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

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

#201

Post by nradov » Wed, Jun 08, 2022, 4:40 PM UTC

chiefalchemist wrote: post #152

nradov wrote: post #135

Earlier quoted context omitted.

We don't even know what all the factors are, and we don't have a practical or affordable way to gather and record all that data in a high-quality, consistent manner.

So we don't even start to try? That's not a good enough reason. Given the social and financial magnitude the excuse is nearly criminal.

It's always disappointing to see comments like this on HN by arrogant, ignorant technologists who haven't done their homework and fail to understand the complexities of healthcare delivery. Biology is a lot harder than software or engineering. There are many researchers working in this area but outside of a few limited areas they haven't succeeded in creating models that are useful for assessing the quality of individual practitioners. And that generally wouldn't even be useful since healthcare is a team activity where systems matter more than individuals.

We can do somewhat better at measuring quality for larger provider organizations across patient populations. The NCQA HEDIS measures are evidence based and reflect current consensus on best practices.

https://www.ncqa.org/hedis/

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

#202

Post by dTal » Wed, Jun 08, 2022, 4:41 PM UTC

giantg2 wrote: post #172

dTal wrote: post #106

Earlier quoted context omitted.

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…

"And no amount of training is a reasonable substitute for the autopilot with a habit of nosediving" If they would know that the system even existed then maybe they would have known how to disengage it. Yes, the design was flawed. Even then, you train for equipment failures because everything can break. It's hard to do that if your not even told that the MCAS exists. The training aspect still squarely places blame on…

My memory is fuzzy here, but wasn't it the case that even with training, you only had a window of a few seconds to disengage the MCAS before the aircraft became unrecoverable? If you waited too long, it cranked the jackscrew to its extreme position, and there was no way to un-crank it with the MCAS disabled (i.e. MCAS had exclusive control over it). That seems like an unacceptably fragile failure mode to me.

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

#203

Post by danachow » Wed, Jun 08, 2022, 4:44 PM UTC

jaywalk wrote: post #199

danachow wrote: post #183

Earlier quoted context omitted.

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.

Yes, as stated, just like with the side stick/yoke it’s a superficial difference - but since you were making your case with pictures - whether they look similar or not really has to do with how detail oriented you are.

Though you ignore the relevant point made about the autopilots. The entire workflow of the flight computers differs. And ask any pilot type certified in both, they typically have preferences.

I’m not arguing these need to be made more standard but there’s a continuum where at one extreme the standardization is so rigid that muscle memory transfers from type to type. That’s not the case here at all.

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

#204

Post by ellopoppit » Wed, Jun 08, 2022, 4:48 PM UTC

ncmncm wrote: post #74

ChrisRR wrote: post #44

Earlier quoted context omitted.

Who could've expected a country that glamourises gluttony would have a shorter life expectancy?

That is not why we are sick. We are sick because practically everything pushed on us is pumped full of sugar.

Sugar biochemically induces gluttony and laziness

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

#205

Post by nradov » Wed, Jun 08, 2022, 5:01 PM UTC

rscho wrote: post #186

VancouverMan wrote: post #184

Earlier quoted context omitted.

I don't think that any profession or system with extensive state-imposed restrictions and regulations (education requirements, medical boards, licensing, exams, continuing education requirements, and so on) should be considered "private". Perhaps such a system incorporates some aspects of private enterprise, but ultimately it should still be seen as a non-private system. A truly private healthcare system would allow…

With private healthcare as you describe, poor people are left with subpar care, and you've got a revolution on your hands. At least I would be very prone to violent action in such a system.

I support affordable universal access to basic healthcare regardless of ability to pay, but you're overestimating the impact of the healthcare system. Up until a few generations ago there was no real "system" at all, and treatments frequently caused more harm than benefit. This wasn't a significant cause of violent revolutions.

Even today, organized healthcare beyond vaccines and antibiotics has only a marginal impact on lifespan and healthspan. It's way behind sanitation (clean drinking water, sewage systems, waste disposal) and lifestyle issues (substance abuse, obesity, lack of exercise).

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

#206

Post by rscho » Wed, Jun 08, 2022, 5:05 PM UTC

nradov wrote: post #205

rscho wrote: post #186

Earlier quoted context omitted.

With private healthcare as you describe, poor people are left with subpar care, and you've got a revolution on your hands. At least I would be very prone to violent action in such a system.

I support affordable universal access to basic healthcare regardless of ability to pay, but you're overestimating the impact of the healthcare system. Up until a few generations ago there was no real "system" at all, and treatments frequently caused more harm than benefit. This wasn't a significant cause of violent revolutions. Even today, organized healthcare beyond vaccines and antibiotics has only a marginal impac…

Sure, but not long ago medical care was essentially useless even for rich people. If now, poor people see rich people get cured while they die or suffer major consequences from common illnesses, I don't think that's gonna go well.

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

#207

Post by 908B64B197 » Wed, Jun 08, 2022, 5:15 PM UTC

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.

> 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 former will however cover for the latter. Same thing with police unions. That's why it's so hard to prove malpractice.

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

#208

Post by ncmncm » Wed, Jun 08, 2022, 5:18 PM UTC

ellopoppit wrote: post #204

ncmncm wrote: post #74

Earlier quoted context omitted.

That is not why we are sick. We are sick because practically everything pushed on us is pumped full of sugar.

Sugar biochemically induces gluttony and laziness

Sugar causes excess uric acid in the blood, which causes type 2 diabetes and high blood pressure, among a dozen other ills. And, does not reduce hunger like real food. On a choice between fat and sugar, always choose fat.

To be precise: sugar without enough fiber causes illness. With enough fiber, as is provided by all fruit except grapes, sugar absorption is delayed long enough that intestinal bacteria get to eat most of it. Keep your intestinal bacteria fed; if not, they eat you.

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

#209

Post by sangnoir » Wed, Jun 08, 2022, 5:23 PM UTC

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.

That sounds like too broad a generalization. In their bid to maximize profits and "increase efficiencies" Medical institutions themselves have a huge impact on outcomes. I wish the medical industry was closer to airlines/FAA, which is more effective and investigating accidents and suggesting systemic fixes, instead of the current culture that suggests "That's a bad-apple/negligent doctor. No need to dig deeper into their load or processes. Case closed"

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

#210

Post by sangnoir » Wed, Jun 08, 2022, 5:26 PM UTC

spaetzleesser wrote: post #161

temp0826 wrote: post #137

Earlier quoted context omitted.

I believe this is a big part of it. Anecdotal as well, but my grandmother had a new leadless pacemaker installed for dubious reasons by a doctor that specialized in this particular type of leadless pacemaker. The pacemaker migrated at one point and it resulted in her chest filling with fluid, the removal procedure was very tough on her (leading to other complications on an already frail body) and marked the beginning…

"installed for dubious reasons by a doctor that specialized in this particular type of leadless pacemaker" That's the problem with a fragmented health system. A lot of doctors are specialists in a certain procedure and want to repeat their pet procedure on every patient they see. I saw this with my ex who had chronic leg pain. Most of the doctors we met just wanted to repeat what they do every day (and makes them goo…

It's a double-edged sword. For surgeons, specialization improves outcomes as practice makes perfect. Since this is HN, I'll liken it to using the same programming language daily, versus being asked to fix a bug in a language you last used years ago, within a fixed time window.

The only missing peace is the a doctor on the care team who chooses which type of surgery is best, becasue once one is referred to a specialist: they are going to get that specific specialized care.