The toll on human life by preventable medical errors in the U.S. (and elsewhere) is unbearable and unacceptable. We are told that some 100,000 patients die annually from hospital errors alone, and an untold number of patients suffer complications and morbidity, adding to the already high burden of health-care costs.
Some errors in written communications (e.g. spelling errors, wrong doses) or drug interactions have received a lot of attention, mostly because they could be fixed by technological solutions. Another factor mentioned often is human fatigue, usually the result of long hours of in-hospital on-calls by more junior staff.
The 800 pound gorilla in this story is more insidious and related to the knowledge and attitude of practicing physicians. One of the major differences between physicians today and those 30 years ago (when I first practiced medicine) is today’s excessive reliance on technology and too little reliance on information supplied by the patient or her family.
This is a tough problem to solve, because technology is here to stay, and the system is unlikely to reward physicians for spending more time with patients (and thus forcing them to see smaller number of patients).
There are some ways to indeed use low-tech for improving outcomes: What if every interaction between health giver and patient (or patient’s family) is recorded? This will, at the very least, avoid debates and misunderstandings as to who said what and when. But this may not suffice. Our lives, and those of our families, are too important to be left totally to the control of tired and overworked medical staff.
A new type of healthcare provider (or intermediary) must enter the picture: an advocate for the family who will make sure the physician’s orders are properly executed, the IV is running properly, correct medicine is given at the right time, and the risk of a potential in-hospital “error” is drastically reduced.
Finally, the family of a patient who is a victim of medical errors (assuming they find out about it) should not have to pay any bills. Of course, many issues need to be resolved before these can be implemented, but it is important to explore any new idea that might just work. Even a single avoidable death of a patient due to medical error should not be tolerated.