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Doctors, Patients Find Medical Errors No Big Deal

Survey: They see other health-care problems as more pressing

WEDNESDAY, Dec. 11, 2002 (HealthDayNews) -- Although a major report found more Americans die each year from hospital medical errors than from automobile accidents, physicians and the public don't think this problem is the biggest one facing the health-care system.

Those are the conclusions of a survey appearing in tomorrow's issue of The New England Journal of Medicine.

The issue of perception is an important one for the various national organizations that have called for changes in health-care practices in response to the 1999 Institute of Medicine Report, which said that at least 44,000 people -- and perhaps as many as 98,000 -- died each year as a result of medical errors.

If these proposed changes are ever to see the light of day, they'll need the support of both practicing physicians and the general public. This latest article suggests the support is simply not there.

"Particularly among physicians, they just are not buying into what the experts are saying," says Catherine DesRoches, a co-author of the study and a senior research associate at the Harvard School of Public Health in Boston.

Only 5 percent of physicians and 6 percent of the public identified medical errors as one of the most pressing problems.

Researchers at the Harvard School of Public Health asked 831 practicing physicians and 1,207 members of the general public about their personal experiences with medical errors, how serious they thought the problem was compared to other health-care issues, and what actions could be taken to prevent such errors from occurring.

Thirty-five percent of the physicians and 42 percent of the public said they or a family member had experienced a medical error; 18 percent of doctors and 24 percent of the public reported an error that had had a serious health consequence, including death (7 percent of physicians and 10 percent of the public). Nevertheless, neither group reported this as one of the most urgent problems in health care.

"We were surprised by that. There was a little bit of disconnect between the number of people who said they'd had some kind of problem that had serious consequences and the way they seem to view the problem," DesRoches says.

The disconnect might be explained by the fact that not all mistakes are created equal. "'Mistakes' is a very generic word and can encompass everything from the wrong diet to a more grievous mistake and, in the vast majority of cases, the mistakes that are made are not serious mistakes and do not ultimately cause any harm," says Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in New Orleans.

The problems considered most serious were of an entirely different nature. Physicians most frequently cited the cost of malpractice insurance (29 percent), the cost of health care (27 percent), and problems with insurance companies and health plans (22 percent).

The general public cited the cost of health care (38 percent) and the cost of prescription drugs (31 percent) as the most pressing.

Physicians and members of the public disagreed both on the causes of medical errors and on effective solutions.

More than half of the physicians surveyed felt that requiring hospitals to develop systems for preventing medical errors (55 percent) and increasing the number of nurses in hospitals (51 percent) would go a long way towards reducing the number of medical errors.

Members of the public put emphasis on physicians spending more time with patients (78 percent), requiring hospitals to develop systems for preventing errors (74 percent), better training of health professionals (73 percent), and using only physicians trained specifically in intensive care medicine in intensive care units (73 percent).

If they want to change current practices, national organizations have their work cut out for them.

"Physicians have to be convinced of a couple of things," DesRoches says. "One is that this is a systemic problem, not just something they might see in their own day-to-day practice. They need also to be convinced that these strategies will work."

What To Do

To prevent medical errors from happening to you, check out the Agency for Healthcare Research and Quality. You can also try the National Patient Safety Foundation.

SOURCES: Catherine DesRoches, Dr.Ph., senior research associate, Harvard School of Public Health, Boston; Jay Brooks, M.D., chief, hematology/oncology, Ochsner Clinic Foundation, New Orleans; Dec. 12, 2002, The New England Journal of Medicine
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