New Orleans When you go into a hospital or under a doctor’s care, you are literally putting your life in someone else’s hands. When you’re sick and walk into a hospital, most of us would like to feel better crossing the door, finally we are someplace where someone will know what to do and take care of us.
It’s a comforting thought, but talking to James Lieber about his recent book, Killer Care: How Medical Error Became America’s Third Largest Cause of Death, and What Can Be Done About It, on Wade’s World strips away any allusion you might enjoy on that score. The book subtitle has to almost be the longest ever, but it makes the main point quickly. After cancer and heart disease, medical error is our largest killer in the United States.
We’ve all heard about the mix-ups in hospitals where they operate on the wrong arm or amputate the wrong leg. Maybe you can’t escape human error, but how about reading the charts and using a marks-a-lot or something. Lieber says they have made huge progress on this score, but then he remarked that “only” 30 patients a week continued to be wrong footed in this way. As he talked, I quickly did the math, that’s more than 1500 deaths a year. Damn!
By now we’ve all heard the less than cheery warning to be careful going into a hospital because you can get sicker in there than on the outside. Largely they are talking about the various forms of staph infections that are part of a constant guerrilla war against patients in hospitals. All of which according to Lieber should be classified as medical error and all of which can be fairly easily corrected, though it takes accountability and care. Lieber argues that if the federal government’s Center for Disease Control recommendations were strictly followed, this could be shelved permanently, but, sadly, these are just guidelines rather than required or “standard” practice. Meanwhile he puts this number at 100,000 deaths per year.
When not writing Killer Care or pieces for Social Policy which excerpts a section in the current issue, Lieber is a civil rights lawyer based in Pittsburgh. I asked him why there’s not more litigation on medical error. I would have thought there would be lines miles long in front of courthouses around the country. Part of the problem is the difficulty of proving malpractice if such doctors and hospitals followed “standard” practice, which may be why good solid guidelines are not regulations. Lieber did remind everyone that they have the right when they go into a hospital to demand to see the history of the room which would allow them to find out if there has been a backlog of infection there so that they can move elsewhere. That’s worth remembering!
Some states have stepped up, and Lieber claimed some of the best protections are in Pennsylvania. That’s a long way for most of us to travel, but in the meantime, it might be worth reading Killer Care and pushing back on doctors and hospitals to “do no harm.”