
Researchers: Medical errors now third leading cause of death in US - DanBC
https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/
======
ada1981
If you spend anytime with the medical industry you soon realize the issue.

I helped launched (the now deadpooled) Theil backed MetaMed a few years --
essentially a private research team for medicine, and what the founders taught
me was astounding.

That things like amputating the wrong limbs, doctors not washing their hands
and killing you by infection and a horror of other preventable errors are
shocking common.

This didn't even take into consideration that things discovered in labs that
might cure you take at least 30 years to reach the doctors who might implement
them, if they ever do.

The distortion of hubris from doctors, economic incentives and other systemic
issues results in a "health care system" that doesn't realily seem to do what
it sets out to do -- we spend 10x what some developing countries do per year
per person with no better outcomes.

Accute care seems to be reasonably good, fixing a broken arm, etc. (assuming
they don't accidentally remove it); but chronic care is often just a pipeline
for the recurring revenue model of big pharma (at best).

The examples are never ending but for fun, take a google to discover how many
pap smears are performed annually on women _who have already had their uterus
removed_ \- then consider the cost to insurance and tax payers.

~~~
agumonkey
I often think that the medical industry enjoys (or suffers) from some sort of
a given god complex. They can do what they want as soon as they reach a
certain threshold of saving. Nobody will debate them (most of us don't have
the articulate knowledge anyway) and will morally and existentially satisfy
from still being alive.

I just went through 4 doctors (gen. and specs.) about deep yet diffuse cardio
vascular problems (life altering if not threatening). Their diagnosis was
"nothing to see you are depressed". Since my problems started I can't sleep on
my right side (causes heart race, pain and suffocation), and have now back
pain; in order to sleep without pain I tried on my stomach. This configuration
changed something, I felt stings around my heart, and a sudden relaxation,
warm blood reaching my fingers and feets (something I didn't feel for a year).
Stings moved along, hurting at finger and toe tips. I felt sweetly alive,
jumped out of my bed (because now I can). Even cleand my browser tabs. So much
for depression.

I tried discussing with doctors calmly. Accepting the data, their knowledge.
Yet not backing down if I felt they weren't really solving my problems. But
it's impossible. One doctor even dared me to reproduce transient symptoms with
an annoyed tone. You start considering being hypercondriac, a crybaby.

Deep down all I want is a way to monitor myself deeply so I can take care of
myself but I'm facing this paywall.

~~~
iradik
Don't give up! I was told the same thing you are depressed. Doc even wanted to
push meds on me. Took months of seeing specialists but ended up getting a real
diagnosis which required a major surgery. Now I'm finally better but you have
to work within the system which means finding a good doctor.

~~~
selestify
What was the diagnosis, if you don't mind me asking?

------
paviva
These kinds of metrics are almost not interpretable, for two main reasons :

(1) as _logicallee_ has mentioned, we're getting better at treating patients
and preventing death due to disease. The better we get, the more different
treatments patients get, the higher is the risk of a medical error happening.

(2) it is very difficult to know exactly what proportion of "medical errors"
are preventable. For instance, the seemingly "simple" case of healthcare-
associated infection is far from simple, and except for a few cases (infection
associated with elective surgery, and so on), there are _NO_ known
intervention to reduce risk further. I will give you an example: a patient
needs a central catheter in order to survive. If we don't put it in, and he
dies, he'll be classified as a "death due to primary disease X". If we do put
a central line, and he acquires an infection (and a certain baseline rate of
infection IS inevitable, because the catheter is indwelling and gets colonized
by the patient's own flora), and dies 2 months later due to sepsis, it will be
codified as "medical error". Adverse drug reactions are also codified as
medical errors, even if the drug was administered in a life-or-death
situation, when even the patient's ID was not known, even less his full list
of medications (and thus, the error could not be prevented in any way). I
could go on and on.

That being said, I also see stupid preventable errors like quietly giving the
drugs to the wrong patient going unreported. Hospital stay is certainly
dangerous.

~~~
nradov
Actually research shows that many central line catheter infections _are_
preventable. The AHRQ and CDC have published best practices and checklists,
yet many hospitals still don't adhere to those.

[http://www.cdc.gov/hai/bsi/bsi.html](http://www.cdc.gov/hai/bsi/bsi.html)

[http://www.ahrq.gov/professionals/education/curriculum-
tools...](http://www.ahrq.gov/professionals/education/curriculum-
tools/clabsitools/index.html)

~~~
paviva
> many central line catheter infections are preventable

Again, of course some of them are preventable, and nobody's saying its OK to
install central lines without putting gloves on, and so on. However, there is
a baseline rate of infection which is not preventable, and will continue to
happen. Check the Figures S1 and S3 in this recent study :
[http://www.nejm.org/doi/suppl/10.1056/NEJMoa1500964/suppl_fi...](http://www.nejm.org/doi/suppl/10.1056/NEJMoa1500964/suppl_file/nejmoa1500964_appendix.pdf)

> many hospitals still don't adhere to those.

What is the source ? As far as I'm aware, around ~ 90% facilities do have
checklists -- I do not follow this literature closely, though.

------
JshWright
These studies do not prove that medical errors _caused_ these deaths. It
proves that people who died had some sort of medical error in the weeks
leading up to their death.

As it turns out, people who are going to die soon get a fair number of medical
'interventions', which means there are many opportunities for errors to occur.
This inflates the error rate for these patients. But if we're talking about
patients who are going to die very shortly anyway, did a nurse accidentally
giving them a double dose of their evening antacid really hasten their death?
Probably not...

This is not to say that there aren't preventable deaths due to medical errors.
There absolutely are. But studies like this seriously inflate the numbers...

I'd recommend the Healthcare Triage video on subject:
[https://www.youtube.com/watch?v=1JkFN_2mzR4](https://www.youtube.com/watch?v=1JkFN_2mzR4)

------
booleandilemma
Just want to mention a book I recently read about a doctor's quest to
eradicate medical errors through the use of something as simple as checklists.

The Checklist Manifesto, by Atul Gawande.

It's a quick read and very enjoyable. I'm not a medical professional, but
Gawande makes the value of checklists clear for people in any profession.

------
oneplane
Isn't this simply because the US tries to run everything as a company or takes
economics and legal above everything else? You can't do anything unless you
make a profit or are completely legally covered (or can completely sue
something/something out of existence). It's that the US runs on, and as soon
as you get near something that doesn't work that way (i.e. infrastructure - a
road needs to be good, it doesn't need to be cheap or legally covered) or that
can't work that way (humans and health don't bend to the rules of law or
economics) you're going to have a really bad time.

~~~
wepple
This. Recent exposure to the US healthcare/medical system has horrified me.
The fact that it's majority for-profit enterprises and isn't equal-access
leads me to conclude the US shouldn't be able to call itself a developed
nation.

------
jcbeard
From the article: _He said that in the aviation community every pilot in the
world learns from investigations and that the results are disseminated
widely._

 _“When a plane crashes, we don’t say this is confidential proprietary
information the airline company owns. We consider this part of public safety.
Hospitals should be held to the same standards,” Makary said._

Seems like this number would be higher if they also included HAI's (healthcare
associated infections, about 75K additional deaths):
[https://www.cdc.gov/hai/surveillance/](https://www.cdc.gov/hai/surveillance/)

And it's right, the rates of what are essentially malpractice haven't changed.
Arguably despite spending more, we get worse care:
[http://www.npr.org/sections/health-
shots/2013/09/20/22450765...](http://www.npr.org/sections/health-
shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-
hospitals)

If infections are included in the numbers then the US is only slightly above
average: [http://www.euro.who.int/en/health-topics/Health-
systems/pati...](http://www.euro.who.int/en/health-topics/Health-
systems/patient-safety/data-and-statistics)

The WHO suggests by reducing HAI, the EU could reduce deaths by about 95K/year
vs. US's 75K (actually normalizing by population makes the US's number look
really bad..assuming stats apply to entire EU's pop of 508-ish million and the
US's ~308 million).

I can't find in the cited study (original article) if they included hospital
acquired infections like the WHO does. If they didn't then we've a lot of work
to do. Likely will never be an issue though, unless we treat the med
profession like any other professional service provider with the power of life
and death. We need to open the books on investigations, share data publicly,
and likely provide more oversight. Also...seems like a wonderful area where
big data and ML could contribute to meaningful improvements...

------
thr0waway1239
A few questions:

1\. Is there a metric similar to deaths per passenger mile in automobiles?
That is, is it possible that more people go and stay at the hospital, more new
kinds of diseases (which were considered incurable previously) are now being
treated, even if people know it is some what futile? How much of the jump
would it explain? How about the increase in the population itself?

2\. From the word "now", we could infer a couple of things. It is possible
that medical error itself has risen drastically (or not, depending on whether
we have a good answer for 1), or just that treatment for whatever used to be
number 3 previously - respiratory disease - has improved in recent times? It
is entirely possible that medical error could climb further up and top this
chart and still allow the possibility that medical care is actually improving.

3\. From the article:

\---------

Although all providers extol patient safety and highlight the various safety
committees and protocols they have in place, few provide the public with
specifics on actual cases of harm due to mistakes. Moreover, the Centers for
Disease Control and Prevention doesn’t require reporting of errors in the data
it collects about deaths through billing codes, making it hard to see what’s
going on at the national level.

"The CDC should update its vital statistics reporting requirements so that
physicians must report whether there was any error that led to a preventable
death, Makary said.

“We all know how common it is,” he said. “We also know how infrequently it’s
openly discussed.”

\---------

There was a similar discussion a while back, about the topic of the coding of
the cause of disease not being consistent and that it could be misreported.
Before that situation is improved, shouldn't we be considering these kinds of
articles from a more skeptical viewpoint?

------
kazinator
I suspect this statistic is inflated by "failed to extend this person's life
by another three weeks" type errors. A genuine medical error is one which
creates a problem completely unrelated to the treatment or original health
issue.

~~~
quantumhobbit
I wouldn't be surprised at all. Far more than most people realize, a lot of
medicine today is focused on keeping people who likely have no hope of
recovery alive for just another week.

------
joaomagalhaes
Here is the link to the original article -
[http://www.bmj.com/content/353/bmj.i2139](http://www.bmj.com/content/353/bmj.i2139)

~~~
mlinksva
Thank you. I find it bizarre that these days articles include text such as
"Their analysis, published in the BMJ on Tuesday" without providing a link,
even though the article is sadly paywalled.

------
lifeisstillgood
I know that each of these deaths is a tragedy, but if we turn back the clock
to an era of polio, TB, cholera and malnutrition it is amazing to find
_doctors preventable mistakes_ in the top three.

Yes it needs fixing, but it also needs a quiet fist pump in the same way more
people die from obesity related diseases than starve to death.

It's the very definition of a first world problem.

------
protomyth
_Their analysis, published in the BMJ on Tuesday, shows that “medical errors”
in hospitals and other health-care facilities are incredibly common and may
now be the third-leading cause of death in the United States — claiming
251,000 lives every year, more than respiratory disease, accidents, stroke and
Alzheimer’s._

Title of article omits the "may". I hope someone is able to review their
report and data.

~~~
DanBC
Frustratingly I put in the "may", because the current title is both link baity
and inaccurate.

Mods edited it. :-/

------
lumberjack
Just an anecdote but on a subreddit I sometimes browse there's two MDs who
boast of sleeping only 3 hours per day.

And then on the financial incentives side of things, at this point practice
insurance might be so robust that it might not be so risky any more to end up
committing a medical error while working those extra 3 to 4 hours per day
might mean you're making enough money to retire in your early 40s.

~~~
chimeracoder
> working those extra 3 to 4 hours per day might mean you're making enough
> money to retire in your early 40s.

The only way you could retire in your 40s as a doctor these days is if you
were already independently wealthy before becoming a doctor.

If you go into medical school today, you're looking at finishing off your
student loan payments in your 40s (depending of course on which school you go
to, where you do your residency, whether you do a fellowship, and what
specialty you choose).

The pre-tax, pre-insurance, pre-expenses, _gross_ pay looks high on paper, but
the lifetime ROI on going into medicine is nowhere near as good as what you
describe, no matter how many hours you work.

~~~
TuringNYC
That is a gross generalization. It is true in the US if you are a primary care
physician or one of the lower-paid/lifestyle specialists. It is far from true
if your are a higher-paid specialist or sub-specialist.

Also consider that unlike tech, where you get paid more for working in higher-
cost-of-living cities -- in medicine you get paid more for working in lower-
cost-of-living cities.

Also note that unlike tech, the peaks and valleys are much less pronounced.

~~~
chimeracoder
> Also note that unlike tech, the peaks and valleys are much less pronounced.

The point is that, unlike tech, you have to take on _massive_ amounts of debt
before you can even begin to work[0]. And even after that, there's a really
high latency before you're earning enough to make more than the minimum
payments. Six-figure debt compounded over a decade or more really adds up.

> That is a gross generalization. It is true in the US if you are a primary
> care physician or one of the lower-paid/lifestyle specialists. It is far
> from true if your are a higher-paid specialist or sub-specialist.

It's actually more true if you're a specialist or subspecialist. People who
don't practice medicine tend to overestimate what specialists get paid, and to
underestimate what PCPs get paid. It also doesn't help that, in the last ten
years, the relative reimbursement rates have changed dramatically, and to top
it all off, private practices have been rapidly going the way of the dodo - so
it's understandable that the public perception would be out-of-date.

Overall, reimbursement rates for specialists have been slashed far faster than
they have for primary care (with some specialties hit harder than others).
Combine that with the fact that they have to spend even more time in training
(during which time their debt compounds

> Also note that unlike tech, the peaks and valleys are much less pronounced.

Quite the opposite - tech salaries are relatively flat and stable compared to
most other industries, and we get to take home pretty much 100% of our salary,
less taxes. Yes, the industry as a whole has booms and busts, but so does
literally every private industry. In medicine, unlike tech, even if you're
salaried, you're oftentimes paying for a large chunk of your business expenses
out of your "salary". This is one of the reasons why looking at listings of
what doctors make is incredibly misleading. The insurance rates vary
dramatically between fields of medicine (and practice locations), as does the
necessary equipment and mandatory continuing medical education expenses
(again, even salaried doctors will oftentimes have to cover these out-of-
pocket).

In tech, we don't have to worry about any of that. We have it pretty easy.

> in medicine you get paid more for working in lower-cost-of-living cities.

This used to be the case. It still is, for some fields like emergency
medicine. It's a lot less the case in other fields, partly because of the
consolidation of practice groups and the downward pressure on reimbursement
rates across the board.

[0] Unless, as I said in my previous comment, you're independently wealthy
beforehand, in which case this whole discussion of early retirement is moot.

~~~
TuringNYC
With respect - you are comparing apples vs oranges. You are comparing
independent/priv-practice doctors vs salaried technologists. If you had an
independent contractor technologist, they also have to eat all the overhead
(Liability insurance, E&O insurance, benefits, office, supplies.) Similarly,
if you have a doctor working at the hospital, just like a salaried
technologist they don't have to pay the overhead.

To be fair, doctors' overhead is higher for certain practices, but remember
that facility fees can be billed back to the insurance or directly to the
patient and even sent for collection. Those are extra fees on top of the
doctor's pay -- essentially a form of rent forwarded to the patient for the
doctor's facility costs.

Finally, we're not comparing tech salaries to other industries, we're
comparing them to doctors. I've rarely seen doctors face a 2001 market crash
or 2008 market crash and mass unemployment or had their entire training wiped
out when JE22 went south. Tech is very volatile. Also consider that doctors
generally make more as they age, whereas technologists often face increasing
age discrimination. Yes, MLK in LA and St Vincent's in NYC did shut down, but
have you ever seen the equivalent of a Lucent or Lehman or IBM or Intel in
medicine? Rare...

You are right that I don't practice medicine, but I work 75hrs a week in
hospitals since my startup sells to hospitals. I've seen the relative function
and dysfunction of both American and single-payer overseas systems. And BTW, i
pay _gigantic liability insurance bills for my diagnostic technology product_
, and it effectively comes out of my salary.

------
sakopov
5 years ago my uncle was hospitalized with a knot in the gastrointestinal
tract which usually gets treated within days. He never left the hospital and
died 3 weeks later after every single organ in his body started failing post-
treatment. The man has always been healthy and never had any serious
illnesses. His daughter witnessed (and on a few occasions so did i) plain
stupidity and negligence of the medical staff who insisted to take him off
life-support after putting him on it. We eventually ended up moving him to
another hospital where he showed signs of improvement but eventually died when
his kidney and then lungs gave out. She and her mother are convinced that he
died because of numerous medical errors. I watched him suffer for 3 weeks and
have since developed a phobia of hospitals. I basically lose my shit over any
hospital visits these days.

~~~
siculars
There's an old joke inside hospitals. Hospitals are where people go to die.
Unfortunately, it's not a joke. Hospitals are the definition of asymmetric
information warfare. You know nothing and they _think_ they know everything.
Absolutely have someone on your side who knows what's what. Family/friend who
is a doctor, nurse, PA, NP, etc. Hospitals are so wedged that some actually
have "patient advocates" who work there and whos sole job is to be that
advocate for the patient and patients family.

------
ericdykstra
This isn't a new phenomenon, there's even an ancient word for it:
[https://en.wikipedia.org/wiki/Iatrogenesis](https://en.wikipedia.org/wiki/Iatrogenesis)

Doctors are pre-disposed to do something rather than nothing, and doing
something is more dangerous than doing nothing in the vast majority of medical
cases. This is especially true when "doing something" has unknown or unbounded
side effects and the original ailment is something that the body will take
care of by itself in short order.

Every prescription you take for a minor inconvenience is a tiny chance that
you're taking the next recalled drug for something that does long-term damage
that wasn't found in short-term medical trials, or the chance that your
pharmacist makes an error in filling the prescription.

~~~
blazespin
Maybe. I wonder if these 'medical errors' also counted situations where the
patient was probably going to die anyways.

~~~
ericdykstra
What is this "maybe" in response to?

Going to the doctor or taking a medication, even if the _chance_ of risk is
low, has a downside that is a lot worse than the upside, except in cases that
are life-threatening or have potential long-term health downsides.

So next time you're thinking of taking something to fix your acid-reflux,
maybe try listening to your body and changing your diet, instead of risking
that the drug you take to mask the symptoms is the next Nexium.

~~~
fghgfdfg
Everything has risks. Maybe you change your diet and end up doing an
unfamiliar food preparation and you screw it up and end up with a case of
salmonella or e. coli. Or you do your usual thing and it happens anyway.

It's inane to suggest anything labeled "medication" should only be taken in
life-threatening circumstances. Everything you ingest is going to have an
impact on your body - some good, some bad, many both. Medications have a
particularly strong impact, but are also highly controlled. You can judge the
probability of various outcomes very well, which makes it a lot easier to come
to a clear conclusion about using them or not.

And I'm going to assume you didn't intend to say that merely going to the
doctor should be avoided except in life-threatening circumstances.

~~~
ericdykstra
Of course everything has risks, but I'm just advocating not taking risks with
extreme downside when the positive upside is small. Eating is necessary for
life, but taking a pill to reduce the risk of acid-reflux symptoms is not.

> _Medications have a particularly strong impact, but are also highly
> controlled. You can judge the probability of various outcomes very well,
> which makes it a lot easier to come to a clear conclusion about using them
> or not._

This is the main point where we disagree. You say medications are controlled,
but I see alarming numbers of recalls of drugs [1]. Controlled studies only
show a small part of the picture of the long-term impact of a particular
drugs' use.

> And I'm going to assume you didn't intend to say that merely going to the
> doctor should be avoided except in life-threatening circumstances.

All I'm saying is that going to the doctor has risks that need to be
considered. And when a doctor recommends some treatment, ask what he would do
if he was in your situation, or what recommendation she would give to her
brother.

1\. [http://www.raps.org/Regulatory-
Focus/News/2014/08/11/20005/N...](http://www.raps.org/Regulatory-
Focus/News/2014/08/11/20005/Number-of-Drug-Recalls-Surges-at-FDA-Led-by-Mid-
Level-Concerns/)

~~~
fghgfdfg
It's not just a question about the magnitude of the possible upside or
downside though, it's also about how likely they are to occur. If you offer me
the opportunity to almost certainly make every day slightly better with the
risk of killing me at a rate of once in the current age of the universe I'm
going to take it. It's a tiny upside with a massive downside, but it would be
irrational not to take it given the chances involved.

Medications absolutely are controlled. That doesn't mean they don't have
issues, but are you willing to suggest medications are less controlled than
food? I don't need to hope I've washed my medications well enough, nor do I
need to ensure I've heated them to at least a certain temperature for a length
of time, nor do I need to worry about cross contamination or any such thing.
This isn't to say medications are without risk, but compared to produce, meat,
or eggs I have a much better idea about what exactly is entering my body when
I consume it.

>All I'm saying is that going to the doctor has risks that need to be
considered.

I doubt that very much. Are the risks significantly greater than the risk you
likely took getting to the doctor in the first place? I'd be shocked.

------
logicallee
This is a good thing.

If all causes of death were medically preventable (which would be _awesome_ ),
by definition preventable medical errors would cause 100% of deaths. (Since
they could have prevented it and assuming it's an error not to.)

It's simple logic. In other words, the better the standard of medical care,
and the better the state of medical science, the higher this number will be,
right up to 100% if medical science has an answer to everything. It will never
be 100% of zero, as obviously in practice not everything will be done
perfextly - but medical error is the delta between theoretical standard of
care and actual outcome. The better the theoretical standard, the more deaths
must be deemed errors.

It can still be far better than if that were not the standard.

~~~
maxerickson
_This is a good thing._

Just looking at the cause of death percentages misses the point. Imagine your
dream scenario has been achieved and all deaths are caused by errors. 2
hospitals that treat the same number of patients (with similar complexity
across the patient populations) are performing similarly on the death metric,
100% of deaths are caused by errors. Never mind that Hospital B kills 100
times as many people.

Putting it another way, without some information about what good performance
is, you'd better not make any conclusions about whether this is a good thing
or not.

------
nradov
For those interested in this topic I strongly recommend reading the Institute
of Medicine report "To Err Is Human" linked in the article.
[https://www.nap.edu/catalog/9728/to-err-is-human-
building-a-...](https://www.nap.edu/catalog/9728/to-err-is-human-building-a-
safer-health-system) It set the foundation upon which a lot of this later
research is based.

------
doener
Medical error is third biggest cause of death in the US, experts say:
[https://www.theguardian.com/society/2016/may/03/cause-of-
dea...](https://www.theguardian.com/society/2016/may/03/cause-of-death-united-
states-medical-error)

------
annerajb
Nobody has comment on the ridiculous amount of hours doctors have to work on
emergency rooms. 7 hours with 3 hours of sleep between going to class and
being into the ER again. This is actually illegal but every student I talk to
is afraid of complaining and risk their careers.

------
brooklyndude
As a most awesome MD, really at the front lines told me once after a 36 hour
shift:

1\. 50% of the patients are in this hospital are here because of medical
errors.

2\. Don't get sick.

But if you do get crushed by a car, you really are going to be damn happy I'm
here.

------
JudasGoat
My foster son died in 90's after taking a powerful steroid where the dosage
was multiplied by 10 by a transcription error. I never found out if the doctor
or pharmacist was the one responsible.

~~~
tomcam
That is absolutely disgusting and tragic. I am so sorry for your loss.

------
JoeAltmaier
Hm. Article strongly states we need to measure this invisible killer. Also
ranks this (unmeasured) risk high on a chart by number of deaths per annum.
Seems like guessing to me?

I'm thinking 'medical error' is a catchall for some constellation of events,
and only shows up high on the chart because its an aggregate of several
causes. Once its measured and dissected, it will turn into 12 low-frequency
entries and disappear from the conversation.

~~~
sjg007
Medical error is actually underestimated. You get preventable deaths that are
attributed to "complications of an underlying cause".. You might consider MRSA
infections as a preventable medical error but frequently sepsis is not listed
as a cause of death.

~~~
JoeAltmaier
My point exactly. Split it into a dozen causes, they all fall down the list to
10th or 12th place.

------
imaginenore
I find that hard to believe, 250K is a huge number. CDC's list:

• Heart disease: 614,348

• Cancer: 591,699

• Chronic lower respiratory diseases: 147,101

• Accidents (unintentional injuries): 136,053

• Stroke (cerebrovascular diseases): 133,103

• Alzheimer's disease: 93,541

• Diabetes: 76,488

• Influenza and pneumonia: 55,227

• Nephritis, nephrotic syndrome, and nephrosis: 48,146

• Intentional self-harm (suicide): 42,773

[http://www.cdc.gov/nchs/fastats/leading-causes-of-
death.htm](http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm)

------
taksintikk
Would love to compare this stat to other nations. G8 at the very least.

------
wodenokoto
What would be a _good_ 3rd leading cause of death?

~~~
merpnderp
Being struck by lightning?

------
mlinksva
Any estimate in terms of DALYs?

------
albertTJames
Among other things I have worked as a researcher, a Psychiatrist, a
Neurosurgeon, and a web developper. Reading comments about how much distrust
there is in doctors saddens me. Medical errors are killing people but it has
to be put in perspective to the reality of modern medicine in hospitals.
Usually medical errors kill patients that are the most vulnerable, who need
several invasive acts, strong and potentially harmful treatments, who need to
stay in bed, in the hospital, for days or even months. The first comment by
ada1981 talks about how acute medicine seems to be doing ok, that is not
because acute doctors are good, and chronic doctor are asshole sold to big
pharma. It is because longer stay in the hospital means a more severe
condition, and an incremental risk of yes, preventable errors. Actually, this
feeling of mistrust is one of the main reason I stopped practicing, the other
reason was that I was frustrated by the way doctors have to practice medicine
and is of course related to this issue. The way we practice medicine has not
changed for years, although medical knowledge increase exponentially and
doubles every two years. This immobility is mainly due to three things: the
highly hierarchical and rigid structure of the medical field that resist
adaptability and innovation, economic constraints imposed by big pharma and
insurances who basically decide of how medicine is practiced in the whole
world, as well as misguided political/societal views as to what should be a
doctor of the 21st century, what tools should he use and how should he study.

In the article, the author - who by the way seems pretty biased and judging
from previous work to hold a profound grudge against physicians, is comparing
doctors to pilots, and medical errors to crashes. And besides the simple
demagogic argument of doctors are dumb and proud and pilot are better formed
and humble, the reality is that pilot are using machines worth millions that
are able to diagnose, fix, and steer themselves. They are three in the
cockpit, and communicate with flight controllers for the most critical parts
of the flight. They have real time weather prediction and course change. Their
tools are evolving in time, does she even know that modern airplanes produce
more than a terabyte of data on every flight ? This data is used to make
airplane safer every year, update software, hardware, security...

Practice of medicine has to change yes, and article pointing at medical errors
will help change minds and practices in the coming years. Technology will play
a big role in it.

But the author, and some people commenting here should remember that pilots
are not battling death. People who die in hospitals from medical errors are
usually the one who are suffering from chronic and hard to treat diseases. You
all want to live forever, blaming doctors of the sad reality that most of you
will die from a chronic disease.

Instead of drawing a dark portrait of physicians who for the most part work
selflessly to make a positive change in the world, you should ask yourself:
why is there medical errors, what can they do better ? What could they do in
this context ? Go to school 18 years instead of 12? Work 120 hours instead of
90 ?

The solution is a deep change of how medicine is practiced, a revolution
driven by technology (IOT, big data, AI) and the open science movement. But
you have to realize that this revolution was not possible before maybe 4-5
years ago. Now it is, and soon it will change.

------
airbreather
So why are doctors paid so much, it obviously has not improved service any?

~~~
DanBC
You used to die at 50 from cancer or heart disease. Now you die at 80 from
cancer or heart disease or medical error.

I think that's an improvement.

~~~
hga
Indeed, one of the things that needs to be kept topmost in mind when reading
statistics like this is that people are going to die of _something_ , and as
we reduce or all but eliminate other causes, _something_ or things are going
to shift to being the new "top causes".

ADDED: and because nowadays, no later than the end of WWII, the former
somethings have be forestalled by medical interventions, as those increase,
the number "killed" by the simple fact that healthcare workers are fallible
humans is going to rise.

My father survived the immediate post-WWII period when he got a nasty
bacterial pneumonia I think it was because civilians were then able to get the
earliest form(s) of penicillin. Thanks to that medical intervention, which
could have killed him (I've read that penicillin would never get approved by
the FDA today because of its allergy potential), and others, now he'll die of
Alzheimer's in his mid-'80s or his '90s, if nothing else gets him first.

------
fapjacks
I guess of all problems, this is one of the better ones to have.

