Doctor: Medical Mistakes Are Killing a Jumbo Jet Full of People Per Day
Cancer surgeon and former director of the Johns Hopkins Medical Safety Group has identified and confirmed the research revealing the extent and causes of medical mistakes in U.S. hospitals, and has characterized the massive level of hospital deaths as equivalent to a jumbo jet crashing every day with all passengers on board dying.
Dr. Marty Makary, M.D., M.P.H., has published his findings in a new book: Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.
“This is the number three cause of death in the U.S.” confirms Dr. Makary. Some 100,000 patients are killed and nine million are harmed by medical mistakes every year. It is the third single greatest cause of death in the U.S., behind cancer and heart disease.
“We have become a little numb to the problem,” Dr. Makary explained in an interview on the the NBC show, “The Doctors.” Comparison to a jumbo jet full of people dying each day helps put the problem in a more urgent perspective according to Dr. Makary.
“Dr. Hodad” was the term used by hospital staff for one of its most popular surgeons – an Ivy League school doctor whose surgeries resulted in more complications and mistakes than usual. The moniker “Hodad” stands for “hands of death and destruction.”
“His patients absolutely worshipped him, clearly grateful to have him as their doctor,” Dr. Makary states in his book. “Behind his charm and soothing bedside manner, Hodad’s patients didn’t really know what was going on. They had no way of connecting their extended hospitalization, excessive surgery time, or preventable complications with the bungling, amateurish, borderline malpractices moves we on the staff all witnessed.”
Fellow staffers and physicians in a hospital will often know those who make more mistakes, Dr. Makary has observed during his work in hospitals. “There is terrible guilt about keeping quiet, but there are strong social forces against speaking up when you think something doesn’t look right: It can get you fired,” Dr. Makary told Reuters last fall.
“We are just starting to recognize we have a problem,” according to Dr. Makary. Dr. Makary identified that those hospitals that had poor teamwork procedures had worse outcomes.
Dr. Makary explains that doctors are dealing with a system rife with profit motives that are burning out doctors. “Perverse incentives, quotas, pressure from Medicare,” are among the issues according to Dr. Makary. “Doctors are getting crushed out there,” he adds. “46% of doctors are burned out.”
Dr. Makary also identified that patients sometimes encourage overtreatment. “Patients come in with an expectation… that I better get a prescription.” Overtreatment encouraged by patients comes partly as a result of aggressive pharmaceutical and treatment media advertising targeted at patients.
Dr. Makary identified how quotas from hospital administrations can significantly pressure doctors to do more procedures. “Some doctors actually get emails and text messages saying ‘do more operations – this is important for you to get your year-end bonus.’”
Unnecessary procedures and overtreatment are rampant in the U.S. medical system. “This is a real problem on a national level, even at epidemic proportions,” says Dr. Makary.
According to an Institute of Medicine report, up to thirty cents of every dollar of medical care goes towards unneccessary tests, fraud and overtreatment.”
Dr. Makary suggests second and third opinions are important. “30% of second opinions are different than the first opinion,” he states.
Currently there is no reliable way to determine which doctors and which hospitals are more or less dangerous than others. “People are essentially walking into a hospital blind,” he states. While Johns Hopkins conducts regular surveys of up to 60 hospitals about safety, participation is contingent upon confidentiality, so the results are kept secret according to Dr. Makary.
The Society of Thoracic Surgeons tracks and publishes cardiac surgery outcomes, but only a third of hospitals will allow the data to be posted on the Society’s website. A few states – Oregon, California and New York – now require death rates to be reported by their hospitals. When New York State published their results in 1989, heart surgery death rates in New York hospitals fell by 41%.
Makary M. Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care. Bloomsbury Press, 2012.