Medical errors are both very real and also misunderstood by the public and mismanaged by our system. From Doctors Are Not Crashing Jumbo Jets:
But a bad outcome…is not automatically evidence of an error.
The public is uncomfortable with this because the public wants medicine to be deterministic. They want to prevent the next error with a new rule.
There is a tragic irony here. The exaggeration of preventable error can make genuine patient safety worse. When every adverse event becomes evidence of system failure, physicians learn to avoid risk, and systems learn to game the metrics to obscure the actual truth.
Truth.
…there is a persistent claim: that doctors are just offing patients. And it is often emphasized with the analogy that doctors are killing the equivalent of several jumbo jets full of patients every week. Then comes the inevitable appeal to aviation. If commercial pilots crashed planes at this rate, we are told, the public would revolt. Therefore, hospitals must be more like airlines.
It is a powerful analogy. It is also wrong.
Errors are common, but the way the Institute of Medicine’s original 1999 report, To Err Is Human, and the subsequent discussion have defined and managed death-by-error is fundamentally flawed. Errors in proximity to death are not necessarily errors causing death.
The medical error narrative, as commonly presented, offers the public a fantasy that enough regulation can make illness behave like a mechanical system. It tells policymakers that if doctors would simply comply with more rules, hundreds of thousands of deaths might disappear.
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Doctors are not crashing jumbo jets. They are caring for fragile human beings in a world where risk cannot be abolished, only moved around. The sooner we admit that, the sooner we can have a serious conversation about patient safety.
The Law of Unintended Consequences is amongst the most depressing wonders of the world.