Most of us know that heart disease and cancer are among the biggest killers in the United States. They’re actually numbers one and two, having caused 614,000 and 591,000 deaths, respectively, in 2015, according to the Centers for Disease Control and Prevention (CDC). But the third leading killer, which takes the lives of about 250,000 Americans every year—is one that few people have ever considered: medical errors. And in a bizarrely ironic twist, those deaths are happening at the hands of professionals who are trained to help us live a longer, healthier life. To put this in perspective, medical errors kill more people than strokes, car accidents, guns, and drug overdoses combined. So why haven’t we heard about this before? In large part, it’s because the insurance billing system is organized around diseases, conditions, tests, procedures, and medication—all of which are assigned a number that physicians, hospitals, and labs can put on a form so they can get paid. It never occurred to the people who created billing codes to have one for mistakes. Fortunately, a team of researchers from Johns Hopkins University School of Medicine decided to look into this issue. They crunched numbers from four different studies that analyzed medical death data and cross-referenced it with hospital admissions rates. They concluded that in 2013, there were 35,416,020 admissions and 251,454 deaths from medical error—nearly one in 10 deaths that year.
The whole issue of medical errors hit home in a big way a few weeks ago when my 82-year-old mother—who’s in amazing health—went to the emergency room, unable to catch her breath. The doctors thought she might be having a heart attack or that she might have had a blood clot in her lung. They gave her a battery of tests, all of which came back normal, and admitted her to the hospital. The next day, her symptoms weren’t much better. After more tests, the doctors decided that she was having an anxiety attack and sent her home. A few days later, my mother, still short of breath, had a follow-up appointment and saw a physician assistant, who went through her record and identified the problem right away: she was having a reaction to a new medication she’d recently started taking—a reaction that could have killed her. No one at the ER and no one in the hospital had asked my mother anything about her medication (which shouldn’t have made any difference since all of it was in her electronic medical record anyway).
Good News, Bad News
The good news is that “most medical errors aren’t due to inherently bad doctors,” according to the study’s lead researcher, Martin Makary, M.D., M.P.H., in a University press release. In Makary’s view, “reporting these errors shouldn’t trigger punishment or legal action.” For the most part, he says, the problems are systemic and include poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability. “Unwarranted variation is endemic in health care,” Makary said in the press release. “Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care. More research on preventing medical errors from occurring is needed to address the problem.” In my mother’s case, it’s hard to pinpoint exactly where the system went wrong. But the bottom line is that she nearly became a statistic. Unfortunately, the research Makary is calling for isn’t likely to happen anytime soon. And it’s all about the numbers. Since official data on medical errors isn’t being collected, medical errors as a category aren’t likely to show up on the CDC’s list of top causes of death. And there’s a strong correlation between that list and how much money and attention get directed to combatting those killers. As Makary puts it, “Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”