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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)

#191

Post by y-c-o-m-b »

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.

Yeah I can confirm that as well.

My wife for many years has been complaining of bone and joint pain, strange rashes, and other odd symptoms suggestive of an auto-immune condition. I kept telling her to ask her doctor for at minimum an ANA to see if it comes back with anything. Her doctor kept brushing it off as "stress and anxiety" - something I've learned incompetent medical professionals throw around without ever gathering a mental history or referring the patient to a psychologist - and basically refused to do further tests. The GP basically wrote her off as a hypochondriac with zero evidence; no tests, no referrals to a mental health provider, no looking back at her history, nothing. Doesn't "give a whiff of a shit" is spot on.

I finally convinced my wife to see another GP. This one definitely fits the bill of "extraordinarily competent and dedicated" and on that first visit the new GP ordered an auto-immune panel. Well well well, she came back with high ANA and Rheumatoid Factor markers. She's been seeing a rheumatologist since then who has been evaluating her for rheumatoid arthritis and lupus.

EDIT: this is not my only anecdotal experience either. There's so many of them. For myself: over many years I was slowly losing sensation from the neck down along with a myriad of other neurological issues that were strange but had no specific point of origin. Got several MRIs all of which came back inconclusive.

About 3-4 years later the problem suddenly progressed to me running into walls, losing significant sense of sensation, and losing my balance. I visited an orthopedic clinic and got a second set of MRIs (brain and neck), but this time I asked for a CD so I could review the material myself. The radiologist reported no issues, but I used radiopedia and medical journals to study and cross-reference normal/abnormal MRIs with mine. I found an area between C5-C7 on my neck with significant spinal cord compression. The orthopedic doc read off my radiology report and said "your results were normal". I ended up begging her to go through the MRI stack with me just to see it with her own eyes. She reluctantly agreed. We get to the C5-C7 section and she pauses, says "I'll be right back, I need to consult with one of our surgeons" and boom, I was scheduled for surgery for the next month. Unfortunately I didn't make it a month. Over the next week things deteriorated quickly and I ended up having emergency surgery.

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

#192

Post by ncmncm »

TaupeRanger wrote: post #121
ncmncm wrote: post #71

Earlier quoted context omitted.

We don't know whether it is the case or not. It could just as easily be worse than it says. Probably is. If I had to tell you about all the medical mistakes experienced by just my immediate family, just the facts, I would be at it all day long.

Unless the mistakes led to death that wouldn't have otherwise occurred in a similar timeframe, the anecdotes wouldn't even be relevant.

Mistakes don't sort neatly by causes into fatal and non-fatal. Some of almost any kind are fatal. Anything that prevented fatal mistakes would eliminate most others.

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

#193

Post by HelloMcFly »

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.

Judging surgeon competency is much easier than judging physician competency, and physicians make up a much larger share of "medical doctors" than surgeons.

Physicians sometimes jokingly refer to surgeons as "technicians" because what they are doing is often more discretely defined, clearer boundary conditions, clearer indicators of performance/success/quality (especially over X number of cases when you know the national averages for outcomes), and ultimately of a mechanical nature. The work physicians do can sometimes be described similarly, but much less frequently and it can be much harder to do.

The physician/surgeon distinction is a critical one in medicine that is under-appreciated in most conversations about "doctors".

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

#194

Post by ncmncm »

giantg2 wrote: post #170
ncmncm wrote: post #76

Earlier quoted context omitted.

The computer was not flying it. The computer was actively fighting the pilot, who was desperately trying to keep it flying, while the computer was forcing it to crash instead. To be clear: with the computer entirely powered off, the plane would have flown just fine. Not exactly like other 737s, but more like them than anything else.

"The computer was not flying it. ... the computer was forcing it to crash instead." Sounds to me like the computer was in fact in control of the plane if it causes it to crash. The "computer" is the MCAS system that sits between the pilot and the actual control surfaces. This is a fly by wire aircraft. Yes they could have turned the MCAS off and had it fly ok... if they even knew it existed. Although they weren't tra…

No, 737MAX is not a fly-by-wire aircraft. The controls are physically connected to control surfaces via actual physical cables.

But, the computer can yank on those cables, and it can also run the elevator trim up and down, and does. So, no, I am not just talking about "the MCAS". There is no such thing. That is a software feature that is part of the autopilot system, not any sort of hardware. They could have pulled the circuit breaker on the whole flight computer, and flown without it.

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

#195

Post by throwawaylinux »

InitialLastName wrote: post #171
throwawaylinux wrote: post #105

Earlier quoted context omitted.

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.

> Maybe it still is, someone just accused me of being "far-right" for the thought-crime of questioning Pfizer's profiteering, lmao. Well, no, you accused yourself of that; they just played along.

Wrong on both counts. I did not, and they did.

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

#196

Post by throwawaylinux »

synu wrote: post #182
throwawaylinux wrote: post #105

Earlier quoted context omitted.

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.

It seems like somehow the people who complain they have been silenced are always the loudest these days.

It seems like the bullies and censors and corporatist bootlickers are still far louder. It's great if you're hearing them being called out by those speaking their truth to power though.

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

#197

Post by nradov »

spaetzleesser wrote: post #166
nradov wrote: post #145

Earlier quoted context omitted.

While the Affordable Care Act (Obamacare) did introduce a minimum medical loss ratio, insurers still have a strong incentive to hold down costs by encouraging use of cheaper generic medication so that they can offer lower prices to plan purchasers. Most medical insurance is purchased by employers and other group buyers, and they look closely at costs. In most cases, physicians have to obtain specific approval in orde…

My impression is that they mainly focus on pushing costs to the patient in the form of higher and higher deductibles.

Who is "they"? Medical insurance companies don't really set deductibles. They offer a menu of options to customers (mainly large employers) and let them pick. Insurers are happy to offer plans with zero deductible, but the premiums will be higher. This is all based on actuarial calculations; insurers generally don't make any more profit on high-deductible plans. If you think your deductible is too high then complain to your employer.

There is a tax incentive at work here as well. Individuals enrolled in high-deductible health plans (HDHP) can often receive a federal income tax break, so you have to factor that in when calculating your net cost.

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

#198

Post by willcipriano »

nradov wrote: post #144
willcipriano wrote: post #122

Earlier quoted context omitted.

Don't behave like a cartel if you don't want to be called one. From limiting residency slots, making it nearly impossible to hire foreign doctors and lobbying for safe medications that are sold over the counter in the rest of the world to be sold as prescription only in the US. Just to name a few, the AMA has served it's members well to the detriment of anyone buying healthcare in the United States. That to me is a c…

Please stop spreading misinformation. The AMA doesn't limit residency slots. They have been actively lobbying Congress to increase residency slots, and have even put their own money into it. https://www.ama-assn.org/education/accelerating-change-medic...

> Launched in June 2019

They were actively lobbying to reduce residency slots as late as 2012. They only started the program you linked to when became common knowledge that they were attempting to limit the number of doctors.

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

#199

Post by jaywalk »

danachow wrote: post #183
jaywalk wrote: post #158

Earlier quoted context omitted.

Boeing 737NG cockpit: https://cdn.wallpapersafari.com/16/15/2AyKUB.jpg Airbus A320 cockpit: https://airbus-h.assetsadobe2.com/is/image/content/dam/produ... They aren't very different. For normal flying, the biggest difference is that Boeings have yokes and Airbus uses sidesticks. The important stuff is all roughly the same.

The yoke/sidestick is really a superficial difference. Though I will also point out that anybody that is good at the 10 differences puzzles will call bullshit on your claim they aren’t very different - in appearance at least - just look at the primary flight display. More relevant, look at the autopilot stack - they not only appear different they have some deeper fundamental differences in operation.

Oh come on. The PFDs are damn near identical. The biggest difference is that the Airbus attitude indicator has rounded corners while Boeing's is squared. That's an entirely superficial difference that changes nothing about how it works or is interpreted.

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

#200

Post by dontbenebby »

permo-w wrote: post #147
dontbenebby wrote: post #146

Makes sense, everyone I met in college who said they were pre-med would immediately suffer narcissistic injury and refuse to be professional in any future context when I'd remind them Pitt has no pre-med program then go back to doing whatever I want on the wifi. (I also met a few folks who took what they needed to do well on the MCAT then also did some practical courses on information science or focused on art so the…

what does this mean

It means that someone would say I am "pre med" as in, they are sure they will one day be a medical doctor. However, not only is that not guaranteed -- you need to do a standardized test called the MCAT, as well as a number of other things.

Further, while at many universities there is a defined "pre-med" major, there is no such major at the University of Pittsburgh, where I obtained my BS.

So if someone who is a Pitt student says "I'm pre med", they're engaging in a best, a bit of stretching of the truth in order to impress people.

When myself, more of a science oriented person, would say "There is no premed at Pitt. What do you study? Biology? Chemisty? Something else?" they would get angry and refuse to interact.

This is known as "narcicistic injury":

>Narcissistic injury and narcissistic scar are terms used by Sigmund Freud in the 1920s. Narcissistic wound and narcissistic blow are other, almost interchangeable, terms.[76] When wounded in the ego, either by a real or a perceived criticism, a narcissistic person's displays of anger can be disproportionate to the nature of the criticism suffered;[12] but typically, the actions and responses of the NPD person are deliberate and calculated.[2] Despite occasional flare-ups of personal insecurity, the inflated self-concept of the NPD person is primarily stable.[2]

https://en.wikipedia.org/wiki/Narcissistic_personality_disor...

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