Medical Mistakes

A recent study¹ conducted by Louis Harris & Associates (LHA) for the National Patient Safety Foundation at the AMA has uncovered the extent of medical mistakes in the United States. LHA conducted telephone interviews with 1,513 adults (age 18 and older) on "patient safety issues in the health care environment." The response rate provided the study with a confidence level of 95 percent.

Perhaps the most interesting findings came under the heading of "personal experiences with medical mistakes:"

"More than two out of five respondents (42%) have been involved, either personally or through a friend or relative, in a situation where a medical mistake was made."

That percentage equates to over 81 million people in the U.S. who have experienced a medical mistake either directly or have been affected indirectly. Of those 81 million adults, almost 27 million (33%) experienced the medical mistake themselves. The remainder 67% experienced the unfortunate event through a relative or close friend.

Worse yet, over 34 million (42%) of those 81 million have been involved in more than one medical mistake:

How many times have you been personally involved in a situation where a medical mistake was made?

Once	56%
Two to three times	34%
Four to five	4%
More than five times	4%
Don't know	2%

The "what?" and "where?" of these medical mishaps was somewhat of a surprise. The most prevalent type of medical mistake was a misdiagnosis or wrong treatment. The most likely place for the mistakes to happen was in a hospital (48% of medical mistakes) rather than in a nursing home:

What type of a mistake was made?

Misdiagnosis/wrong treatment	40%
Medication error	28%
A mistake during a medical procedure	22%
Administrative error	4%
Communication error	2%
Inaccurate lab results	2%
Equipment malfunction	1%
Other	7%
Don't know	1%

In what setting did the mistake take place?

Hospital	48%
Doctor's office	22%
Operating room	7%
Clinic	5%
Emergency room	5%
Pharmacy	4%
Home	3%
Medical lab	1%
Nursing home	1%
Other	5%
Don't know	1%

What was done about the mistake is even more revealing. Much of the time (38%) the answer was "nothing." But in 6% of the cases, there are lawsuits pending (nearly five million):

What was done about the mistake?

Response	Mentioned By
Nothing	38%
Changed/corrected medication	14%
Changed doctor/hospital	10%
Mistake corrected itself	9%
Required surgery	6%
Lawsuit pending	6%
New tests/treatment/correct diagnosis	6%
Health care professional lost/suspended from job	1%
Other	8%
Don't know	2%

The factors leading to the mistakes and their potential prevention were not surprising. Carelessness and negligence were the reasons most often cited for the mishaps. More conscientiousness on the part of the caregivers was considered the best way to avoid these mistakes:

What factors do you think could have led to the mistake?

Response	Mentioned By
Carelessness/negligence	29%
Improper training/incompetence	14%
Communication/lack of communication	12%
Misdiagnosis	8%
Inadequate evaluation/testing	8%
Staff overworked/hurried/stressed/understaffed	8%
Misread RX/pharmacy error	6%
Other	14%
None	6%
Don't know	8%

How could this mistake have been prevented?

Response	Mentioned By
Caregiver more conscientious/thorough	27%
Better qualified caregivers	17%
Listen to patient/work with patient	13%
Check medications/prescribe more carefully	7%
Offer/get second opinion	7%
More/better testing	6%
Improved communication	4%
Surgery more accurate/no unnecessary surgery	4%
Nothing could have prevented	6%
Other	5%
Don't know	8%

The cost of these mistakes on the physical, emotional and financial well-being of patients is quite high:

"Regarding (your/the patients') physical health, emotional health, and financial situation, did the mistake have a short-term, long-term, or permanent effect, or did it have no effect?"

Statement	Short Term	Long Term	Permanent	No Effect	Don't Know
Physical health	32%	13%	32%	20%	2%
Emotional health	28%	22%	26%	22%	2%
Financial situation	19%	15%	13%	50%	3%

It isn't hard to get the message, when the data speaks this loud.

With over 81 million adults experiencing some form of medical mistake, the public is learning the hazards of medical care first hand, many of them more than once. The hospitals are the most frightening, accounting for almost half of all medical mishaps.

Over 36 million people (45%) experienced some kind of permanent or long-term effects to their physical health from medical mistakes. Almost 39 million (48%) experienced some kind of permanent or long-term emotional trauma. And the financial health of over 22 million (28%) was affected either permanently or over a long period of time.

Of the factors attributing to the steady erosion of medicine's cultural authority in the United States, medical mistakes would have to rank highest. With literally two out of every five adults experiencing the physical, emotional and financial trauma of a medical mistake, there is a real fear for many people about medical providers and hospitals.

The severity of the treatment offered added to the apparent acceptance by patients of certain percentage of side-effects, poor results, failed surgery syndromes, etc., leaves medicine as a viable choice only in times of the most serious injury or illness.

With medicine holding the high ground on disaster care, it seems to leave the wellness territory open. This may explain why so many MDs are moving toward holistic approaches. As the public becomes increasingly educated by medical mistakes, conservative chiropractic will continue to be more attractive.

Reference

1. Public Opinion of Patient Safety Issues Research Findings. National Patient Safety Foundation at the AMA. September, 1997.