'Medical Errors' Uproar IOM's Scary Report Is Badly Flawed; Key Data Are Stale, Veiled, and Skewed
March, 2000, New York, NY
http://www.probenewsletter.com/article.asp?articleid=33 Shocking!
Between 44,000 and 100,0000 Americans die each year in hospitals as the result of medical errors.
This devastating finding was announced late last year by the conservative Institute of Medicine (IOM), an arm of the similarly conservative - and recondite - National Academy of Sciences (NAS), in Washington, D.C.
Congress and the President responded rapidly:
Senate hearings have already been held. Bills were introduced, and at least one has been passed and signed into law. President Clinton's proposals and directives call for new federal and state offices to oversee patient safety, which, as the New York Times pointed out approvingly, "will now . . . be a federal and state responsibility," as well as a medical one. Tens, and eventually hundreds of millions of dollars will be committed to these efforts.
"President Clinton's proposals, or something similar, seem likely to become reality," health care reporter Robert Pear wrote in the New York Times (Feb. 22), on page 1. One reason, he explained, is "the issue has great appeal to consumers, and this is an election year."
In a word, pandering.
Much of the public debate is about finger-pointing: How to find ways to report medical errors to government officials. This concern was heightened by news coverage last month of criminal charges against a New York City obstetrician, Allan Zarkin, M.D., who - bizarrely - had carved his initials into the belly of a woman whose baby he had just delivered.
The IOM report, entitled To Err Is Human, and its dire findings, thus have become a persisting source of public concern and policy debate. Surely, the data to back this indictment of America's health care system must be rock solid!
Problem: They're not.
Not at all!
This, too, suggests that politics, rather than scientific understanding, is driving the headline scramble. It also raises our sense that, as has happened before, the medical care system, and particularly doctors, are being scapegoated in pursuit of others' political agendas.
Let's look at the evidence behind the IOM report, which was written by a committee chaired by business administration expert William C. Richardson, Ph.D., president and CEO of the W.R. Kellogg Foundation, in Battle Creek, Mich. The report is 221 pages long, and contains hundreds of footnotes. In fact, however, the report's scary findings are based on just two studies. Here's what the report says, on Page 1:
Two large studies, one conducted in Colorado and Utah and the other in New York, found that adverse events occurred in 2.9% and 3.7% of hospitalizations, respectively. In Colorado and Utah hospitals, 8.8% of adverse events led to death, as compared to 13.6% in New York hospitals. In both these studies, over half of these adverse events resulted from medical errors and could have been prevented.
Extrapolating these estimates to all U.S. hospital admissions, the IOM panel says, this comes to 44,000 deaths annually (based on Colorado and Utah), or "as high as 98,000 deaths," based on the New York study.
Full article here at: http://www.probenewsletter.com/article.asp?articleid=33
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