What Sicko Doesn’t Tell Us

As I mentioned in yesterday’s post, Michael Moore’s movie Sicko provides background on how our American healthcare system has become so dysfuncational, and some of the horrifying ripple effects on the health of our nation. What it fails to mention is one major group of ripples: medical errors and misdiagnoses.

According to the US government’s Institute of Medicine, between 44,000 and 98,000 Americans DIE each year from medical error or misdiagnosis. Other organizations, including HealthGrades, suggest those numbers are way too conservative, that, in fact, the numbers are much higher. Beyond those who die, millions more are injured by these mistakes.

So it begs the question: what differences in the rates of medical errors and misdiagnoses might we find between universal health care, such as those systems cited in Sicko in Canada, France and Great Britain, and privatized healthcare programs such as the system we use here in the United States?

I’ve poked around the internet and can’t find any numbers to speak of… I can find a few within certain diseases, but nothing that helps compare apples to apples…..

When I refer to medical errors, I’m referring to problems such as:

• surgeries: operations on the wrong body part, called “wrong site” surgeries, or mistakes made during the surgery, or even equipment left inside the patient.
• drugs: the wrong drug is prescribed, or the wrong drug is dispensed, or the wrong dosage is prescribed or dispensed, or the drug is given at the wrong time, or a dose is missed
• other treatments: therapies are mis-prescribed, for example, an orthopedist sends a patient for physical therapy which ends up exaserbating the problem, not helping it
• infections: usually facility acquired (such as in hospitals or nursing homes) — a patient is admitted for one problem, but acquires an infection while resident in the facility. MRSA, C. Diff and necrotizing fasciitis (flesh eating bacteria) are examples

When I refer to misdiagnosis, I mean:

• the patient is told nothing is medically (or mentally) wrong when, in fact, something is
• the patient is told s/he has one ailment when, in fact, s/he has a different ailment
• the patient is told something is wrong when, in fact, nothing is wrong

[A request — if anyone can point me to real numbers among the other countries, I would really appreciate it!]

My sense is this — purely a guess, but an educated one — that the error rate in the privatized US system, where healthcare is more about money and less about care — is higher. That we are dying and getting sicker because of our privatized system.

Why do I think this is true?

If you review the kinds of errors listed above, you’ll see that most are time-related. If the professionals who made them weren’t in such a hurry, if they weren’t worried about reimbursement rates or malpractice insurance payments, if they were more inclined to spend the time that is really needed to LISTEN and communicate with patients, then those errors could, in many cases, be prevented.

Drill it down: who will make fewer errors?

• a doctor who has the time necessary to listen to a patient? — or — the doctor who knows that in minute #7, he begins losing money because the insurance company won’t reimburse him for any time beyond that?
• a surgeon who has the time to carefully review the charts prior to a surgery, takes the time to mark which body part needs to be cut, then operates correctly — or — the one who knows s/he has only one hour to perform the surgery and move on to the next one or it will impact the hospital’s profits?

Patients — take heed — there are many many ways you are hurt by our current dysfunctional system…. not all are raised in Sicko, but at least its the start of a conversation.

… and in the meantime? Regardless of what system provides us with health care — or no health care — we still need to advocate for ourselves in all those good practice ways I talk about on this blog, and through my columns, every day.

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Read two more posts about Sicko:

A Patient Advocate’s Reaction to Sicko
Why Sicko is only the tip of the Iceberg

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