Today In BS: “Doctors Kill More People Than Car Wrecks”

A video clip of GOP freshman Sen. Vicki Marble, speaking yesterday in opposition to a bill to require naturopathic doctors to be licensed. Here's the transcript of Sen. Marble's remarks:

MARBLE: Thank you, Mr. Chair. So we have one person that we know of that has been harmed by a naturopath. How many people are estimated killed by doctors every year? Physicians, who have degrees, and are practicing–and that is a good word for it, "practicing" medicine.

More people are killed by doctors and physicians than car wrecks, overdoses, you name it. [Pols emphasis] So I would say, you know, stating that one person that we know of that have been hurt by a naturopath, doesn't really hold up to the standard of what we think licensing does.

There is a vast amount of misinformation out there on the subject of physician "errors" and preventable deaths. Sen. Marble seems to be relying on an oft-quoted claim that upwards of 100,000 people or more die each year due to "hospital mistakes." But as the Journal of the American Medical Association found when it looked deeper, that frightening number doesn't hold up to scrutiny. 

Medical errors are a major concern regardless of patients' life expectancies, but our study suggests that previous interpretations of medical error statistics are probably misleading. Our data place the estimates of preventable deaths in context, pointing out the limitations of this means of identifying medical errors and assessing their potential implications for patient outcomes.

A recent Institute of Medicine report quoted rates estimating that medical errors kill between 44 000 and 98 000 people a year in US hospitals. These widely quoted statistics have helped create initiatives directed at patient safety throughout the United States. The numbers are undeniably startling; they suggest that more Americans are killed in US hospitals every 6 months than died in the entire Vietnam War, and some have compared the alleged rate to 3 fully loaded jumbo jets crashing every other day. Widely disseminated quotes include, "medical mistakes kill 180 000 people a year in US hospitals" and "medical errors may be the 5th leading cause of death." If these inferences are correct, the health care system is a public health menace of epidemic proportions…

Fortunately, it's not. A more accurate look at the issue comes from the Bureau of Justice Statistics:

During 2005 an estimated 2,449 medical malpractice cases were disposed of by bench or jury trial in state courts of general jurisdiction throughout the country. A jury decided about 99% of these trials.

In 2006, 15,843 malpractice payment reports were received by the National Practitioner Data Bank–consistent with the fact that the overwhelming majority of malpractice cases are settled out of court. And note these aren't just wrongful death payouts, but malpractice payments of all kinds. The JAMA study, which takes a much more sensible approach to defining what a "preventable death" under a physician's care means, doesn't attempt to assert a number, but makes clear the claim by Marble and others about the number of people "doctors kill" is massively overstated–and that's before you even look at the number of actual claims. By way of comparison, in 2006, just under 43,000 Americans undebatably died in automobile accidents.

In short, Sen. Marble, "that's BS."

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  1. Gray in Mountains says:

    Vicki Marble for Governor!

  2. AristotleAristotle says:

    Another "common sense conservative." Heh.

  3. rathmone says:

    Nutro-paths are the doctors of the future.

  4. BlueCatBlueCat says:

    Kidn of like the hammers to guns thing.

  5. cholera doob servercholera doob server says:

    Sounds like Sen. Marble is making a strong case for removing caps on damages in medical malpractice lawsuits.

  6. slumdog says:

    While I can understand going after Sen. Marble, the problem is that you marginalize the true problems with patient safety in the US.  The Medical Malpractice Myth reported that a team from Harvard looked at about 15,0000 hospital records from Utah and Colorado "and found conclusive evidence of a serious injury from medical malpractice inthe records of 161 patients.  How many of those patients brought a claim?  Four. That is also less than 3 percent."

    Other studies have concluded that only 1% of the adverse events due to medical negligence result in a claim.

    As Victor Schwartz, General Counsel to the American Tort Reform Assocation said, "It is 'rare or unusual' for a plaintiff lawyer to bring a frivolous malpractice suit because they are too expensive to bring."

    If this is the case, does Sen. Marble still support the draconian medical malpractice caps here in Colorado? 

    • DaftPunkDaftPunk says:

      To ask such a question one must define their terms.

      What makes Colorado's caps draconian?

      • slumdog says:

        This website gives a good overview of the med mal caps in CO.

        http://www.capsharmcolorado.com/medical-malpractice-caps-harm-colorado.html

         

        • DaftPunkDaftPunk says:

          Neutral site, that.

          It fails the same test as your previous post.  Both proclaim that bad things happen.  Neither demonstrates that busting Colorado's caps would increase cases being brought, nor that injred patients are suffering unduly under Colorado's caps.

          Frivoulous cases exist and Judges are loathe to restrict patients' access to courts should their claims be technically insufficient (allowing a case to proceed absent a certified expert in favor prior to the statute of limitations.)

          • slumdog says:

            In fact it doesn't.  Judges may be loathe to restrict patients' access to the courts, but our legislature has already done that.  In Colorado there is a law that requires the loser in a medical malpractice lawsuit to pay the prevailing party’s costs. The average medical malpractice case, by the time the case gets to trial, typically costs around $100,000.00.  There always cases in which the costs far exceed that figure, however. When there are multiple defendants in a case, each one of them incurs costs associated with their defense. This means that a loss at trial could result in the plaintiff being ordered to pay a very large sum to the defendants. The rule works in the other direction as well, requiring defendants to pay the plaintiffs’ costs in the event the plaintiff wins. This ‘loser-pays-costs’ rule has a bigger effect on plaintiffs than on defendants, however, because the plaintiff is an individual who has to pay the debt personally–the defendants’ debt, if it is the defendant who is hit with a bill of costs, is paid by the insurance company.

            • DaftPunkDaftPunk says:

              What doesn't what?

              The winning party often relinquishes the claim to costs in return for relinquishing the right to appeal.

              Again, you haven't shown data that plaintiffs are being bankrupted by defendants' legal costs.  

              Could medical liability be handled in a better way for both sides?        Absolutely. Is removing the caps that way?  Not according to anything you've presented.

              • slumdog says:

                 When the injuries are catastrophic, and the costs of future medical care exceed the bounds of what the injured person’s resources can provide, litigation starts to look like a better option from a business perspective. For minor injuries, the rewards often do not justify the risks. And, given that most lawyers who handle medical malpractice claims routinely do so on a contingency basis, there is no incentive for plaintiffs’ lawyers to invest in cases that lack merit and are unlikely to resolve in the client’s favor. Even when legitimate cases arise, it is often the case that the value of the claim will be limited to such a degree that the costs may equal or exceed case value. In Colorado specifically, med mal caps and the CGIA cap (used by government providers) operate as an effective deterrent to the initiation of litigation in many cases of legitimate injury.  Thus, the small amount of malpractice cases that get filed in Colorado.  The last look at malpractice cases filed in Colorado shows that it is a very small percentage of the overall civil docket.  Med mal cases are an even smaller amount because this number includes all types of medical malpractice http://www.courts.state.co.us/userfiles/file/Administration/Planning_and_Analysis/Annual_Statistical_Reports/2012/District%20Court/table16.pdf

    • Colorado PolsColorado Pols says:

      We're not trying to understate real problems that exist with malpractice and patient safety. The JAMA study we referred to makes clear that malpractice is a problem, but refutes the methodology used to produce the extremely high number of deaths cited by Sen. Marble. The explanations offered by JAMA for the types of cases studied, and circumstances other than "optimal care" as factors, are persuasive that the actual number of such deaths is substantially lower than Marble claims.

      As to the question about caps and Sen. Marble, we suspect you already know the answer. 🙂

    • GalapagoLarryGalapagoLarry says:

      If by "you" […you marginalize the true problems with patient safety in the US.] you mean Pols, the diairist, you're off-base. It's Marple who's diminishing the tragedy of health provider caused injury or death with her stupid, wacko hyperbole.

  7. DaftPunkDaftPunk says:

    Marble's argument seems to be if medical doctors are killing people right and left, why not create a licensure system for another alternative medical field of dubious qualifications.  After all, it turned out so well in licensing lay widwives:
     

    Colorado homebirth midwives bury dead babies twice

     

     

  8. ohwilleke says:

    The notion that all physician caused deaths led to malpractice lawsuits is simply not true, not even remotely.  Deaths from medical mistakes are very common and deaths from prescription drug overdoses are the the fastest growing cause of accidental death in the nation, by far.  It is extremely difficult to prevail in a medical malpractice suit, even when the physician has caused death through professional negligence, and it isn't easy for a layperson to know that medical malpractice has occured.

    Senator Marble is actually quite right on this point, although, of course, naturpathic doctors account for a miniscule share of the total deaths from medical mistakes.

    • JeffcoBlueJeffcoBlue says:

      Dude, I don't think that's the point. I support victims, not liability caps. You can support that without pushing bullshit like the idea that doctors kill more people than car wrecks. That's just nuts. That JAMA study is a good debunker.

      • BlueCatBlueCat says:

        Exactly. The problem of death due to malpractice is real. The car wreck v doctor stats are phony. Like hammers and guns. Like the Heritage report on how much immigration reform is going to cost the economy.  Like…. you name it, the right  has phony stats for it that fall apart immediately upon the most cursory inspection.

        Even if you accept the stats, how does it logically follow that because doctors kill so many people it's wrong to demand that naturopaths be licensed? Huh?  Granted that kind of logic free "reasoning" is familiar to anyone reading responses here from our own rightie regulars or who listens to much rightie radio. It should no longer surprise.

      • ohwilleke says:

        "CDC’s analysis shows that . . . Overdose deaths involving opioid analgesics [i.e. prescription drugs] have shown a similar increase. Starting with 4,030 deaths in 1999, the number of deaths increased to 15,597 in 2009 and 16,651 in 2010. . . . In 2010, nearly 60 percent of the drug overdose deaths (22,134) involved pharmaceutical drugs." Note that a drug overdose death classified as suicide is not included in this total and that this number was almost certainly higher in 2012.  This means that if there are just 21,000 deaths a year from medical malpratice other than prescription overdoses which result from mismanagement of an physicians privileges, that the number of deaths from car accidents and medical error is the same.

        This is just half of the low end figure from the Institute of Medicine and not inflated at all.  The JAMA report argues that the Institute of Medicine figures are misleading, but not that they are factually incorrect.  Some of the big conceptual arguments against framing the issue the way that the Institute of Medicine report did that critics can legitimately object to are:

        (1) Almost all medical professionals save more lives than their malpractice takes away.  If you reported on a net basis per medical professional, the number of medical provider caused deaths would be zero in 99.999% or so of cases.

        (2) Many patients who are victims of medical errors would have lived had they received care in accordance with reasonable professional standards, but would have died anyway if they received no care at all (e.g. someone who had emergency surgery from a gunshot wound who dies of a surgery related infection because a doctor didn't wash his hands first, instead).  Any measurement of lives lost from medical errors needs to be clear about what this measurement is relative to.

        (3) Many people killed by medical errors are frail people with terminal conditions and/or elderly and would have died not terribly much later (perhaps just a few days or months or a year) even if they had received care in accordance with reasonable professional standards, but died earlier because of medical errors.  While the proximate cause of their death was medical error, the number of years of life lost due to medical error in these cases is far smaller than the number of years of life lost due to car accidents where most victims have long lives ahead of them.  (This distinction is a huge one in cost-benefit analysis of health care and environmental regulations and is usually resolved in favor of a years of life lost measure.)

        • ohwilleke says:

          Specifically, the JAMA evaluation focused on point 3.  It confirmed the Institute of Medicine conclusion that 6% of cases involved deaths due to medical errors, but found that about 11/12th of those deaths from medical errors (all but 0.5%) affected people who had a life expectency of three months or less.

    • GalapagoLarryGalapagoLarry says:

      I would assume that neuropathic doctors also make up a miniscule share of all medical practitioners, also. What's the point?

  9. Duke CoxDuke Cox says:

    Before my wife and I moved away from Garfield county, our doctor was a young man named Jeremiah Eckhaus. He was both a naturopath and a board certified MD. He was brilliant, and one of the best doctors, if not THE best physician either of us have ever known.

    His great skill was balancing the naturopathic approach to health and healing with the benefits of traditional western medicine. We grew to trust him immensely in the time that he cared for us.

    Incidentally, it was Dr. Eckhaus who finally convinced us to move away from Silt Mesa. Along with the rest of his patients, we received a letter one day announcing that he was taking his pregnant wife and his three year old daughter and moving to Vermont because oil and gas operations around Rifle had made the place unsafe to live.

  10. Albert J. Nock says:

    Silly Marblehead

     

    Marbleheads real crime was naming a State Highway after a Federal soldier. Her and Buck should resist presenting such bad ideas because anybody who says no is automatically a villain.  I know it is a sad story and all but it is not like kid was a great General or something special. Did your people really elect you to waste your time on this?  Maybe you should think about road repair rather than road names.

    Keep your Nationalism and bleeding heart in the closet, please…

     

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