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We Need More Autopsies, to Help Save the Living

nautil.us

11–20 of 61 posts

Re: We Need More Autopsies, to Help Save the Living

#11
"In the United States, we usually don’t autopsy people unless the cause of death is mysterious or foul play is suspected."

In any case, health insurance doesn't cover autopsy. Turns out its classified as postmortem to deny insurance coverage. there was an hour long special on NPR sometime in 2014.

Re: We Need More Autopsies, to Help Save the Living

#13
"Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta-analysis and review" http://www.pathkids.com/autopsy/hasleton%20on%20discrepancie... , Roulson et al 2005 (excerpts: https://plus.google.com/103530621949492999968/posts/e983tqSE... )

Re: We Need More Autopsies, to Help Save the Living

#14
"Doctors, meanwhile, learned humility. If you’re a doctor, it’s one thing to know, as an abstract fact, that 10 or 20 percent of patients who seemed to die of heart attack actually died from pulmonary embolism. It is quite another to have a pathologist dissect one of your patients and tell you No, this woman you took care for 25 years, and whose husband you pass on the street each day, did not die of heart attack; she died of a pulmonary embolism, and that’s probably why she complained of shortness of breath when you examined her three months ago. An angiogram might have spotted it."

If we increase the rate of autopsies, the higher degree of accountability for doctors will lead to higher stress levels in the profession. The rate of suicide in physicians is already far above average. The US should be doing more autopsies, but we should increase them in a way that supports the profession, rather than giving our culture another way to point fingers at doctors and say "your mistake killed that person".

Re: We Need More Autopsies, to Help Save the Living

#16
former pathology resident here- disagree. The main reason we do fewer autopsies is because of better diagnostics while the patient is alive. The numbers they provide for significant changes in diagnosis based on autopsy seem pretty high (based only on my own experience). Even the examples they pick for the article are kind of lame- it wasn't St. louis encephalitis, it was west nile! Um...so? Do we have a treatment now for West Nile? Would they have done something different knowing that it was west nile (honestly I don't know; I've been out of the medical biz for years)

Re: We Need More Autopsies, to Help Save the Living

#17

"In the United States, we usually don’t autopsy people unless the cause of death is mysterious or foul play is suspected." In any case, health insurance doesn't cover autopsy. Turns out its classified as postmortem to deny insurance coverage. there was an hour long special on NPR sometime in 2014.

Why should health insurance cover autopsy?

Given no chance of "recovery" from the condition, there's no health interest to the subscriber, right?

Re: We Need More Autopsies, to Help Save the Living

#18

I understand that there are 1400 different brands of over-the-counter medication that contain acetaminophen. That's what destroyed my father's liver.

Is there some rational reason you downvoted this?

He was taking tylenol for neuralgia. It harmed his liver so bad he had severe jaundice. He was barely able to walk and was completely unable to speak.

He died at the age of 68.

Re: We Need More Autopsies, to Help Save the Living

#19

"Doctors, meanwhile, learned humility. If you’re a doctor, it’s one thing to know, as an abstract fact, that 10 or 20 percent of patients who seemed to die of heart attack actually died from pulmonary embolism. It is quite another to have a pathologist dissect one of your patients and tell you No, this woman you took care for 25 years, and whose husband you pass on the street each day, did not die of heart attack; sh…

In software development and system administration - automation, variables, and copy-paste (instead of retyping) can be used to remove the possibility for human error to occur. Instead of seeing the number "0x80007003" and accidentally retyping it as "0x80070003", we can just copy it, and paste it into the other system. Or have the systems talk to each other and take us out of the loop.

How do we remove opportunities for human error in medicine and health care?

Re: We Need More Autopsies, to Help Save the Living

#20
post #6

"Not really; not always; and sometimes not even with causes of death you’d think would show up easily in a good scan. Doctors take far too much confidence in scan results, feeling they see everything with certainty. They don’t. As a Florida coroner told me a few years ago, “We get this all the time. The doctors get our report and call and say, ‘But there can’t be a lacerated aorta. We did a whole set of scans.’" I wo…

Wow, that would be an incredible source of data and a boon to the world. Imagine if it were 1) required by all deaths, and 2) freely released to researchers (for research purposes).
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