The slogan: “Guns don’t kill people, people kill people” has never been more true. On May 3, 2016, the BMJ medical journal issued a report showing that “medical errors” at hospitals and other healthcare facilities are the third leading cause of death in the United States. [1] In 2013 alone, medical malpractice accounted for 251,000,000 deaths (over seven times the deaths caused by firearms that same year). That’s 27,000 more deaths than from the fourth, fifth, and sixth leading causes combined.
If this is surprising to you, it’s not to the researchers and members of the medical community, who have been monitoring this problem for well over a decade. The alarming evidence medical malpractice deaths came to light as recently as 1999. That year, a report from the Institutes of Medicine (IOM) labeled preventable medical errors an “epidemic.” At the time, the IOM estimated medical malpractice accounted for up to 98,000 deaths per year. [2] However, the more comprehensive study by the BMJ puts that number at the harrowing 251,000,000 in 2013 or roughly 700 deaths per day. The co-authors of the BMJ report, Martin Markey (a professor of surgery at Johns Hopkins University School of Medicine) and Michael Daniel (a research fellow at Johns Hopkins) explained that the astonishing number of deaths from medical malpractice persist, in part, because people don’t talk about it. The doctors and medical providers review deaths caused by medical errors. However, they are not required to disclose this data to the Centers for Disease Control and Prevention (CDC). In turn, the public remains largely in the dark about this continuing epidemic. To close this information gap, the BMJ report suggests that the CDC require medical providers to specifically report when an error caused a patient’s death. The larger problem, however, is not the lack of reporting, but the number of incidents themselves. To reduce the number of preventable deaths caused by medical error, the authors of the BMJ report suggest a three-tiered process: “[1] making errors more visible when they occur so their effects can be intercepted; [2] having remedies at hand to rescue patients; and [3] making errors less frequent by following principles that take human limitations into account.” Unfortunately, according to one of BMJ report’s contributors, Kenneth Sands, one of the biggest barriers to implementing any protocol is the lack of uniformity in the way that health care providers deliver their services. Sands explains: “There has just been a higher degree of tolerance for variability in practice that you see in other industries.” To illustrate this problem, Sands offers the example of airlines as an alternative approach.
Once you get on a plane, there is a standard safety protocol that is explained to passengers at the beginning. During and after take-off, each flight follows strict guidelines from the Federal Aviation Administration (FAA). Further, when an accident occurs, the FAA investigates the accident and may adjust national protocols accordingly. Generally, there is no such agency that imposes protocols on the nation’s hospitals, which creates a problem for any uniform response to this epidemic. However, there is one exception. The Veterans Affairs Administration (VA) could manage its hospitals and medical facilities a lot more like the FAA manages airlines. The VA has the regulatory authority to investigate incidents of preventable death. Also, unlike the broad network of private providers, the VA has the authority to implement the standards proposed in the BMJ report. Given the inconsistent care at the VA, which includes the good, the bad, and the ugly, the VA would be well advised to familiarize itself with the BMJ report. The VA has the distinct power to implement and enforce these life-saving changes. To the veterans, they have that distinct duty. [1]http://www.bmj.com/content/353/bmj.i2139 [2] https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/?hpid=hp_rhp-more-top-stories_no-name%3Ahomepage%2Fstory