By John Ballard
An imaginative post at The Health Care Blog is entertraining, provocative and informative. The phrase "complications following surgery" is cited to underscore how doctors are sometimes termpted to conceal surgical errors that may have been preventable.
There is no clear "bottom line" but I have read about a quiet trend under the radar toward doctors and hospitals explaining what happened when surgical complications (mistakes?) result in one of the "risks" that may (or may not) be listed in a consent form. In a number of instances straightforward candor may be averting malpractice suits, but I don't think there is a lot of literature published on this subject. That old tort reform argument bedevils the wider debate, but don't get me started.
Read the post for amusement. Then scan the comments for an array of rather serious responses.
The subject is serious, but overall this is lightweight stuff.
�I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life � well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.
But then I read what killed me: �serious complications following minor surgery.�
Now what the heck is that?
Nobody gets run over by a �serious complication.� You don�t hear about a guy getting shot in the chest with a �serious complication.� Sure, I didn�t expect to live forever (well, maybe only a little bit), but I was sorta going for passing out some Saturday night into my strip steak at that great restaurant on Broadway. Maybe nodding off in my favorite chair, dreaming of reeling in a 40-pound striper. You know, not waking up. This whole �death by complication� thing is just so, I don�t know � vague and annoying. Here�s something else that bothers me. This note I got a few days ago from a lady who says she�s a fan. She talked to a reporter at a national newspaper the other day. Asked the reporter, basically, what kind of complication ��did me in�? The reporter said �No idea what killed him. Unless someone dies unusually young, we don�t deal with the cause of death.�
Here are two additional links triggered by this post.
OK, that was a cheap Andy Rooney imitation. But as it happens, I did have a phone conversation with Rooney about patient safety. It came right after the Institute of Medicine released its landmark report, To Err is Human, in November, 1999. The appalling toll of medical errors wasn�t exactly a secret back then, but doctors and hospitals had gotten used to publicly tut-tutting about the �price we pay� for medical progress every time a new study came out and then going back to doing exactly what they�d been doing before.
But this time was different. First, the IOM used names of real victims, taken from news reports. That meant real families who could appear on TV or testify before Congress to give the raw numbers a human face. Second, those numbers were raw, indeed: 44,000-98,000 preventable deaths each year in hospitals alone. Maybe not news to JAMA readers, but a jolt to the general public. Third, the group making this claim wasn�t some nattering nabob of Naderite negativism, but a prestigious part of the National Academy of Sciences. This was the �House of Medicine� demanding a housecleaning.
?Why We Still Kill Patients: Invisibility, Inertia, And Income
By the same author, last December, a serious look at a serious problem too often swept under the rug. Anyone doing homework about healthcare reform should regard this as essential reading.