Medical Errors and the Cult of Expertise in the Age of CovidTags Health
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Ever since the covid panic began in February of this year, medical personnel such as doctors and nurses have been treated to a level of hero worship generally reserved for the government's soldiers and cops. We were told they were heroically slaving away to treat covid victims. And although many of these nurses were apparently spending their time choreographing TikTok videos and dancing in hospital hallways, we were assured by government officials and their obedient allies in the media that medical staffers are the new model for self-sacrifice and civic virtue.
Yet in the two decades leading up to 2020, researchers were repeatedly alarmed by the extent to which medical errors were a persistent problem in American clinics and hospitals. Beginning at least as early as 1999, an increasing number of studies suggested that perhaps nearly a hundred thousand patients per year were dying due to medical errors.
Numerous articles appeared in mass media outlets suggesting that medical training was insufficient, that systems devised by hospitals were error prone, and that malpractice was not as rare as doctors would have us believe.
Not surprisingly, politics also intervened. Many outlets took the apparent prevalence of medical errors to prove that more government regulation and government funding were necessary. Others noted problems in how government agencies count deaths.
But then the covid panic happened. Not surprisingly, concerns over medical competence have receded into the background, and medical personnel have instead been treated to a status of near apotheosis, with the opinion of every run-of-the-mill nurse or physician on everything from racism to "essential businesses" being of the utmost gravity.
Moreover, with a focus on the maximization of counting covid deaths, it is likely we'll see fewer deaths due to medical errors in official counts. And lobbying groups devoted to representing doctors and nurses are likely to use the current political situation to their own advantage. As has long been the case with police and soldiers, the medical profession is pressing the "never question us, we're experts" line. The actual record, however, suggests the level of "expertise" ought to receive more scrutiny.
How Many Deaths Are Caused by Medical Errors?
After years of growing discussion on the topic, Johns Hopkins University in 2016 released a study concluding that “medical errors” were the third leading cause of death:
Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S. Their figure, published May 3 in The BMJ, surpasses the U.S. Centers for Disease Control and Prevention’s (CDC’s) third leading cause of death — respiratory disease, which kills close to 150,000 people per year.
A death caused by a medical error is defined as a death caused by poorly skilled staff, errors in judgment, a preventable adverse effect, or systemic problems such as computer malfunctions or mix-ups over medication.
The Hopkins study concluded that the methods of reporting deaths in the United States are inadequate to account for the full role of medical errors.
The Hopkins statistic was widely reported in the media, such as in this 2018 article at MSNBC. MSNBC even notes that other studies have reported medical errors as the cause of over four hundred thousand deaths per year.
Closer to 100,000 per Year?
Since then, some researchers have expressed dismay and disbelief over the notion that deaths caused by medical errors could be so numerous. For example, researcher and medical doctor David Gorski insists that many who believe the Hopkins number of 250,000 are no better than “quacks.”
Gorski suggests that only fifty-two hundred deaths per year result from medical errors. But in this Gorski relies on a very narrow definition of medical errors as the overwhelming and obvious cause of death. He nonetheless admits that more than 108,000 deaths per year are cases in which “adverse effects of medical treatment” (i.e., medical errors) are “contributory.”
Gorski’s number of fifty-two hundred is likely little more than wishful thinking. While 250,000 may be on the high end, it’s unlikely medical errors are nearly as rare as Gorski hopes.
In this study published in 2020 at the National Institutes of Health, for example, the authors take for granted that “[m]edical errors in hospitals and clinics result in approximately 100,000 people dying each year.”
And it is also widely assumed, as noted in this study by the Washington Medical Commission that “Medical errors remain vastly underreported.” After all, medical personnel are often reluctant to report errors so as to avoid potential legal problems or sanctions from supervisors.
But while some doctors insist they're being unfairly targeted, others have been sounding the alarm for years. Today, a commonly accepted number is between one hundred thousand and two hundred thousand deaths per year.1
These are not small numbers. A total of one hundred thousand medical-error deaths makes medical errors among the top cause of deaths. If the current covid-19 pandemic plays out like previous pandemics, the total number of deaths will be much lower in 2021 than 2020's official total of approximately 350,000. But deaths due to medical errors will continue to number around a hundred thousand year after year after year.
Covid and Medical Errors
Gorski slams the practice in which cases where medical errors were only contributing factors in deaths are potentially counted as deaths due to medical errors. The debate has long been over how much medical errors must contribute to death before they are reasonably counted as the cause of death.
In 2020, however, look for the final tally to show that counting medical errors has been swept aside in the mortality documentation in favor of attributing more deaths to covid-19.
After all, it is now common practice to count any death in which covid-19 was a contributing factor as a death due to covid. That is, anyone who dies “with covid” is reported to be a death caused by covid.
A nurse gave a covid patient the wrong medication, which led to a severe adverse reaction? That’s a covid death. A doctor mixed up two covid patients and administered inappropriate treatment to both? That’s two covid deaths right there.
In other words, unless steps are taken to ensure accurate recording somewhere, if covid deaths are being overreported, we can expect medical-error deaths to be underreported.
Seizing a Political Advantage
Meanwhile, trying to take advantage of the current goodwill showered on medical personnel, many medical professionals are seeking additional legal protections from malpractice suits. Reuters reports:
State chapters of the powerful American Medical Association and other groups representing healthcare providers have been pressing governors for legal cover….More than half a dozen emergency room doctors and nurses told Reuters they are concerned about liability as they anticipate rationing care or performing unfamiliar jobs due to staff and equipment shortages caused by the outbreak.
Yet, there is no reason to assume covid treatments will make doctors and nurses easy targets. States already have standards in place which require plaintiffs to show that medical personnel “negligently deviated from the reasonable standard of care.” The fact that a doctor made a mistake is not enough to make a malpractice lawsuit successful.
Thus, some attorneys who represent victims of medical error and negligence worry that covid will be used as an excuse to further shield healthcare workers from legitimate lawsuits:
Joe Belluck, a New York lawyer who brings medical malpractice cases, said he’s concerned the coronavirus crisis could be used to enact a wish list of changes sought by doctors, hospitals and the medical industry to curb unrelated lawsuits.
Given the way that medical personnel have been treated by media and government personnel in the age of covid-19, it’s not hard to see how this current state of hero worship could be employed to ram through legislation favored by longtime rent-seeking special interest groups like the AMA.