Medical Mistakes and Mortality Rates
“There’s a dangerous mindset in modern medicine that more is always better – more tests, more treatments, more surgeries. Well, it’s not,” explains E.R. physician Dr. Travis Stork. “In fact, you could unknowingly be putting yourself in harm’s way.”
Dr. Travis is joined by surgeon Martin Makary, M.D., M.P.H. to discuss the alarming mortality rates caused by medical mistakes. Dr. Makary served as the co-director of The Johns Hopkins Quality and Safety Research Group (QSRG), and details his findings in his book Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.
“This is such a difficult topic because I’ve talked so many times on this show about how proud I am of this profession, and I am, but let’s just face reality – not every single health care provider out there has the skill set to provide great care,” Dr. Travis says.
“People, essentially, are stuck walking in blind to a hospital. They don’t have the resources and tools to figure out what’s the best place to go to,” Dr. Makary says. “People are frustrated out there. We’ve got more information in choosing a restaurant than you do a hospital.”
Choosing the right hospital and the right doctor for the right procedure can be the difference between life and death. It’s estimated that between 195,000 and 250,000 deaths occur every year from preventable medical mistakes, making it the sixth-leading cause of death in the U.S.; however, some experts, Dr. Makary included, argue that medical mistakes are actually the third-leading cause, behind heart disease and cancer.
Dr. Travis adds that patients looking for a quick fix could unwittingly be supporting the practice of overtreatment.
“I honestly feel that we’ve become a little numb to the problem," Dr. Makary says. "If we thought of a jumbo jet crashing every day or every two days with patients that are dying from preventable medical mistakes, or medical errors that are unintentional but very harmful, we’d be shocked about this problem. For the first time ever now, there’s a movement of transparency in health care to call out this problem and try to make it better.”
• More on preventing a medical mistake.
The Institute of Medicine reports that up to 30 percent of all health care expenditures in the U.S., including high deductibles and insurance premiums, are unnecessary. To address health care costs, Dr. Makary suggests first looking at the common practice of overtreatment.
“We don’t want people to be suspicious of their doctors, but they should know that 30 percent of second opinions are different from first opinions,” Dr. Makary says.
Must-Do Actions before Electing Surgery
• Get a second or even a third opinion before determining your next course of action.
• Ask how many surgeries the doctor performs each year and whether the doctor will be performing your surgery.
• Ask if there is a less-invasive option.
• Inquire about the top risks of the operation.
• Ask how long you will be in the hospital and what the home recovery time will be.
• Ask what could happen if you choose to not have the surgery.
“We don’t want to scare people, but we want to equip you with knowledge, because not every procedure needs to be done, not every procedure is done the right way, but there are so many good ones being done out there, so many great procedures, necessary surgeries,” Dr. Travis says. “In the end, it’s getting a good opinion. That’s what it’s all about."
Health Care Quotas
Dr. Makary reveals that some doctors have incentives for seeing more patients and performing more operations to obtain a year-end bonus or meet criteria mandated in their contracts. Since this practice of health care quotas supports overtreatment, some hospitals elect to pay their doctors on a flat salary system instead.
“Health insurance used to be about giving patients access to doctors and hospitals, but now health insurance is more about giving providers access to patients,” Rosemary says.
Citizens for Patient Safety
Michael J. Skolnik was 22 years old when he was rushed to the hospital after suddenly seizing and losing consciousness while sitting on the couch in his family home. Doctors performed several tests, including a CT scan that showed a small, 3-mm dot on Michael’s brain. His parents, Patty and David, were informed that their son had a colloid cyst and immediate surgery was required.
Six-and-a-half hours later, after what the Skolniks claim they were told to be a routine operation, they received an update from the surgeon. The cyst was never found but the doctor reportedly performed “heavy manipulation of the brain.”
“Suddenly, we saw Michael had had a craniotomy and we were both in disbelief,” Patty says.
Michael suffered permanent brain damage that left him partially paralyzed. His verbal skills were also dramatically impacted. Despite further procedures to fix his condition, Michael passed away at the age of 25, approximately three years after the initial incident.
“It still stops my breath, because there are just some days I can’t believe he’s not going to walk through that door. How could we have not asked the questions?” Patty says. “How could we so blindly – two intelligent, educated people – so blindly, humbly nod our heads saying yes? The pain that he couldn’t speak or tell us… we never asked.”
Patty joins the show to further discuss her son’s untimely death and what measures she’s taking to prevent a similar tragedy from befalling another family.
“Michael’s case was unusual in the fact that it was 32 months long. He went from a 6-foot-4-inch nursing student to a 6-foot-4-inch young man that could do nothing, I guess an infant, I would say. Our promise to him before he died would be that we would leave the medical industry better than he found it, because he loved it,” Patty says.
Since Michael’s death, Patty founded Citizens for Patient Safety, an organization committed to promoting the safe health care of patients through advocacy, education and systemic change while working with health professionals and medical institutions. The Michael Skolnik Medical Transparency Act was signed into law in 2007, making malpractice judgments in the state of Colorado part of the public record.
“Just like people can go [online] to find out about their car, you should be able to go on your health board of examiners and find out about your health professional,” Patty says. “You’ll be able to look up their background – what are the good things, what do they specialize in, if they’ve had disciplinary action and so forth, and if their medical malpractice insurance has ever been denied, which is the biggest.
One of the things we do that will help with all of this is we train consumers – hospital-sponsored training. We do a six-hour workshop to tell consumers what are the questions to ask, how you can be part of the health care team, how you can be an extra set of hands for the nursing staff that does not have enough help,” Patty adds.
Online Doctor Ratings
The Doctors and Dr. Makary discuss whether online doctor ratings should be the deciding factor when it comes to selecting a particular physician or hospital over another.
“The hospital performance is a great level for transparency and accountability,” Dr. Makary says. “We’ve got to empower people who want to find good care and use good information.”
Dr. Makary recommends consumerreportshealth.org and hospitalcompare.hhs.com as valid and informative online sources for learning more about a specific hospital or doctor.
Choosing the Right Doctor
Plastic surgeon Dr. Andrew Ordon explains the difference between a plastic surgeon and a cosmetic surgeon and why board certification is so important. Plus, pediatrician Dr. Jim Sears offers advice on choosing a doctor for your child.
“We’re all physicians up here, but not one of us knows everything there is to know in health care,” Dr. Travis says. “We should be collaborative, we should have this transparency, we should have this openness.”
“When somebody knows their limits, when somebody says [to] get a second opinion, when somebody is honest and is listening to you, those are the doctors you want to latch onto,” Dr. Makary adds.
• Celebrity chef and bestselling author Rocco DiSpirito's Ginger Lassie Smoothie.
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