Based on 173 deaths in the Harvard Medical Practice study, and extrapolating to the entire U.S. population, the Institute of Medicine (IOM) has been claiming for almost a decade that as many as 98,000 Americans are killed by medical errors every year.
Moreover, it is asserted that Americans have only about a 50/50 chance of receiving “proper health care.”
The proposed solution: electronic records with constant surveillance of compliance with government-approved protocols. The IOM claims that its methods could reduce errors by 50% over 5 years.
The IOM’s definition of error, the assumption that a death was a result of the error and would not have occurred anyway, and its guesstimate of the number of deaths all lack independent confirmation. The IOM number is three to seven times higher than a 1998 estimate by the National Safety Council.
Although the IOM analysis is uncritically accepted by the AMA and other influential bodies, there is no evidence at all that the proposed solution would result in any improvement in mortality or other patient outcome measurements. More likely results are:
- Choice of therapies not embraced by mainstream medicine would be much curtailed. Nutritional approaches, long-term antibiotics for Lyme disease, chelation, hyperbaric oxygenation, acupuncture, prolotherapy, treatment for multiple chemical sensitivities, and other innovative, nonstandard, or “alternative” modalities could become unavailable.
- Intensified oversight and rigid protocols might make physicians even less likely to provide adequate relief for chronic pain. National electronic databases of prescription drugs would facilitate stigmatizing patients who use controlled substances whether for pain or mental health reasons.
- Patients’ freedom to decline “recommended” therapy—such as vaccines and psychotropic drugs—would be threatened as doctors feared being penalized as “outliers.”
- “Recommended” therapy has possibly done more harm than medical errors, and more rapid and widespread adoption could amplify the harm resulting from a misdirected “guideline.” For example, more than 50,000 individuals are estimated to have died from encainide (Enkaid) and flecainide (Tambocor), used as directed to treat abnormal heart rhythms, before their adverse effects were recognized (Kilo CM, Larson EB. Exploring the harmful effects of health care. JAMA 2009;302:89-91). A trial of aggressive blood sugar control was stopped because the “common wisdom” was apparently wrong: more patients died from the “improved” treatment (Couzin J. Deaths in diabetes trial challenge a long-held theory. Science 2008;319:884-885).
- Guidelines focused on cost control would deprive patients of newer, more effective drugs. Oncologist Karol Sikora states that thousands of premature deaths result from the British National Health Service’s restrictions on new drugs through its National Institute of Clinical Excellence (NICE) (Union Leader 5/12/09).
- “Perioperative Beta Blockers [which were supposed to protect the heart] Associated with More Heart Attacks,” AAPS News of the Day 11/18/08.
- “Nonpayment for Noncompliance,” and To Err Is Human”—Six Years Later,” AAPS News, September 2006.
- “Pay for Performance,” “Performance Measures Can Be Harmful,” “No Evidence for Evidence-Based Medicine,” “ ‘Systems Approach’ to Research,” “Nursing Home Quality Data 80% Inaccurate,” “JCAHO 70% Inaccurate,” AAPS News, September 2004.
- “Insurance, Health, and Control,” AAPS News, March 2004.
- “New Patient Safety Crisis Proclaimed,” AAPS News, January 2000, p 2.