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

hopkinsmedicine.org

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

#111

Post by reader_x »

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.

Anecdote here, but my friend who is an anesthesiologist (MD) says:(1) anesthesiologists know exactly who the good and bad surgeons are (they see the outcomes and also must manage fluid loss), and (2) bedside manner by surgeons has no correlation to good surgical technique so patients have no idea.

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

#112

Post by vidarh »

hobs wrote: post #73
arethuza wrote: post #37

Earlier quoted context omitted.

As someone who lives in a country where medication is "free", I always like to clarify that "free" in these kinds of contexts means "free at the point of delivery" - we're all perfectly aware that they are paid using money from taxpayers.

Who have an insanely better price anyway because of their negotiating power as a nation instead of an individual payee.

It's not just negotiating power, but that they're actually allowed to negotiate.

E.g. Medicare has a substantially higher demand for drugs than most single payer universal healthcare systems due to a combination of number of people covered plus covering mostly older, more expensive, patients. It's larger than the UK's NHS for example. But Medicare is subject to various legal restrictions on their ability to negotiate the best prices possible, while the NHS can use whatever leverage it pleases.

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

#113

Post by concordDance »

jcims wrote: post #80
pjc50 wrote: post #66

Earlier quoted context omitted.

Good way to make medical tech even less feasible and affordable.

In other words, there’s no free lunch. Regulations can be incredibly expensive to support and almost always stifle innovation and increase time to bring a product to market. Sometimes it’s still worth it. The aviation industry has had to deal with this forever because its hard to hide a plane crash. But in the end we have a very reliable mode of transportation despite its inherent risks. Accidentally overdosing an el…

Note that the more rigorous the regs the more likely that a particular treatment or tool will not be affordable and the more likely someone will die because there just isn't enough X to go around.

There isn't a single definite answer, it depends on how expensive the regs are and how much they help avoid damage.

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

#115

Post by rscho »

reader_x wrote: post #111
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.

Anecdote here, but my friend who is an anesthesiologist (MD) says:(1) anesthesiologists know exactly who the good and bad surgeons are (they see the outcomes and also must manage fluid loss), and (2) bedside manner by surgeons has no correlation to good surgical technique so patients have no idea.

Am also MD and anesthesiologist. This is partly true. The true part is because anesthesiologists are more able to appreciate medical abilities than the layman is. The false part is that people, including colleagues, tend to judge on what they see and hear. Oftentimes, you won't work every day with the same surgeon, so you actually have no idea regarding success/failure statistics.

That's why I said you're what people say you are. Heck, I don't know my own statistics and I don't know where I stand in comparison to my colleagues. Yet I enjoy a very good reputation with colleagues, but patients often are weary of me because I'm socially awkward.

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

#116

Post by nradov »

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?

It's not a legal or insurance issue, it's a data gathering and classification issue. There is no such thing as a standard patient. Especially when it comes to surgical procedures, everyone is unique. We generally don't have ways to accurately assess the impact of factors like patient age, fitness level, body composition, and co-morbid conditions. So instituting a quality measurement system like you describe would have the perverse effect of causing physicians to keep their numbers up by refusing to take the riskiest patients on at all.

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

#117

Post by tpoacher »

Tempted to use that "always has been" meme template here.

As an ex-doctor, I can tell you that I very quickly realised that at the top of my "surgical sieve" (a mnemonic that helps docs consider categories of differential diagnoses) one should always start with the category "Iatrogenic" before considering other, more textbook-medicine differentials.

And also that for some reason, most doctors seem to treat this category as last on the list, if they think of it at all.

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

#118

Post by pdpi »

An important factor to consider any time you see really worrisome things like medical errors or suicide as leading causes of death: counter-intuitively, that can be good news. Every time you solve your #1 highest priority problem, your #2 becomes your new #1. At some point, if you have good-enough solution for a broad-enough range of problems, the only option left is that your biggest problem is now failing to apply those solutions correctly!

By way of example, let's take a look at WHO data[0]. Across Europe, the leading cause of death for children under 4 is congenital anomalies. That sounds bad in isolation, but is actually pretty good in context. First, because the actual rate at which children die from congenital anomalies in Europe is a fair bit lower than the world-wide average, but most importantly because those anomalies float to the top simply by virtue of every other cause of death being exceedingly rare.

0. https://www.who.int/data/gho/data/indicators/indicator-detai...

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

#119

Post by npteljes »

pdpi wrote: post #118

An important factor to consider any time you see really worrisome things like medical errors or suicide as leading causes of death: counter-intuitively, that can be good news. Every time you solve your #1 highest priority problem, your #2 becomes your new #1. At some point, if you have good-enough solution for a broad-enough range of problems, the only option left is that your biggest problem is now failing to apply…

This really is similar to the statistic of head protection increasing the number of head injuries. With the explanation being that otherwise, many of those injuries are deaths instead.

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

#120

Post by nonameiguess »

Forgetting the measurement issue with no standardized definition of what even constitutes a medical error, this is still a very poor way of framing a change in rank. Is the absolute rate at which people are killed by medical errors higher than it used to be? Is it higher than in comparable countries? Or did the rank change because the old 3rd leading cause of death now kills fewer people? Those are very different pieces of news and this press release doesn't indicate which is the case.
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