A new book takes a close look at medical errors and the real human cost when physicians miss the mark.
Dr. Danielle Ofri is a clinical professor of Medicine and an attending physician at Bellevue Hospital in New York City. Dr. Ofri is also an accomplished writer and her seventh book, “When We Do Harm,” explores the danger of medical error—a leading cause of death in the United States.
In her book, Dr. Ofri identifies key areas of concern that underpin high rates of medical mistakes, including:
- The ways in which a physician approaches a diagnosis, a problem, or a patient. The attitude that a physician brings to the table can set the stage for a missed diagnosis. Assumptions may lead to a lack of creative thinking about the cause of an ailment or symptom.
- Interaction between healthcare providers can defy the best of intentions. Studies repeatedly show that the hierarchical structure of the medical profession can limit critical dialogue between members of a care team. If allowed to problem solve without blind deferral to a senior physician, the same team may find a novel approach to solving a patient problem—or more safely conducting a surgical procedure.
- The relationship and dialogue between members of the healthcare team and the patient and their family can be fraught with mistaken perspectives and information provided by both parties.
- Healthcare technology can be a blessing and a hindrance in caring for patients. Ofri discusses problems inherent with Electronic Medical Records (EMRs). She notes that the older paper charts allowed a physician to find everything in one spot—without endlessly repetitive information.
The true number of medical errors made in the US will never be known. Dr. Ofri points out that errors are frequent, but many are “near misses” that do not lead to an adverse event. She notes, “Near misses are the huge iceberg below the surface where all the future errors are occurring. But we don’t know where they are … so we don’t know where to send our resources to fix them or make it less likely to happen.”
Dr. Ofri offers advice for healthcare consumers including:
- Try to be aware of your treatment. Understand what you are undergoing and where your treatment is headed.
- Keep notes, or have an advocate take notes on the medication you are receiving and why. Know the side effects.
- Take ownership of your treatment and be sure to speak up if you do not understand what is happening and why.
On the future, Dr. Ofri points out, “Reducing diagnostic error will ultimately require a shift in healthcare. This will involve, as a research colleague pointed out, acknowledging uncertainty and associating humility rather than heroism with our diagnostic decision-making capabilities.”
Illuminating the underlying causes of medical mistakes is a powerful tool for understanding what is wrong with the American healthcare system. Unfortunately, it is not a cure.
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