Safety Perspective

A study recently released from John Hopkins University is causing a bit of a stir. It is bringing forward numbers from medicine’s own data bases indicating that the third highest cause of death in the US is due to medical error.   This is more than lung disease, diabetes, Alzheimers, motor vehicle accidents, and gun deaths combined. It trails behind only cancer and heart disease. Wow.

Heart disease takes about 23.5% of lives. Cancer takes about 22.5%. Medical error, it states, is responsible for just under 10% of all deaths in hospital.

Screen Shot 2016-05-14 at 2.21.00 PMAdd to this that the study only was able to calibrate deaths in hospital and would not account for any error related deaths in old age homes, patients who had returned home, or any other care facilities. It should also be noted that “medical error” is not recorded on US death certificates. This insight is not regularly recorded.

Maybe this will be easier to grasp in real number. Of 2.6 million deaths in the US (and you can divide these numbers by 10 for similar values in Canada), 611,000 are due to heart disease, 585,000 are due to cancer and 251,000 deaths per year are from medical error. By the way, error is defined as: an unintended act (either omission or commission,) or failure of a planned action to be completed, or the use of a wrong plan, or deviation from a process of care.

I first heard all this on the CBC morning edition. It is a shocking revelation. Shocking for an organization that sits so firmly in the center of our health. This is a system that boasts about its efficacy and basis in science, as by far the most proven and effective. A system that we are expected to trust and indeed look up to. I am pleased with and applaud their honesty in revealing these startling numbers.

However, what shocked me more was the interview on CBC radio. They brought on the editor of a Canadian Medical Journal to help digest this information for the non-medical public. I have heard this man before. He has a very reasonable and balanced approach when interviewed. I like his messages for the most part. Indeed, this day, he was this way too. But here is the piece that really gets me. The interviewer asks him questions about these statistics in a calm and reasonable fashion, more like they were discussing a small change in weather patterns or something entirely of our control. The questions were kind of illusive in nature, in the sense that solving this crisis in care would take so many layers and so many years to sort out, that one could really not articulate the solution to such a massive problem on the spot or in a few words, or even really start to attempt change. So, like many interviews, the listener is left feeling stirred, but not really feeling too confident that anything would or indeed could be done about it. But at no point was there any blame or suggestion that the human error at the heart of the problem was due to carelessness or lack of science or lack of training or some systematic flaw in the infrastructure; it was just rather some vague inevitability that was inconvenient and it would be nice if the trend could be reversed. An awkward issues. A margin of error. The cost of doing business.

Here is my rub. Two weeks ago, the three AltaVie DC’s (and Sequoia, our office baby) traveled to San Francisco to attend a pediatric workshop. We love the work we do and we want to not only be current but ahead of the pack on these issues. We listened for 2 days to speakers on advanced manual techniques, brain chemistry, neurological development, and safety considerations about our care. We learned that in the US, there were approximately 30 million spinal manipulation treatments given to children. (So in Canada, let’s assume there are about 3 million treatments given to children.) We learned that WORLD WIDE, in that same time frame there were a total of 15 recorded adverse affects from treating children. The definition of adverse effects varies slightly per paper. It should also be noted that this number was not exclusive to chiropractic care; it included ALL manual therapies such as: physical therapists, osteopaths, massage therapist as well as chiropractic. Certainly training could be called into consideration.

Recalling that I am comparing a worldwide incident to only US treatment numbers (so this value is going to be too high), that math comes out to an incident rate of .00005%. I felt indeed, very proud to part of these incredibly low statistics.

So here is the crux of my rub… The allopathic medical system can live with causing 10% of hospital deaths admittedly due to human error. Indeed, the editor went on to emphasize and ask for compassion for the medical people involved in these incidents, as they were traumatized by these events too!!

But God help us if one person goes to hospital in Canada from a chiropractic adjustment. Just God help us for that! We are accused of being careless, untrained, ineffective, and unscientific. That is my rub. Even if what we did was ineffective, and all of us reading this know that isn’t true, how about a level playing field on the accusations and assumptions constantly leveled at us for our safety, lack of science and human error. I’m pretty tired of it! Getting old I guess.

Anyway, this was in no means intended to be a rant against medicine, so please don’t misunderstand my meaning. I am all for the appropriate use of medications, surgery, and the works. And I very much applaud the transparency and commitment to care required to publish this data. I am simply asking for some level headedness when comparing the standards our professions are held to.

 

Article Referenced

Makary Martin ADaniel MichaelMedical error—the third leading cause of death in the US 

http://www.bmj.com/content/353/bmj.i2139

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