Poll: Should doctors apologize after a medical error?

One of the problems (not just with medicine) is that the law has made “responsibility” synonymous with “blame”, when they are not the same. Reponsibility is accepting that when you have the ability and resources to improve a situation, you should — no matter how the problem was created. When I look at my medical clinic’s web page, I see every page footnoted by “We take no responsibility…” Seems very wrong. Shouldn’t I be able to have some expectations that they will take responsibility?

On the patient side, I don’t like what lawyers (including risk management attorneys) and insurers have done to medicine any more than you. I can’t believe that doctors and patients together are powerless here.

Strange how repeating something enough times makes it a fact.

Lawyers and politicians have repeated the medical error estimates from IOM’s 1999 study so many times that even physicians accept as fact that almost 100,000 patients die from medical mistakes each year.

The truth is, we don’t have any reliable nationwide data on how many people die or are injured by medical errors.

According to the very studies that the IOM misused, injuries due to medical care has been decreasing – from a rate of 4.6 percent in 1976 California, to 3.7 percent in 1984 New York, to 2.9 percent in 1992 Colorado and Utah.

To be sure, it isn’t statistically valid to compare different regions like that, but it is precisely this misuse of statistics that allowed the IOM to overstate medical errors nationwide.

And they did so while ignoring the decreasing rates of injury over the years.

Physicians must continue to promote patient safety efforts because one medical error is too many. But physicians shouldn’t validate the misperception that patients are being harmed by mistakes in ever greater numbers.

If jury verdicts are any indication, few of the claims are due to mistakes, since 70% of them end in favor of the physician.

“If jury verdicts are any indication, few of the claims are due to mistakes, since 70% of them end in favor of the physician.”

I think you are guilty of selection bias here. The really egregious errors never come before a jury because they’re generally settled out of court. The cases that *do* end up before a jury tend to be more equivocal in nature – differing interpretations of medical judgment, parties who refuse to settle because they’re convinced they’re right, and so on.

It’s not really known how many people who’ve sustained a medical injury end up suing, but the best estimates available are that it’s fewer than 10 percent. It would be interesting to know why this is; is it because these patients/families haven’t been told the truth?

So no, jury verdicts are really not any indication; they are merely a tiny slice of the overall picture which you are inflating to suit your argument.

I really don’t know why you people continue to quibble over the IOM numbers. That’s like quibbling that The Gulag Archipelago grossly overstated the number of people that Stalin killed; it wasn’t 10 million, it was really 1 million, blah blah blah. Even if 25,000 or 10,000 patients die from preventable medical errors in the U.S. every year, that’s still way too many.

I’m trying to figure out why you claim, on the one hand, that we don’t have accurate data on how many patients are injured by errors each year… yet on the other hand the injury rate has been decreasing over the years. How do we know it’s decreasing if we don’t have accurate data?

Spoken like a true lawyer.

Every thing you do as a doctor can drastically affect someone’s life and you’re liable for all those effects. Patients can lie and not follow directions and if something goes wrong, they can sue. It’s not a big deal to lawyers, but I’m sure most of them haven’t been sued.

Anon 6:19. You were spot on when you pointed out that if something is repeated enough, it becomes fact. The 100,000 number is used so often people have forgotten that the landmark IOM study actually estimated “as many as 44,000 to 98,000 people die in hospitals each year as the result of medical errors.” It was much better from a media point of view to use the larger end and initially say “almost 100,000″ which morphed into simple parroting of the 100,000 commonly quoted. Of note, also, is the definition of error:
“The IOM emphasized that most of the medical errors are systems related and not attributable to individual negligence or misconduct.” So we are not really talking about malpractice usually or physician specific actions and thus blur who or whom should be making an apology if any. These points would unfortunately not generate nearly the reader interest so they were conveniently downplayed in many ways. The important point remains: research has shown that system improvements can reduce the error rates and improve the quality of health care.
That should continue to be our motivation.

Interesting since you say that since you can make the same argument with tort reform opponents

Medicine is not a exact science. It is not possible to be perfect in the management of disease. The patient ought to bear some risk. If a patient seeks treatment for a gall bladder stone and he is told that a cholecystectomy is the way to go, and that there are some risks inherent to the procedure – the procedure is done if he gives informed consent. If he sustains a CBD injury following the procedure, is that deemed a mistake or just hard luck? I would say that he entered the contract with eyes wide open and hence has to bear consequence of the risks he has taken. Similarly if a 28 week premature baby loses a limb due to a misplaced IV. as unfortunate as it seems, the child simply has to bear the risks of treatment.Only if the patient accepts these risks can the doctor begin treatment.