Have you ever heard a doctor say

sorry?

Nobody’s infallible, but some make more mistakes than

others...

I've recently had to spend some time at a busy London hospital.  I was unable to read and, as I waited in some anxiety to see the consultant, I watched the busy medical staff flurrying round. There was some confusion about the frequency and dose of a patient's medication and I started to seriously wonder about the number of slip-ups that are made in the medical profession.  I've never heard a doctor apologise for making a mistake but, as they're human, they must also be fallible.  The problem is that a doctor's error can be fatal for a patient.  So how many medical mistakes are made?  Equally importantly, are they acknowledged?  Could I be a victim? Before my hospital visit, I'd been looking at the dataset above.  The data is derived from The Commonwealth Fund which commissions a regular survey to compare healthcare standards between different nations.  A telephone survey of 18,000 participants defined as sicker adults was conducted by Harris Interactive in 11 different countries.  "Sicker adults" were identified as those in poor or fair health who had been hospitalised in the last two years, or who had recovered from a serious or chronic illness, injury or disability within the past year.  In short, people in such a vulnerable condition that even a relatively small medical mistake could be life threatening. A first glance at the data showed that on average the chances of being involved in a medical mistake in the UK were fortunately not that high.  In fact, compared to other countries the UK's 8% error rate was the lowest.  A patient in a hospital in Canada, New Zealand, the U.S. or Norway would be about three times more likely to suffer a medical error.  That got me thinking: does this have anything to do with money?  After all the rational, intuitive view would be that the more you pay, the better the medical service you receive anywhere.  Fortuitously the Commonwealth Fund also includes the latest country expenditure on healthcare as a percentage of GDP (Gross Domestic Product).  So is there any relationship between the amount of money spent on medical care and the number of errors in the 11 countries examined?  The answer, using a Pearson R correlation co- efficient, is 0.1284, which means that means there is absolutely no statistical relationship.  Whether a country spends more or less on healthcare has no bearing on the number of medical mistakes made in that country.  For all its faults, the U.K. health system (the National Health Service or NHS) apparently makes a third fewer mistakes than the U.S. health system despite getting less than half the money as a percentage of GDP.  But wait a minute; having a smaller medical budget doesn't seem to be the answer because Norway produces the highest medical error rate of all and it has the same percentage of GDP to spend as the U.K.  Of course all of these suppositions might be totally wrong:  Because the data is self-reported by the sick patients, it can only represent the problems that those patients know about.  On this basis, could this indicate that Norwegian doctors are more honest and upfront that the U.K. doctors and that they tell their patients about the mistakes they make?  If so this would mean that the U.K. doctors are much more efficient at covering-up mistakes than many other country's doctors.  And what about the U.S.?   In that highly litigious country, where chronic ill health costs so much it's the main cause of bankruptcies, are the doctors likely to be more careless or more honest?  According to the 2011 Health Grades Hospital Quality in America Study, the incidence rate of medical errors causing harm to patients is estimated to be over 40,000 a day, and about 100,000 U.S. citizens are believed to die from preventable hospital mistakes each year.  The British Medical Association estimates that similar levels of harmful and lethal medical errors are made in the UK, but that goes completely against the dataset above.  And regardless of any under or over estimating, or indeed any whitewash, what about the problems that neither the doctors nor the patients are aware of?  Those worrying "unknown unknowns" so aptly described by Donald Rumsfeld?   It's obvious that without other types of reliable information to provide context and to cross reference with this set of figures, viewing this chart raises far more questions than it answers.  Yet this crude data from The Commonwealth Fund is being used by many healthcare professionals to benchmark and compare their industry's performance with those in other countries.  These reflections started to make me feel very uneasy....it was now my turn to see the specialist.  I still had absolutely no idea of how likely it was that I could suffer a medical mistake, nor could I begin to reckon if I would I get to know about it if I did.  So, I could only cross my fingers and put my faith in the doctor. June 2012
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2012
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Have you ever heard a

doctor say sorry?

Nobody’s infallible, but some make

more mistakes than others...

I've recently had to spend some time at a busy London hospital.  I was unable to read and, as I waited in some anxiety to see the consultant, I watched the busy medical staff flurrying round. There was some confusion about the frequency and dose of a patient's medication and I started to seriously wonder about the number of slip-ups that are made in the medical profession.  I've never heard a doctor apologise for making a mistake but, as they're human, they must also be fallible.  The problem is that a doctor's error can be fatal for a patient.  So how many medical mistakes are made?  Equally importantly, are they acknowledged?  Could I be a victim? Before my hospital visit, I'd been looking at the dataset above.  The data is derived from The Commonwealth Fund which commissions a regular survey to compare healthcare standards between different nations.  A telephone survey of 18,000 participants defined as sicker adults was conducted by Harris Interactive in 11 different countries.  "Sicker adults" were identified as those in poor or fair health who had been hospitalised in the last two years, or who had recovered from a serious or chronic illness, injury or disability within the past year.  In short, people in such a vulnerable condition that even a relatively small medical mistake could be life threatening. A first glance at the data showed that on average the chances of being involved in a medical mistake in the UK were fortunately not that high.  In fact, compared to other countries the UK's 8% error rate was the lowest.  A patient in a hospital in Canada, New Zealand, the U.S. or Norway would be about three times more likely to suffer a medical error.  That got me thinking: does this have anything to do with money?  After all the rational, intuitive view would be that the more you pay, the better the medical service you receive anywhere.  Fortuitously the Commonwealth Fund also includes the latest country expenditure on healthcare as a percentage of GDP (Gross Domestic Product).  So is there any relationship between the amount of money spent on medical care and the number of errors in the 11 countries examined?  The answer, using a Pearson R correlation co-efficient, is 0.1284, which means that means there is absolutely no statistical relationship.  Whether a country spends more or less on healthcare has no bearing on the number of medical mistakes made in that country.  For all its faults, the U.K. health system (the National Health Service or NHS) apparently makes a third fewer mistakes than the U.S. health system despite getting less than half the money as a percentage of GDP.  But wait a minute; having a smaller medical budget doesn't seem to be the answer because Norway produces the highest medical error rate of all and it has the same percentage of GDP to spend as the U.K.  Of course all of these suppositions might be totally wrong:  Because the data is self-reported by the sick patients, it can only represent the problems that those patients know about.  On this basis, could this indicate that Norwegian doctors are more honest and upfront that the U.K. doctors and that they tell their patients about the mistakes they make?  If so this would mean that the U.K. doctors are much more efficient at covering-up mistakes than many other country's doctors.  And what about the U.S.?   In that highly litigious country, where chronic ill health costs so much it's the main cause of bankruptcies, are the doctors likely to be more careless or more honest?  According to the 2011 Health Grades Hospital Quality in America Study, the incidence rate of medical errors causing harm to patients is estimated to be over 40,000 a day, and about 100,000 U.S. citizens are believed to die from preventable hospital mistakes each year.  The British Medical Association estimates that similar levels of harmful and lethal medical errors are made in the UK, but that goes completely against the dataset above.  And regardless of any under or over estimating, or indeed any whitewash, what about the problems that neither the doctors nor the patients are aware of?  Those worrying "unknown unknowns" so aptly described by Donald Rumsfeld?   It's obvious that without other types of reliable information to provide context and to cross reference with this set of figures, viewing this chart raises far more questions than it answers.  Yet this crude data from The Commonwealth Fund is being used by many healthcare professionals to benchmark and compare their industry's performance with those in other countries.  These reflections started to make me feel very uneasy....it was now my turn to see the specialist.  I still had absolutely no idea of how likely it was that I could suffer a medical mistake, nor could I begin to reckon if I would I get to know about it if I did.  So, I could only cross my fingers and put my faith in the doctor. June 2012
Click here to download the PowerPoint chart: Click here to download the PowerPoint chart: