Patient Safety - Reality Check

What are the Odds?

Is medicine the most dangerous place you ever go?

According to the U.S. Dept of Health & Human Services there are 700,000 physicians in the USA and at least 120,000 unnecessary deaths caused in medicine each year. That is .171 preventable deaths per physician.

The number of people in the USA who own guns is 80,000,000. The number of accidental gun deaths each year is 1,500. That's .000188 deaths per gun owner.

Statistically doctors are 9,000 times more dangerous than gun owners.

Guns don't kill people. Doctors do.

 

(A sense of humor is a good thing, isn't it?)

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The quip has been in various places on the web for a number of years. One place was in the conclusion of an article posted at the news site examiner.com (links to the article at their site).

I have been asked to back up the numbers. I do below because I think the quip makes a valid point, although the humor was what appealed to me. When a sociopath with a medical degree intentionally ruins your life, and then sues you to make sure you don't tell anyone, if you ever get your sense of humor back, what flavor would you expect it to have?

The Most Dangerous Place

It really could be that medicine is the most dangerous place people in America go. Doctors are more harmful than germsDoctors might be the most dangerous people you ever see. At the bottom of the page are additional statistics that should inspire a legitmate concern about that.

Someone should do a study of a group that never seeks medical treatment, like Christian Scientists, and compare them to a demographically similar group of people who do and provide us with some perspective on that.

One doctor told me that 90% of the things for which patients seek medical care would heal fine with no treatment. Identifying what those are for the patient population could reduce their exposure to significant risks and side effects and costs.

The Numbers:

Newer numbers have come out since the quip began circulating, but I'm sticking with the old ones for how conservative they are.

The CDC reports that the number of ACCIDENTAL gun deaths in 2011 was 851. Another source confirms that by saying that generally there are between 500 and 1000 accidental gun-related deaths per year. I use the number 1500. The more current numbers would make doctors more than 9,000 times as dangerous as guns - almost double that.

According to the Johns Hopkins School of Hygiene and Public Health, Death by Medicine by Gary Null250,000 deaths per year are unnecessarily caused by health care. Other estimates put the number higher. 320,000 per year probably is more accurate (see Preventable Deaths on this site). Lucian Leape himself has revised his original estimates and now says 420,000. There have been estimates much higher than that (for instance, Gary Null in the book at right), but I've kept the older number of 120,000 to avoid the appearance of exaggeration. The newer numbers would dramatically increase the calculation of how dangerous doctors are.

Gallup says that 34% of Americans admit to owning a gun. It also says that there probably are more than that because many might not want to admit it. There are 315 million people in the USA, but a portion of those are children. Would that mean about 80 million people own guns?

According to wiki.answers (links to their site), since there is, by law, no general registration of firearms in the USA, there only are estimates of how many people own guns. The estimates range from a low of 76 million to a high of over 120 million gun owners. The 80 million number I used is on the conservative end of that spectrum as well.

Just using the older, more conservative numbers is enough to make the point. 700 thousand doctors. 80 million gun owners. 120 thousand accidental deaths in medicine. 15 hundred accidental gun deaths.

If you want to do the math in a different way, I'd be happy to see this from a different perspective. My email is at the bottom of the page.

Other dangers accidentally killing us

According to a site called listosaur, these are the numbers of accidental deaths in the USA from other causes:

1. Motor Vehicle Incidents (42,000 annual deaths)
2. Poisoning (39,000 annual deaths)
3. Falls (25,000 annual deaths)
4. Fires (2,700 annual deaths)
5. Choking (Approximately 2,500 deaths per year)
A number of other causes probably fit in the range following, but here are two more.
Drowning (2,000 annual deaths)
Accidental Shootings (600 annual deaths)

Death by Prescription - An over medicated nationInterestingly, they don't include the number of accidental deaths caused by health care, a number that dwarfs all these other causes combined. According to the book at left, adverse reactions to prescriptions alone is the number 3 killer in the USA.

Shouldn't we be thinking about limiting our exposure to the most risky things that should be on the list?

26 children got shot in a school and a national debate ensued about taking away everyone's guns so that it wouldn't happen again. At least that many children must get killed unnecessarily in medicine everyday without anyone even being interested. Perhaps we respond more strongly to images reminiscent of action movies than we do to statistics and people going missing.

The list above covers car crashes and fires and things of which it is possible to take alarming photos of the harmful thing or event. Of what happens in medicine, the best that could be done is a photo of someone with tubes and bandages afterwards, or perhaps of a headstone. Do we need to think of a more compelling representation of injured patients in order to get on the map?