With every test, procedure or medication ordered, doctors increase the risk of making a medical mistake, endangering not only a patient’s physical health but his or her emotional well-being.
According to The New York Times, a 1999 report from the Institute of Medicine revealed that 98,000 Americans die every year because of medical errors. A more recent estimation indicates that medical mistakes account for about 200,000 Americans deaths every year, making them the main cause of death in the U.S.
One theory suggests that these mistakes happen because of a type of treatment known as defensive medicine, in which doctors order extra tests, procedures or prescriptions to double-check a diagnosis. Many of the tests ordered often do not fulfill a medical need; they offer protection to doctors or hospitals in the event of a lawsuit. In fact, in an anonymous survey, orthopedic surgeons admitted that 24 percent of the tests they ordered had no medical purpose.
While defensive medicine tries to eliminate the possibility of doctor-made mistakes, each new test, procedure or medication only increases the probability of a medical error. For example, preventative measures such as an unnecessary CT or MRI scan could result in a false positive and unneeded surgery, which could result in death or complications like infection and bleeding.
Many people have attempted to find a way to solve this problem. Peter Pronovost at Johns Hopkins created a checklist proven to decrease hospital-acquired infections. Others have instituted rules that prohibit interrupting nurses while they give out medications or created software that lets doctors know if a patient’s medications will have an unsafe interaction.
Today, doctors may benefit from remembering Rule No. 13 from Stephen Bergman’s tongue-in-cheek novel, “The House of God,” that reads: “The delivery of medical care is to do as much nothing as possible.” When it comes to tests, procedures and prescriptions, perhaps less is more.
We entrust ourselves to our doctors, often forgetting that even they can make mistakes. This reality requires open communication to exist not only among healthcare professionals, who can help each other learn and improve in light of their mistakes, but also between a patient and his or her doctor, so that a patient can give his or her truly informed consent for any test, procedure or medication.