A new study published in the British Medical Journal identifies medical error as the third leading cause of death in the United States (with 251,000 deaths per year), only behind heart disease (with 611,000 deaths per year) and cancer (with 585,000 deaths per year). The report estimates about 700 deaths per day due to medical error from a range of errors, including performing the wrong surgery, prescribing the wrong medication, patient transfers that never take place, orders that are never followed up on, allergies that forget to be checked, and many, many more.
In the U.S., the CDC (Center for Disease Control) is responsible for recording official causes of death but their reports don’t even allow medical error as an option. If someone dies from a heart attack caused by a medical error, the heart attack is what’s reported as the cause of death. The medical error is ignored as if it never happened.
And there is a real incentive for hospitals not to report medical errors even though they are happening all the time. They do this to avoid lawsuits and bad publicity – in other words, just to save money.
The report mentions how systems for catching and fixing errors are not in place throughout hospitals in the country. For example, whenever there is a plane crash, a detailed report is conducted, and then publicly shared so pilots and airline staff can understand the error and come up with new policies to avoid it in the future. In health care, however, similar errors are under-reported, and when they are, the findings are kept secret, again to avoid future legal issues and potential costs.
Overall, the report highlights the true cause of medical error in the U.S. – and that is the entire health care industry, whose primary concern is not patient care but is cutting costs, is revenue and profits. Medical workers, just like all workers, are going to make some mistakes. But the frequency of medical error has to do with the conditions that health care workers are working under.
The largest cost for hospitals is their labor costs. In hospitals, workers are chronically understaffed, just so the hospital can save money. And to do this, hospitals are run on skeleton crews. When staff quit, retire, or are laid off, they are rarely replaced. Part-time and on-call positions are usually all that ever show up. Ever-increasing numbers of tasks are forced onto workers without limits.
Under these conditions, administration pressures workers to cut all sorts of corners. Emergency rooms are overcrowded as patients are packed into the hallways. In the pharmacy, there’s rarely any time to double check prescriptions. In the laboratory, orders can get mixed up or skipped. On the hospital floors, staff is often scrambling trying to cover too many beds without enough help. Medical staff rarely have enough time to type up their reports, and often cram it in off the clock and without pay. The stress that medical workers are under is never ending. And under these conditions, all sorts of mistakes are guaranteed to happen all the time, and just become part of the job.
Of course medical errors could be reduced if staff had more time to do their work, if more staff was available to cross-check important procedures, if systems were in place to monitor and eliminate errors, if workers could simply work under safe, well-staffed working conditions. But that would mean the health care industry would have to dip into their precious profits. It would mean health care was not a business but a right guaranteed to all.
As shocking as this study’s findings are, ultimately they are the logical outcome when health care is treated like any other industry, when the goal is to cut costs and make as much profit as possible. But unlike some other industries, in health care, when profit is put above all else – it actually kills people.
