Forget ObamaCare v. TrumpCare, medical errors are the real challenge

With Republicans failing to repeal the Affordable Care Act and replace it with their own version of healthcare policy in the first 100 days of the Donald Trump presidential administration, it’s back to the drawing board for the federal government. But for providers, it’s business as usual — and that’s a problem.

Policy is important in setting a vision for our national healthcare system and building a regulatory framework for reaching it. Insurance coverage and access to care, the issues at the heart of many current political conversations, are vital. But the national obsession with ObamaCare vs. TrumpCare is diverting attention from a more urgent healthcare issue: medical mistakes.

{mosads}According to a recent report from doctors at Johns Hopkins Hospital, medical errors are the third biggest killer of Americans today, behind heart disease and cancer. Like those diseases, medical mistakes don’t care whether the patient is a Republican or Democrat. Yet even though medical mistakes kill an estimated 250,000 Americans every year, they’re rarely discussed in the halls of Congress or on the nightly news.

Mix-ups happen more often than the average patient might think, and even simple errors can carry life-threatening results: attaching the wrong IV bag because the liquid looked right and the nurse didn’t take the time to read the label; providing the wrong medications to patients with similar names.  These so called “never events” occur everyday.

Other mistakes are more egregious, such as operating on the wrong body part. One of the most common errors is leaving a surgical item, such as a scalpel or sponge, inside a patient after surgery.

The issue is not that nurses, doctors, and other healthcare providers lack awareness about potential mistakes. Nor is it that providers lack ways to prevent mistakes from happening. It’s that the system fails to acknowledge and expose mistakes, and lacks the motivation to change.

Getting rid of medical mistakes is not about prescribing disciplinary actions to doctors and nurses who make mistakes. Patients and their families have access to the legal system to recoup damages but unfortunately only those with grievous injuries typically enter into litigation and the result only addresses the injury of that single individual. The legal system does not typically create systemic change.

Instead, the answer is to create a more robust culture of safety across the entire healthcare industry. In this culture, the responsibility should fall on everyone, including both providers and patients.

Providers should acknowledge the problem and take steps to prevent errors from happening in the workplace. That might mean taking a little bit more time to double check that a medication or dosage is accurate, or adopting technology that, for example, helps track sponges during surgery so they aren’t left inside the patient.

Patients, too, must start speaking up and asking questions of their doctors and nurses. From questions about the meaning of what a physician says, to the numbers a nurse reads after a blood test, to the strange looking tool a surgeon is reaching for, patients who dare to ask may be surprised at how responsive providers will be. And even a modest question could prove life-saving.

Though many providers would prefer the government to stay out of world of healthcare, there’s also a role for regulators and legislators. They can surely mandate the use of safety checklists or new technology, and they can promote transparency in the reporting of medical errors so the profession and the public can get a clear picture of the problem we face together.

But perhaps the most important thing we can all do is to continue talking about it the challenge. Sustained attention to ideas like the culture of safety is the best way to keep it top of mind. It’s said sunlight is the best disinfectant. From a medical perspective, that’s obviously not true. But from a patient safety perspective, it very well may be.

Nicolas Argy, M.D., J.D., is a patient-safety consultant with 30 years of experience in clinical radiology, health policy and public health.

The views expressed by contributors are their own and are not the views of The Hill.