US Doctors killed 251,000 people last year according to John Hopkins

[I Push Buttons]

Yep, I've got a friend that's an ER nurse, and he says that he was recently told to stop calling them "patients", and start calling them "customers". They're moving toward a corporate-style pipeline where they stage you in a waiting room, get you into a bed in the ER as fast as possible, evaluate you, prescribe/administer medication, and then get you out as fast as possible.

And that's just the ER.

Anecdotes are pretty bad man.

A year ago I had a really bad skin reaction to something I came in contact with, it got progressively worse and worse so I went to an ER. Everything was pretty chill... No rush or any of that, literally took a nap in my private ER room while I waited for my test results (and because they dosed me with some pretty heavy pain meds). A few hours later they admitted me, once again a private room, spent the night while they gave me a bunch of IVs and monitored everything. Left the next day. This was all at a hospital in the middle of a big city.

Granted I did get a bill a week later for $21,000, but that is beside the point... Your friends story is hardly representative of ERs everywhere.

[Hiricine]

Yep, I've got a friend that's an ER nurse, and he says that he was recently told to stop calling them "patients", and start calling them "customers". They're moving toward a corporate-style pipeline where they stage you in a waiting room, get you into a bed in the ER as fast as possible, evaluate you, prescribe/administer medication, and then get you out as fast as possible.

And that's just the ER.

The ER is quickly becoming smoke and mirrors as well. The big money in healthcare is now in outpatient immediate care clinics, because you can treat patients without having to accept the ED baggage of uninsured patients and drunks/homeless/psychiatric emergencies (did you know that the vast majority of hospitals don't even admit psychiatric patients and basically act as a holding cell until a facility accepts a transfer of the patient, often days later?). The ERs themselves are prioritizing low-acuity patients (minor falls, minor lacerations, colds) by opening up fast track areas that can see large volumes of low acuity patients that skew wait time numbers while making patients with more severe illnesses wait longer.

Not to mention, as far as the "corporate" side of things go, patient satisfaction is tied to compensation, and higher patient satisfaction has actually been linked to HIGHER mortality rates.

[Masark]

No one has ever said that.

Really? I hear it pretty much non-stop from right-wing posters whenever healthcare reform gets brought up. A constant litany of "Everyone in the world comes to us for treatment!" and related horn tooting used as "evidence" for why no reform should be undertaken.

[Darsithis]

I hate to crap on myself here, but as a working nurse I can tell you that nurses are paid higher for their level of education, per hour than 80-90% of bachelor's degrees (which many jobs don't even require as a nurse), and the 12 hour shifts are mostly a side effect of a female dominated profession where women want to work 3 days so they can take care of their kids at home, which is simple a rationale for why it happens not a criticism. I'd actually argue that nurses earn their keep if not more, but if you compare them to other professions they generally have a job that allows them to be physically active and flexible enough to work at a multitude of locations across the country within a very short period of time.

That's good to hear, because the general perception I've always heard is that nursing, ER, and ward staff are perpetually overworked and underpaid.

Anyways this information (in the OP) is very deceptive, while important. Its not like 26 year olds with no medical history show up, have a medical error performed on them, and then die shortly afterwards (which does happen but not frequently at all). The patients that are dying from medical errors,while not an excuse for the errors, are generally patients with very complex and difficult medical histories, often noncompliant with medication regimens and many times have a medical error attributed to a death by a disease that was not being treated adequately as compared to a death as a direct result of said error. For example, if you have a heart attack, but en route and at the hospital by an act of overt negligence an ECG is not performed and staff fail to identify the heart attack and treat it rapidly, the heart attack kills you, but may be identified as a death due to medical error.

Yeah, no doubt there are plenty of complex patients who are lost due to both mistakes and their own negligence. I'd say, though, that there are plenty of cases where people are killed simply by being given the medication meant for another or not even receiving any at all.

[Canpinter]

There are two issues here:
1. What is this as a percentage of the entire number of medical interventions - that's the figure that really counts. I couldn't find it with any quick search.
2. How do you distinguish a mistake, from a choice made. If there are two paths to follow, and only one can be taken - then one can't count that as doing something wrong if it fails - it is just the way medicine works at this point. That is - the definition of 'medical error' is way too subjective to be discussed as just a number.

good points
another to consider is lets say i have disease A that will kill me without a constant medication, doctors give me the medication and i satay alive for years. then one day the wrong pills get put into my bottle and i die off my disease, do you count that as a medical mistake or me dying of my disease?

[Darsithis]

Anecdotes are pretty bad man.

A year ago I had a really bad skin reaction to something I came in contact with, it got progressively worse and worse so I went to an ER. Everything was pretty chill... No rush or any of that, literally took a nap in my private ER room while I waited for my test results (and because they dosed me with some pretty heavy pain meds). A few hours later they admitted me, once again a private room, spent the night while they gave me a bunch of IVs and monitored everything. Left the next day. This was all at a hospital in the middle of a big city.

Granted I did get a bill a week later for $21,000, but that is beside the point... Your friends story is hardly representative of ERs everywhere.

There is always going to be exceptions, of course. I've never experienced that (Annoying's post) at the ER myself but I readily believe it happens.

[Yvaelle]

We don't pay them peanuts though... Specialists make upwards of $300,000-$500,000 annually average depending on the specialty, which is up in "the 1%" range... The only "poorly paid" doctors are like general practitioners and even they make $150,000 average, which still places them well within the top 10% of income.

Doctors make a lot of money relative to many other professions, true - but:
- ER doctors are often some of the lowest paid in the profession, yet have some of the highest risk for malpractice (which are both incentives for the best/brightest to not take this role)
- ER doctors are often expected to work hours similar (or sometimes worse!) than their nurses, despite having an even greater burden of risk
- The highest paid doctor specialties in the US are often non-invasive subject matter experts, like Dermatologists, Urologists, Oncologists, Pediatricians, Gerontologists, etc. ER Doctors and Surgeons are typically the lowest paid, with the worst hours and benefits - yet often bear the great risk to their patients.
- Hospital administrators often make far more than their best paid doctors, despite being secretaries with fancy hats
- the entire US health insurance industry is unnecessary overhead

And lastly:

- the problem for nurses is in part due to low wages, and part mental exhaustion
- the problem for doctors is especially mental exhaustion, working people long hours also puts a lot of social pressures on people (problems at home, struggling to find a nanny to raise your kids, loneliness, etc) so throwing money at doctors beyond what they need to live a comfortable life doesn't resolve the problems of long hours.

I think the accident problem goes hand-in-hand with the litigious atmosphere of the US. Are the accidents because the care is worse or are there more accidents because people see an opportunity for a lawsuit and bring out otherwise frivolous lawsuits?

This stat is likely ignoring frivolous lawsuits, which is a whole different layer of challenge unique to the US system.

- - - Updated - - -

It's not just total hours, it's total patients. It's one thing to work 16 hours on a critical patient, it's another to work 16 hours on 200 different people and keep it all straight in your head. The 200 is probably exaggerated, but my point is made.

^ Also a really good point about the unique burdens we put on ER doctors and general surgeons.

[hrugner]

Folks, this guess work study is meant to highlight the need for better reporting and a requirement that medical error be public rather than private.

"We calculated a mean rate of death from medical error of 251 454 a year using the studies reported since the 1999 IOM report and extrapolating to the total number of US hospital admissions in 2013."

Yes, a four year range of medical deaths in North Carolina ending three years ago was used to project current medical deaths. So how good are NC hospitals? The answer, not very. They were placed just above the bottom quarter, though really high for the south who make up the entire bottom quarter.

I've linked below the "study" this article references.
http://www.bmj.com/content/353/bmj.i2139

WP can eat it. Always look at their sources, their writers are awful people.

[Hiricine]

That's good to hear, because the general perception I've always heard is that nursing, ER, and ward staff are perpetually overworked and underpaid.

To say that there AREN'T people that are underpaid would be silly, but compare the compensation to like-educated people and you'll find that theres more than parity there. Overworked could be argued, its more like overburdened. I'd consider it being overworked if you were forced to work more hours than you were comfortable with. Its more like you often have more work to do at a point in time than you can possibly complete, so you have to prioritize or put things off. I'd argue if you're working a job and you have frequent downtime you're probably being underworked, seeing as how you're being paid to be there.

Yeah, no doubt there are plenty of complex patients who are lost due to both mistakes and their own negligence. I'd say, though, that there are plenty of cases where people are killed simply by being given the medication meant for another or not even receiving any at all.

I don't think we're going to see a lot of disagreement here. I think one of the points I was trying to make is that if you have a .001% chance of having a medical error performed on you per encounter, and then you go to an emergency room and get admitted for chronic health problems 42 times in a year, the odds of you having said error performed on you are much higher even though your life expectancy probably wasn't much longer to begin with. A 105 year old with dementia dying from a medical error on visit 152 isn't as concerning as a 6 year old with no medical history dying from an error on their first visit, though the stats don't break that down.

[Annoying]

There is always going to be exceptions, of course. I've never experienced that (Annoying's post) at the ER myself but I readily believe it happens.

There are plenty of articles and op-eds done by ER staff in this country proclaiming "My patients aren't my customers" and such. A pretty large amount of them, too. Managing companies, books, and articles on the topic as well. I can't say as to how far it's been adopted, but it's real, and a chunk of hospitals act that way.

[Cthulhu 2020]

I think the accident problem goes hand-in-hand with the litigious atmosphere of the US. Are the accidents because the care is worse or are there more accidents because people see an opportunity for a lawsuit and bring out otherwise frivolous lawsuits?

Well consider the OP, that the US is leading in deaths due to accidents, and it doesn't seem like it's because of lawsuits.

[Sargerasraider]

I apologize for having not read the entire thread, so I am sorry if some of these points have come up.

First of all, we have far to go in eliminating possible medical errors. There have been large strides made in decreasing complications / death due to catheter based infections, ventilator pneumonia, venous thromboembolism, etc. - all common contributors to iatrogenic death - in recent years. Most hospitals now have standardized protocols (which did not occur before in many places) and standard safety practices to avoid issues like this, and other issues (wrong patient / medication / site issues). This being said, there is room to improve and this has to happen.

On the other hand, a couple of points (before people decide to run screaming from the nearest hospital)

1) The title of this thread is wildly hyperbolic. Saying that "doctors kill people" goes well beyond any reasonable normal discourse. As noted, most of these errors described are due to complications arising from treatment in very complex patients. You can't die from a central line infection or ventilator assisted pneumonia if you didn't need a central line or ventilator to begin with. As people survive longer with more and more medical problems, the complication rate for procedures needed for those medical problems will increase as a matter of course. Procedures are more risky in complicated patients and iatrogenic issues will increase.

2) Related to above. Death from medical complications in previously healthy people is exceedingly uncommon. Most of these issues happen in very sick individuals, many of whom would not survive anyway. Wrong patient / wrong procedure / wrong medication / wrong site issues happen, but are very rare.

3) This "study" is simply an extrapolation of old data. It does not actually quantify recent numbers at all. As noted, there has been a big push nationally to reduce complications associated with common procedures / management, and if this data is old, this will not be taken into account (but it uses recent admission data as a part of its extrapolation). I am very surprised that something like this made it through any reasonable peer review.

All in all, medical errors are problems and I would never dispute that this is the case. However, the medical community takes this problem seriously and has made big strides in recent years. Unfortunately, none of this is captured in a poorly designed study which seems to be written more to generate headlines than anything else.

[Kasierith]

It's not just total hours, it's total patients. It's one thing to work 16 hours on a critical patient, it's another to work 16 hours on 200 different people and keep it all straight in your head. The 200 is probably exaggerated, but my point is made.

Is it? I had a day once where I filled 85 CII prescriptions in a 13 hour day. This does not include the hundreds of normal medications... just narcotics and ADHD. Each one requiring a full OARRS check (because god forbid someone in the ER has a computer up to check to see if Mary Sue got 50 vicodin just yesterday), checking for interactions, and considering whether or not to fill. Keeping in mind also that that 85 does not include refused scripts. And this is mostly because if you stood on the roof of where I work, you could see 5 dentist office with oral surgery capacity, two hospice outlets, outpatient orthopedic surgery care, outpatient post op general care, two pain specialists, an entire little village based on palliative care, and a big ass hospital that sees so many people that a 6 hour wait time is, according to regulars there, a pretty fast night.

As for bulk without just narcotics, the most scripts I've filled in a single day was 584.