Parallel to the opioid “epidemic” there is a much larger crisis happening in our healthcare system: The increasing mortality from medical diagnostic errors.
Deaths from medical diagnostic errors in the U.S.
are as high as 440,000 each year.
These numbers are almost 25 times the number of opioid overdose deaths (18,000), yet this has never emerged as an issue like the hysteria aroused over the comparatively small numbers (unless it’s one of your own) of opioid overdoses.
1 in 10 patient deaths is estimated to be caused by errors in diagnosis.
The media pays no attention, no guidelines have been issued; diagnostic errors haven’t been tackled as the public health issue they truly are.
The fabricated “opioid crisis” is a diversion from much more serious problems in our medical system. (25 times more serious).
Hospital “leaders” and administrators, who have been “cost cutting” necessary staff for years, are more than happy to go after doctors and patients using prescription opioids instead of working on their own problems.
These three articles from the last 3 months are from reputable sources (The IOM and medscape.com) :
The prognosis for the IOM’s newest bombshell on diagnostic errors is not encouraging.
[The IOM’s] first report in 1999 on medical errors (To Err Is Human: Building a Safer Health System) promised a 50 percent reduction in 5 years.
Since then the number of deaths has soared to the point where hospital harm is the third leading cause of death in the U.S. and Canada.
1 in 10 patient deaths is estimated to be caused by errors in diagnosis.
the prestigious Institute of Medicine (IOM) revealed last week that most Americans will at some point be affected by a diagnostic error, often with adverse effects to their health
Even with the stunning fact that 1 in 10 patient deaths is estimated to be caused by errors in diagnosis, the mainstream media covered the story for a day. And then moved on.
The report, called Improving Diagnosis in Healthcare, comes a decade-and-a-half after the IOM’s landmark study on medical errors in the U.S. At that time, the Institute estimated that up to 100,000 Americans are killed in the clinical setting every year because of medical errors. But what happened after the release of that report does not bode well for this latest, and even potentially more impactful, bombshell.
The first IOM report set a minimum goal of reducing hospital errors by 50 percent over the next five years. That was in 1999. Not only was the target not met, but the number of medical mistakes substantially increased.
By 2010, a report from the Office of Inspector General for the Department of Health and Human Services warned that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in any given year.
More research led to the discovery of even higher numbers, including the estimate in 2013 by John T. James, a NASA scientist who lost his son to a fatal diagnostic mistake, which put the number of deaths from medical errors in the U.S. as high as 440,000 each year.
This makes medical errors, most of which occur in the hospital setting, the third leading cause of death in America.
Yet this is the same “medical industry” that claims the 18,000 annual deaths from prescription drug overdoses (not necessarily even opioids) is a “crisis” and an “epidemic”.
All the resources are being mobilized against opioid prescribing instead of medical errors, which cause 24.5 times as many deaths. Is this a diversionary tactic?
Add to that figure the number of U.S. patients harmed by hospital errors, which is estimated to be 15 million each year, and you have to ask what really was the impact of this 1999 report, which most healthcare experts describe as groundbreaking.
This contrasts sharply with the numbers harmed by opioids, which is a mere fraction of those harmed by hospital errors.
Writing about the emotional damage to patients and families, Dr. Donaldson noted, “Too often, healthcare organizations, through their inept and unfeeling responses, amplify these later waves of harm rather than mitigating their damaging effects.”
In a stunning moment of frankness rarely seen at his level of global professional esteem, Dr. Donaldson also observed that “…too many healthcare organizations espouse the goal of safer care while regarding harm as the cost of doing business.”
To bolster its case about the conditions that can lead to diagnostic errors, the IOM report highlights three real-life stories. In two of those examples, the patients and their families were either not listened to or had their concerns dismissed out of hand — both with dire consequences.
Unfortunately, even after carefully noting the evidence about the damage of diagnostic failures, and the harm they may portend for the future, the IOM still does not recommend mandatory reporting, in a publicly accessible fashion, of diagnostic errors.
Even as they play up and broadcast the supposed “overwhelming harm” of opioids and require many levels of reporting about their use.
The public is left out in the cold when it comes to being able to assess the performance of its healthcare institutions in diagnostic errors as well as more general medical mistakes.
Government agencies, like the U.S. Centers for Disease Control and Health Canada, which track causes of death from various conditions and diseases such as stroke and breast cancer, will not even acknowledge that there is a category called medical errors which represents the third leading cause of death in both countries.
Yet this same agency has no problem setting unscientfically stringent limits of opioid prescribing to counter the number of overdose deaths.
The IOM apparently has no recommended treatment for myopic politicians who don’t recognize a healthcare crisis when it’s right in front of them.
Diagnostic errors are a factor in 10% of patient deaths, account for as much as 17% of hospital adverse events, and are a leading driver of medical malpractice claims, according to a sweeping report released Tuesday by the Institute of Medicine.
The report, Improving Diagnosis in Health Care, calls diagnostic errors “a blind spot” in healthcare delivery that has been around for decades which persists across all care settings and harms “an unacceptable number of patients.”
“Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in healthcare,” the report said. “Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of healthcare and the diagnostic process continue to increase in complexity.”
The report blamed diagnostic errors on “a wide variety of causes, including:
- Inadequate collaboration and communication among clinicians, patients, and their families;
- A healthcare work system that is not well designed to support the diagnostic process;
- Limited feedback to clinicians about diagnostic performance;
- A culture that discourages transparency and disclosure of diagnostic errors—impeding attempts to learn from these events and improve diagnosis.”
The Persistent Problem of Diagnostic Error | Dec 2015
As an anatomic pathologist who grew up in the autopsy room, I know that people who die have often been misdiagnosed during their lives
As a forensic pathologist who has studied sudden, unexpected, and unattended death in adults, I know that a large number (as many as half, by my data) of such deaths that would have been diagnosed as heart disease were found, on autopsy, to be related to many other causes but not heart disease.
As a clinical pathologist who has supervised the performance of millions of lab tests, I know that physicians often order the wrong tests and subsequently misinterpret the results and fail to act appropriately
In 2015, the IOM, now of the National Academies of Sciences, Engineering, and Medicine, has turned its attention to Improving Diagnosis in Healthcare.
They described errors in diagnosis as a gigantic problem of largely undefined but vast scope, one that will require extensive and warranted changes.
The committee concluded: “Improving the diagnostic process is not only possible, but it represents a moral, professional, and public health imperative.”