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Considering that currently about 1 in 3 Americans die from mistakes made by doctors, limiting their independence might not be such a bad thing.

[1] http://www.ourcivilisation.com/medicine/usamed/deaths.htm



No offense Alex3917, but really - Philip Atkinson is your authoritative source?? Not sure why this is getting upvoted. Quote from his site, re: his experiences growing up -

"Everything about us was different, and we were naturally resented. While the neighbouring [sic] adults never confronted my father, their children were delighted to bully his children. My siblings and myself became social half-castes, accepted by no class and despised by all. The result in my case was an initial bitter resentment of my community, along with the traditional notions that I should pursue a university education then a career; so I dropped out of school to take a job as a bus conductor...

With determination, skill and a little luck I forged a career in computers before being forced into retirement in 1991...

Of course I could have restarted the education that I abandoned in my teens, but by then the true nature of universities had become obvious; they were no longer centres of learning pursuing truth but centres of profit pursuing customers. Inevitably striving for popularity with youth has made universities bastions of Political Correctness, and full of the kind of people who wanted to burn Galileo for daring to question that the sun circled the earth. So I spent my enforced idleness applying the skills acquired as a system's analyst to discover why my society is disintegrating into delusion and impotence...

In January 2000 I became an Internet publisher, placing a variety of books 'online' at my own expense, in an attempt to preserve some of the vanishing wisdom of humanity...

Indeed I am the first philosopher to realise that philosophy is the study of understanding."

Hmmm...


Errors and mishaps pose a substantial risk to hospitalized patients. Iatrogenic injuries affect as many as 18% of patients admitted to hospitals in the United States, at a cost estimated to exceed $100 billion per year.

Weingart SN, Ship AN, Aronson MD (2000). "Confidential clinician-reported surveillance of adverse events among medical inpatients". J Gen Intern Med 15 (7): 470–7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495482/?tool=pm...


This seems a more appropriate response to Alex3917's "at least question the journal articles" bit, as it supports phunel's point fairly well I think.

The "as many as 18%", "admitted to hospitals" and "Iatrogenic injuries" bits make this article say something dramatically different than "1 in 3 of all Americans (not just those hospitalized) die because of an error made by a physician".


There is actually a new study that just came out that the NY Times cited a week ago: http://www.nytimes.com/2010/11/25/health/research/25patient....

Even still that doesn't have much relevance to the 1 in 3 claim, because most people go to the doctors more than once in their life.


It wasn't meant solely as a response to Alex3917, I just thought it might be useful to add something actually from a peer reviewed journal to the discussion :)


You thought right, it was a great find; thanks :)


If you're going to question the source then at least question the actual journal articles instead of just ad homineming the guy citing them. They're all from respectable sources like JAMA.


A third of all Americans dying of medical malpractice is simply a fairly bold claim.

Again, no offense - please feel free to quote the JAMA article itself that supports this. Atkinson does a bit more than simply cite actual journal articles, he's taking, to put it lightly, some liberties with information he compiles and personally interprets at will.


"A third of all Americans dying of medical malpractice is simply a fairly bold claim."

Not really because because most people only die after 4 or 5 things go wrong, which means that the causes of death sum to way over 100. E.g. close to 1 in 3 Americans die from drug use, and 7 out of 10 Americans die from chronic illness. But the way it works is that first someone will start smoking (drug use), which then causes chronic obstructive pulmonary disease (chronic illness), and then they will go to the hospital get MRSA because the doctor didn't wash his hands (iatrogenic death).

In Malcolm Gladwell's book Outliers there is a whole chapter on planes that is actually very similar, in that usually 4 or 5 small mistakes have to be made to actually cause a crash.


How do you figure, even assuming these figures are (still) accurate (many of them are 10-20 years old)? By my reading, "mistakes made by doctors" applies to the "Medical Errors" row in the table at the top of that page. 98,000 deaths per year is horrible, but it's about 0.0319% of Americans. Granted, that's per year; let's assume you have a 0.03% chance of being killed by "Medical Error" every year of your life: with an average lifespan of 80 years, your odds of being killed by "Medical Error" are 1-(.99968^80) = 2.5%.

Now, there are two caveats, other than the (necessarily) very rough nature of the above calculation. First, you may believe that some of the other categories in that row are also things that would be reduced by reducing doctor independence. "Unnecessary procedures" seems like a reasonable candidate for this, though I would assume that since Medical Error is its own category that it tries to be fairly inclusive. Second, you may believe a different number for medical error itself:

"We could have an even higher death rate by using Dr. Lucien Leape's 1997 medical and drug error rate of 3 million. (14) Multiplied by the fatality rate of 14 percent (that Leape used in 1994 (16) we arrive at an annual death rate of 420,000 for drug errors and medical errors combined. If we put this number in place of Lazorou's 106,000 drug errors and the Institute of Medicine's (IOM) 98,000 medical errors, we could add another 216,000 deaths making a total of 999,936 deaths annually."

Side note: Is it just me, or does the author sound hopeful that we might be able to add to the death toll?

If you believe that 420,000 number (about 4x higher than what's in the table), that'd be about 10%.

Did you get "1 in 3" by attributing all iatrogenic deaths to doctor error?


"Did you get '1 in 3' by attributing all iatrogenic deaths to doctor error?"

Yes, because despite the fact that there is a category called medical errors, almost all of the other deaths listed are medical errors as well. It's not like there is really any legitimate reason for more than a trivial amount of people to get MRSA in a hospital seeing as when best practices are followed the rate of line infections goes from 4% to 0%.

"How do you figure, even assuming these figures are (still) accurate (many of them are 10-20 years old)?"

The NY Times just published an article a week ago saying the rate of medical errors hasn't gotten any better, which I linked to below.


Patients getting infected because somebody didn't wash their hands is an abomination, we can agree on that.

This thread was originally about decision-making power being shifted from doctors (M.D.s) to insurance companies, administrators, regulators, laywers, and even patients themselves. Your first comment suggested that this is a good thing because those same M.D.s kill 1/3 of all Americans (and as a corollary, the other parties involved plus the other healthcare providers that outnumber M.D.s many-to-one kill nobody).

I think it's pretty suspect that the linked page cherry-picks its numbers, rather than trying to assemble them all from a single source which has taken some care not to double-count. Granted, such a source may not exist, but essentially the death toll for each cause X is taken from a paper which is trying to make a big deal out of X.

The fact that those numbers sound fishy is orthogonal to the fact that I don't think they would be any better if the power to make treatment decisions is taken from those best equipped to make it.

And all of that is orthogonal to the fact that the linked page does not even attempt to show this, so it doesn't really seem to support the point you were making with that citation.




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