Yes, wrong-site surgery is almost always malpractice, and a bad thing. But your “30%” figure isn’t just talking about wrong-site surgery, it’s talking about young pregnant women who fail to see an obstetrician–a problem caused by the current malpractice regime, rather than solved by it. This is the third time I’ve pointed this out, and you continue to fail to acknowledge my argument, much less refute it.

Do I know anyone who was adversely affected by a preventable medical error? Yes: I was, in 2003. Arguably also in 2004.

Lee, I’ve done you the courtesy of reading what you have to say about malpractice. Before you start throwing talking points at me, at least read what I have to say. You don’t even seem to have read in full the comments where I respond to you.

Are the million and a half medication errors that kill or injure patients each year preventable errors? Malpractice?

Have you read the IOM reports?

I agree that the report that Bruce Japsen cited did not lay out all the detailed reasoning for the conclusion. That hardly makes it a made up stastic.

Do you think the IHI’s estimate is a made up statistic?

Do you know anyone who has been injured by a preventable medical error?

There was an article published in the past few days by the Anesthesia Closed Claims project documenting significant percentages of meritous claims.

I contine to invite anyone to work with me to eliminate medical errors.

best

Lee

As regular readers know, Overlawyered has not hesitated to criticize large business groups, or even other legal reformers, when those groups are incorrect.

Are there readily preventable medical errors? That’s very likely true; IHI proposes reasonable medical reforms, though it plainly exaggerates the impact of those reforms. The point is that the current medical malpractice liability system interferes with medical practice more than it deters medical malpractice.

There are plenty of other groups with similar statistics. However, read through the 94 page report with 192 footnotes. It is a carefully reasoned report by the Midwest Business Group on Health. Here are there members:

http://www.mbgh.org/index.php?t=become/Members&

These are large business groups.
This is not a group of trial lawyers. I wonder if any of these groups are supporters of this website. No time to check now.

How about the recent figure from the Institute for Healthcare Improvement of 40 to 50 injurious errors per 100 hospitalizations?

“To estimate the costs of poor quality that are cited in this report, the authors primarily relied on a review of published literature and the experiences of Juran Institute hospital clients
from 1987 to 2000. Some estimates of the costs of poor quality are based on extrapolations
from single-institution studies to the employed population or the general population. The opinions of knowledgeable experts were used to provide a reality check. Also, this report benefited from the input of a national panel of well-respected experts drawn from both the health care and the business community.”

In other words, they made it up.

More importantly, only a small fraction of that 30% figure reflects alleged medical malpractice, as opposed to “medical errors” such as patient failure to obtain appropriate preventative care–medical errors that, as I noted in the original post, are exacerbated by the current medical malpractice regime.

For the sake of argument, I will grant that assumption.

“Poor care costs more than good care.”

You are assuming that good care comes FREE by simply not making any mor errors.

My point was that getting rid of those errors, in and of itself, will take resources.

It is certainly possible that PROPERLY APPLIED resources could cause a net gain (more resources saved in prevented errors than spent in preventing them) – in fact, it is likely to be the case right now.

But that only goes so far – there comes a point where the resources dedicated to preventing the last %x of errors is greater than the cost of those errors.

I make no statement that we are there now; that’s not the point. The point is that error prevention is NOT FREE. We CAN NOT POSSIBLY save every bit of the resources currently wasted by medical errors, as it takes resources to PREVENT errors.

Net gain? Possible. Saving the full 30% (according to you)? IMPOSSIBLE. Until that trade-off is acknowledged and some numbers put to it, all the screams about the costs of medical errors are one-sided and significantly dishonest.

William Nusslein,

ALL REAL ERRORS ARE BAD. “Mal-practice claims” does not equal “real errors” (as you yourslf pointed out). “Most errors are concocted to get money” means that the mal-practice system is bad at finding real errors (as opposed to concocted ones), but REAL errors are ALL bad.

I agree completely with Lee that errors are bad. I am trying to get him to se that wasting resources is also bad, and in some cases would result in MORE bad than the errors themselves. That is, medical errors aren’t the ultimate pinnacle of bad things, trumping all other bad things that would could spend resources on.

Do you agree that errors that cause the following are bad:

death

patient injury

increased healthcare costs

litigation

I understand that you do not like litigation. I am not asking that question.

I am just asking if errors that result in one of more of the four adverse outcomes are bad, and whether we ought to do what we reasonably can to prevent errors that result in one of those four outcomes.

Can we agree on that?

Lee

“Reducing medical errors comes (in most cases) at a cost.”

Surprisingly, the facts do not support this conclusion. Poor medical care generates more costs than the malpractice system.

Bruce Japsen of the Chicago Tribune indicates that studies show low quailty healthcare contribute to a significant percentage of healthcare costs, perhaps as much as 30% of the $2 trillion we spend on healthcare.

http://the.honoluluadvertiser.com/article/2006/Nov/16/bz/FP611160333.html

Poor care costs more than good care.

As Deming demonstrated decades ago, businesses save significant amounts of money with quality processes.

Good medical care saves money, significant sums of money. Good medical care could save as much as 30% of our healthcare expenses.

This conclusion may seem counterintuitive to those unfamiliar with Deming’s work or recent studies.

Reducing medical errors is indeed a part of that, but only ONE part.

Silly example: what is there was a doctor who could treat 10,000 patients per day, but he was guaranted to make 1 medical mistake each day?

If you could only afford to hire one doctor, THAT is who you would need to hire to do the most good. It would also most certainly increase the number of medical errors.

Reducing medical errors comes (in most cases) at a cost. If the cost is high enough, it would be better to spend those resources elsewhere.

We all agree that errors are bad and that we would like for their to be none… but not all of them are worth preventing.