A License To Kill
Gail Tasch, M.D.
I was able to get a medical license in Florida, one of the more difficult states to get a license due to its history of medical fraud and abuse. In order to maintain a license in the state one has to take a “Medical Errors” continuing medical education course at licensure and every two years afterwards. I read the course and took the easy test and fulfilled the requirement. The course always begins with citing the 1999 study that stated that over 100,000 people die yearly from medical errors. I remember when this study came out and it made news headlines.
For the next license renewal 2 years later, I received the medical booklet for the course and the writer of the course said that now 200,000 people a year die from medical errors. Now this information isn’t coming from some "granola eating people" (that’s how the medical world refers to natural health practitioners) or some other offshoot group from Portland spreading “misinformation.” These courses are mainstream medical education. I was stunned by the doubling of the statistic and even wore the booklets out carrying them around and showing them to people. I brought the course booklets to dinner parties to show to other professionals and friends to see if they shared my outrage (none did).
So at the NEXT license renewal, lo and behold, the course in the booklet reported that “now it is closer to 400,000 people that die each year from medical errors.” Why is no one seriously looking at this statistic? My psychologist friend is fond of telling me “there are no doctor police!” In medical school we are told that each doctor kills an average of 6 people during their practice. Looks like we are crushing it.
There has been some comparison of the healthcare system’s safety record to the airline industry. Hospitals made an effort to copy the airline industry’s stellar safety record with more team decision making and “time outs” in the operating room to ensure surgery took place on the correct side of the body, one of the most common surgical errors.
The number of fatalities in the aviation industry has fallen from approximately 450 to 250 per year. This stands in comparison to the healthcare system where there is an estimated hundreds of thousands of preventable medical deaths each year. This amounts to the equivalent of about three fatal airline crashes per day. The renowned airline pilot, Chesley Sullenberger noted if such a level of fatalities was to happen in aviation, airlines would stop flying, airports would close, and there would be congressional hearings and a presidential commission. No one would be allowed to fly until the problems have been solved.
Sully has been passionate about safety for many years and serves on the editorial board of the Journal of Patient Safety and he is a member of the Greenlight Group, a team of experts supporting a number of global healthcare research and development initiatives. He noted that in healthcare mistakes affect just one person at a time. Mistakes are buried, failures are buried. Sully has referred to an era in aviation where pilots acted like gods with a small "g" and Cowboys with a capital "C". He said sadly some of this culture would still appear to remain in parts of healthcare. He believes patient safely should be a priority at all levels in the healthcare system, from the emergency rooms to the board rooms.
Unfortunately, there is less and less transparency regarding medical errors. The USA TODAY newspaper reported that “The federal government this month quietly stopped publicly reporting when hospitals leave foreign objects in patients' bodies or make a host of other life-threatening mistakes.”
People are likely to die in other ways from our healthcare system. Dr. Gary Null published a very well researched white paper Death by Medicine. In the paper, Dr Null reports that over 700,000 people die each year due to the healthcare system making healthcare treatment the number one cause of death in this country. It is very easy to me to think about friends and family members who died from the treatment they received. My wonderful sister-in-law died from the chemotherapy she received, not the lung cancer that plagued her.
Peter C. Gotzsche wrote an article for the British Medical Journal called “Does long-term use of psychiatric drugs cause more harm than good?” Dr. Gotzsche concludes that psychiatric drugs are responsible for the deaths of more than a half a million people age 65 and older each year in the Western world. He feels the benefits of psychiatric drugs are minimal. He believes that psychiatric prescription drugs are the third leading cause of death after heart disease and cancer. He believes that psychiatric drugs alone are the third major killer, mainly because antidepressants kill many elderly people through falls.
We are told as psychiatrists in our training that when prescribing atypical antipsychotic medications, we take 15-25 years off one’s life. These drugs cause weight gain, diabetes, chronic disease, and early deaths.
According to an article in the Journal of the World Psychiatric Association, antipsychotics, and to a lesser degree antidepressants and mood stabilizers, are associated with an increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, hematological, musculoskeletal and renal diseases, as well as movement and seizure disorders. Higher dosages, polypharmacy, and treatment of vulnerable (e.g., old or young) individuals are associated with greater absolute (elderly) and relative (youth) risk for most of these physical problems.
The rationale is that they work so well that the tradeoff is justified. There is an attitude that because someone has mental health symptoms they don’t deserve the respect a “normal” person does. The psychiatric profession goes to great lengths to keep the current paradigm in place.
How would one best avoid these medical errors and adverse effects from medical treatment? First of all, many of our illnesses are preventable. Eighty to ninety percent of visits to doctors and hospitals are for conditions that are preventable. For instance, 50% of people over 50 years of age suffer from hypertension, a mainly lifestyle related problem.
For the health care system in general, patient safety should be an integral part of medical training. Sully would say, “Safety should be a part and parcel of everything we do. Every decision that is made, whether it is administrative, budgetary, or otherwise should take safety implications into account because there is such an important business case for doing so.” Unfortunately there is a great lack of accountability in our medical system.
I personally do not go to mainstream doctors, I went to midwives when I was having children, I don’t even have health insurance, but I do have an inexpensive catastrophic policy. I do not get mammograms or flu shots.
Our medical system provides the most expensive care, not what is in the patient’s best interest. When one does require care, one has to search out like minded practitioners. Unfortunately we do not have good mental health treatment but societies such as ISEPP and Mad in America are doing great work to reach people in need of help so that one can receive the very best care.
Wakefield, M. (2000). To err is human: An Institute of Medicine report. Professional Psychology: Research and Practice, 31(3), 243-244.
USA Today August 6, 2014.
Death by Medicine. March 2004. Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD.
Committee on Quality of Health Care in American. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press; 1999.
Makary MA, Daniel M. Medical error: the third leading cause of death in the U.S. BMJ. 2016;353:i2139.
Does long term use of psychiatric drugs cause more harm than good? BMJ. 2015; 350. doi: https://doi.org/10.1136/bmj.h2435 (Published 12 May 2015).
JRSM Open. 2016 Jan; 7(1): 2054270415616548. Published online 2015 Dec 2. doi: 10.1177/2054270415616548 Aviation and healthcare: a comparative review with implications for patient safety Narinder Kapur,Anam Parand,Tayana Soukup, Tom Reader, and Nick Sevdalis.
World Psychiatry. 2015 Jun; 14(2): 119–136. Published online: doi: 10.1002/wps.20204. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. Christoph U Correll, Johan Detraux, Jan De Lepeleire, and Marc De Hert.