More Than 15% of Patients Report Medical Mistakes Each Year: JAMA Journal Report

The implications are stunning. It means that people who do as they're told by routinely visiting their doctors will almost certainly suffer from medical mistakes during their lives.

by Heidi Stevenson

30 September 2010

More than 15% of doctors' office visits during a single year result in medical error, according to the Archives of Internal Medicine, a publication of the Journal of the Americal Medical Association (JAMA). Worse, the randomly selected patients indicated that, on average, the mistakes were significant, and some were life-threatening.

The study, entitled "Patient Perceptions of Mistakes in Ambulatory Care", was carried out on 1697 participants who visited one of seven primary care practices in varying geographical areas of North Carolina in 2008. The study focused on four specific issues: mistake made, wrong diagnosis, wrong treatment, and changing doctors as a result:

Mistake Made	Wrong Diagnosis	Wrong Treatment	Changed Doctors
265 (15.6%)	227 (13.4%)	212 (12.5%)	239 (14.1%)

The study's tone is interesting. It doesn't accept that there were actual errors. Rather, the authors used the term "perception", and no discussion of its definition was given. It would be easy to suggest that the patients' perceptions of harm were incorrect—but if that assumption were made, then one would also need to consider whether harm was done without patients' awareness. It seems to me that the only reasonable approach is to assume that most patients have a reasonable sense of whether they've been harmed, and that those who claim to have been harmed, but weren't, would be balanced by those who were unaware of harm done.

Validity of Results

The authors' failure to address this issue leaves some question about the study's veracity. However, there are clues that would indicate the number of mistakes made by doctors is actually greater than reported.

Patients whose education levels were greater than high school, people who would more consistently be aware of the technicalities of procedures performed on them, were twice as likely to report mistakes than other patients. The authors reported:

Depression, heart disease, report of any days in the past month in "not good" mental health, more than 4 visits to a physician within the past year, and self-reported health of "fair" or "poor" were associated with perception of mistakes in bivariate analyses but were not significant in the final model.

That is, the patients' mental state, sense of health, and number of visits to the doctor during the previous year had little or no effect on the results of perceived medical mistakes. It cannot be claimed that patients with greater physical or mental problems were more likely to perceive errors. Therefore, it is reasonable to assume that patients' reports of mistakes were likely, at worst, to be accurate. More likely, though, was that there may have been underreporting of mistakes.

Most of those who suffered from a mistaken diagnosis then went on to be afflicted by a mistaken treatment. Finally, most of them will change doctors—but with such a high rate of medical errors, what are the chances that it won't happen again?

Severity of Errors

Significantly, participants' perception of the severity of errors was high, significantly higher than the researchers had anticipated. The graph below depicts the study's findings:

The x-axis of the graph shows the degree of injury each participant perceived, and the y-axis shows the percentage of participants who felt they'd been subjected to that amount of harm. Each degree of harm is represented by two bars; the left-hand bar represents the patients who reported diagnositic errors, and the right-hand bar represents those who reported treatment errors.

Of those who reported diagnostic errors, 67.8% (26.1 + 22.9 + 18.8) reported "some", "a lot" or "severe" harm.

Of those who reported treatment errors, 74.1% (28.4 + 30.8 + 14.9) reported "some", "a lot" or "severe" harm.

The amount of anguish suffered by patients for mistakes made by their doctors at the primary care level is very high, with 67.8-74.1% of patients reporting a resultant degree of suffering that is significant.

Implications

The study documents that at least 3 out of every 20 patients who visit a doctor's office each year have been the victims of mistakes. Multiply that year after year, and it adds up to an amount of medical mistakes that is utterly mind-boggling. Think of it: If you see a doctor just once a year, the odds are that you will be subjected to a medical mistake more than once during your life, and that the mistake will be compounded by errors made as a result.

  

Then, consider all the errors that aren't counted. The children who suffer from vaccine damage. The huge number of people who suffer from so-called Failed Back Surgery Syndrome, approximately 25% of all back surgeries. The enormous number of people who suffer from damage caused by poison drugs, like Avandia and Vioxx and acetaminophen (paracetamol in Europe) and ibuprofen and statins and hormone replacement therapy and virulent drug-resistant bacteria, viruses, and fungi—and the list goes on and on.

How can anyone possibly doubt that, though wonderful things can be, and are, done by modern medicine's techniques, it has become completely out of control? It's obvious that the odds are that nearly everyone who sees doctors even half as much as we're told we should will probably suffer from an injury induced by a doctor's error...or, even more likely, by the routine administration of treatments or commonly-available products that are foisted on us without adequate information (such as ibuprofen) and without consideration of the risks.

The importance of this study is its implications for the relative risks we take when we give ourselves over to modern doctors. We—and they—sneer at the medical procedures of old, the bloodletting and such. But with their insinuation into virtually every aspect of our lives, their proclivity for redefining normal states of health as being diseased, thus, requiring their treatments and drugs, and their unwillingness to respect the body's ability to heal, it's easy to see why modern doctors are probably the greatest threat to most people's health than anything since the Inquisition.

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