To Err is Human

In November 1999, the Institute of Medicine published a reported entitled “To Err is Human: Building a Safer Health System.” Qual Safe Health Care, 15(3). The Institute of Medicine concluded that it was no longer acceptable for patients to be harmed by a health care system that is supposed to offer healing and comfort -- a system that promises, “First do no harm.” As part of its safety initiative, the Institute studied the degree to which medical errors impacted patients in the United States and what could be done to limit those errors. In its 1999 study, the Institute concluded that based upon an analysis of multiple studies by a variety of organizations, there were approximately 98,000 individuals who died every year in the United States as a result of preventable medical errors, and the number of individuals harmed by medical errors was multiple times higher. Seventeen years lager in 2016, the John Hopkins University School of Medicine completed a study on how successful the medical community had been in reversing the rate of medical errors since the initial study by the Institute of Medicine had been published in 1999. When their study started, the researchers at John Hopkins anticipated seeing a significant decrease in the number of deaths and injuries form that reported in the Institute of Medicine study because of the multiple initiatives that had been undertaken during the intervening years that were supposed to promote a culture of patient safety within the medical community. Shockingly, instead of finding that medical errors and the injuries they caused had decreased, the researchers at John Hopkins discovered that there are now at least 250,000 deaths every year in the United States due to medical errors, and that the number of individuals injured, but not killed, is multiple times higher. After heart disease and cancer, medical errors are now the third leading cause of death in the United States. Medical Error - the Third Leading Cause of Death in the United States, BMJ 2016: 353:2139.

In a study published in 2016 by the New England Journal of Medicine, it has now been shown that a disproportionately small number of medical practitioners are to blame for a significant percentage of the malpractice claims that exist in our country. That study reviewed paid medical malpractice claims or those that ended in the favor of the plaintiff between the years 2005 and 2014. The authors found that roughly 1% of all doctors could be linked to a staggering 32% of all the claims within that time period. This 1% of physicians consisted of practitioners all of whom had multiple claims filed against them. Prevalence and Characteristics of Physicians Prone to Malpractice Claims, N. Engl J Med, 2016; 374:254-362. The study found that doctors who paid for two claims of medical malpractice were twice as likely to pay out a third and doctors who paid for five or more claims were twelve more times as likely to pay for another.

Institute of Medicine - To Err Is Human: Building A Safer Health System