There’s a reason they say that doctors “practice” medicine: they’re only human and not immune to making mistakes. Unfortunately, the mistakes that do occur can have deadly consequences.
According to a new report out of Johns Hopkins, medical errors are America’s 3rd leading killer after heart disease and cancer. Mistakes made by doctors took, at the very least, 251,454 lives in 2013 alone. This is more than double the previously accepted average of 44,000 to 98,000 deaths per year. Experts don’t think this is a case of medical errors suddenly increasing, but a national issue of not properly recording deaths caused by malpractice.
As it turns out, hundreds of thousands may have been dying from errors all along, but hospitals simply didn’t have a way to count or acknowledge them.
The Forgotten Ones
The study, published in the medical journal BMJ, argues that malpractice reports have been grossly inaccurate for years. Data reveals that up to 78 percent of error-related deaths are preventable instead of the previously-accepted figure of 51 percent. To put that into perspective, 78 percent of the total number of 251,454 deaths (itself a low-ball estimate) is nearly 200,000 people who died unnecessarily.
And yet, in many cases, these deaths aren’t counted or acknowledged. A major part of the problem is how the Centers for Disease Control (CDC) keeps records on causes of death. Dr. Martin Makary, who headed the BMJ study, wrote in an open letter to the agency that, “a patient who dies directly from a medical error is not counted in our national health statistics.” Makary explained that the U.S.’s current system for coding and defining causes of death has “serious limitations” that overlook a lot of cases and impede research.
Given the new data, and the implications it may have, insurers and medical professionals alike are now trying to address this critical oversight by examining thousands of old malpractice claims. By mining the data for trends, medical professionals can update training protocols and improve patient safety.
And the data? It points to some frightening trends.
Poor Planning, Few Backup Plans
Data analysis shows that poor planning and a failure to consider alternative methods are 2 big, yet entirely avoidable causes of malpractice suits. Honing in on the field of obstetrics (dealing with pregnancy and childbirth), for example, 882 malpractice claims filed between 2007 and 2014, were related to newborns who were injured when their shoulders became stuck inside of their mother's vaginal canal. This condition is called shoulder dystocia and it can have severe consequences for a baby's future health.
Doctors can, in some cases, screen expecting mothers for a likelihood of shoulder dystocia by examining health factors like obesity and diabetes. However, in examining the malpractice claims, insurers found that doctors often didn't screen for these problems at all. Even in cases where shoulder dystocia would’ve been impossible to predict, doctors proved unprepared to handle the complication.
There appears to be a relatively simple fix: improve training and practice for worst case scenarios. Hillcrest Hospital in Mayfield, Ohio has developed a series of training drills that use simple mannequins to prepare staff members for those cases when shoulder dystocia occurs. No professional should be learning how to do a risky but potentially life-saving maneuver for the very first time on a living, breathing child.
A Failure to Communicate
Perhaps nowhere else is the old saying that “knowledge is power” more true than in medicine.
Patients like Llaulin Cruz, learned the truth of this statement the hard way. Cruz suffered debilitating injuries while giving birth, due to poor advice and an unnecessary episiotomy from her doctor. When Cruz became pregnant with her second child only a year later, she hired a midwife instead of returning to the hospital where she’d been traumatized.
Unfortunately, Cruz’s former hospital and her new midwife allegedly didn’t communicate with one another and, as a result, the midwife gave Cruz poor advice that severely re-damaged her wounds. Cruz now suffers incontinence and chronic pain. She was forced to quit her job as a physical therapist’s aid.
To err is human, but to suffer back-to-back excruciating traumas at the hands of trained healthcare professionals is life-altering. It shatters one's faith in medicine and sets a precedent for wary relationships with doctors in the future.
The Cost of Malpractice: Overhyped or Underestimated?
Malpractice has been touted as the single greatest burden of U.S. healthcare, but this isn't exactly the case. Malpractice, overall, costs the U.S. about $56 Billion a year, as of 2010. Nearly $46 Billion of that is spent on what's called “defensive medicine” – tests and scans that doctors order to avoid getting sued, but that aren't absolutely necessary.
Still, the whole amount of $56 Billion only takes up about 2.4 percent of the country's total healthcare expenses, which total over $2 Trillion. What's interesting to note is that opponents of healthcare reform – known to most as “Obamacare”— insist that malpractice is rampant and expensive in a lawsuit-happy America. But if it’s less than 3 percent of the total cost, how rampant is it really?
While medical mistakes are pervasive and deadly, the risks haven't been accurately conveyed by its financial burden. More people are dying than are reflected in lawsuit claims. In other words, in spite of the reputation of being a “sue-happy” culture, the reality is that Americans may in fact be underestimating the problem of malpractice altogether.
While mistakes might always be a part of medicine, hundreds of thousands of deaths needn’t be. Now that researchers are tackling malpractice data head on, we may be headed into a newer – and safer – era of American medicine.