difference. Although we can see that the different computer related controls and lack of training were a factor in the Max…

Ah yes, the training on what to do if the computer suddenly decides to crash your airplane out of the blue.

I feel this framing mis-allocates blame away from Boeing and towards airlines. The MAX was specifically designed to not require a new type rating (they have now introduced one). And no amount of training is a reasonable substitute for the autopilot with a habit of nosediving into the ground because you were too cheap to build fault-checking into your AOA sensor subsystem (an oversight that should have made the MAX fail certification).

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#107

Post by james-redwood »

TheRealDunkirk wrote: post #23
andreareina wrote: post #13

Or maybe not: https://youtu.be/Jbsy7VObyyM

He’s apparently so important and busy that he has to make these videos while driving in his super car from point A to point B. 15 years ago, this “content” would have been a blog post, which we could have skimmed in 30 seconds to get the gist of the counter argument. Now it’s a 10 minute video with no notes, buried behind 2 ads. Next time, give us a 2 sentence summarization of the argument you’re linking.

He's a consultant (the most senior and advanced type of doctor you get here in the UK) cardiologist, meaning that he likely works crazy hours (read 60-80 hours per week and above). He's not a professional content creator.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#108

Post by rscho »

chiefalchemist wrote: post #104
rscho wrote: post #99

Earlier quoted context omitted.

I gather you are not a healthcare professional, hence the artificial dichotomy stemming from your perception as an outsider. Medical competency is very difficult to assess objectively. You're good/bad because people say so. There isn't any form of performance feedback.

How can that be? A patient gets diagnosed. There's treatment. There's an outcome. That can't be measured? And assessed? There's data flowing all over the place. But perhaps the lawyers and the insurance stand in the way of improvement?

Insurance, precisely. Insurance companies are pushing for performance assessment to put pressure on prices. All well and good until you understand that you can't force hospitals/practitioners to all get a random sample of patients. So measurements are biased, and therefore people game the system. In practice, it means all healthcare providers will concentrate on easy cases to lower risk and maximize revenue. So as you see, free market thought doesn't really work in healthcare.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#109

Post by georgia_peach »

I believe it. In my 40+ years of dealing with the medical profession, Dr. Google, Dr. Wikipedia, & Dr. Pubmed have wiped the floor with them, time after time. If you get sick, do the research. I can almost guarantee that it will pay off.

And these days, medical research is excellent--if only by volume. I know people here like their canned responses--"small n!", "in mice!", "correlation != causation"--but when you're trying to make a diagnosis, every little clue helps!

I can't honestly attribute excellence to the typical medical practitioner.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#110

Post by snarf21 »

causi wrote: post #89
giantg2 wrote: post #67

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” That's because they're hard to standardize. What qualifies as a medical error? It's easy to go back after the fact and analyze a case where someone has a poor outcome and say 'we should have done this another way'. That doesn't mean there was any indicatio…

I'm a little skeptical that there are legitimately 250k that result in unnecessary death each year From purely anecdotal experience, that number is totally believable. Again anecdotally, the medical field seems to only have two kinds of people, the extraordinarily competent and dedicated, and people who don't give a whiff of a shit. The medical bell curve looks more like a bathtub.

It isn't quite as bad as you paint but there is truth in what you say. This is simply Goodhart's Law in action. We've made fee for service the model which means the only way to make money is to see more patients. Pumping patients through as fast as possible isn't conducive to care and you don't have time to give a shit. We need to fix this by moving care to the mid and low levels as much as possible so that we can still pay people and have better care.

That said, there are improvements that can be made. We have very low health literacy in the US and too many providers assume the patients are as literate as them. We need a much stronger teach back style encounter. As above, we need most care done by mid levels. We need to realign incentives among the patients, providers and payers. This is quite broken outside of derm and ortho.

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