Earlier this week, I posted an article about the unnecessary death of a 12-year-old boy, Rory Staunton, from an undiagnosed but easily treatable infection. The boy, an aviation buff, was a big fan of Captain C.B. “Sully” Sullenberger, the pilot who heroically landed a disabled U.S. Airways plane in the Hudson River in 2009. Capt. Sullenberger was quoted in the article as follows:
“If something good comes from Rory’s death, it will be that we realize we have a broken system. Patient care is so fragmented. For the most part, medical professionals aren’t taught these human skills that some deride as ‘soft skills.’ So there’s insufficient sharing of information and ineffective communication.”Some in the medical field look upon these deaths as an unavoidable consequence of giving care. But they’re inexcusable and unthinkable.”
The story of safety in the airline industry and the medical industry could not be any different. While approximately 1,503,323 people die or are injured annually as a result of medical errors
There are important differences that underlie the disparate safety records of these two businesses. First, the airline industry is subject to the ultimate in transparency — every major crash is intimately dissected by the media as well as by F.A.A. investigators. By contrast, medicine is shrouded in the ultimate wall of secrecy. There is no independent regulatory oversight, the results of internal hospital investigations are protected by the peer review privilege and the doctor-patient privilege, and the identity of negligent doctors is protected by the confidential National Practitioner Data Bank. Thus, it is impossible to identify patterns of errors or error-prone physicians or hospitals.
Second, airline travel is optional while healthcare is not. If planes crashed every day, flyers would drive, take a train or attend meetings by phone. The financial incentive to establish a near flawless safety record is compelling for that industry. However, consumers faced with healthcare needs must still go to the doctor, even as hundreds die from preventable errors every week. Thus, the dollars pour in irrespective of the quality of care. In fact, medical errors actually benefit the healthcare industry. The estimated billions of dollars in costs attributable to medical mistakes go to healthcare providers, leaving no financial incentive to improve outcomes.
If a jetliner crashed each and every week in the U.S., killing all aboard, the industry upheaval would be immediate and severe. However, while the equivalent number of deaths occur each week from medical disasters, nothing changes. Sully is right, the U.S. healthcare system is “broken.” But who will fix it and when?