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by trevdarc 4044 days ago
"Doctors, meanwhile, learned humility. If you’re a doctor, it’s one thing to know, as an abstract fact, that 10 or 20 percent of patients who seemed to die of heart attack actually died from pulmonary embolism. It is quite another to have a pathologist dissect one of your patients and tell you No, this woman you took care for 25 years, and whose husband you pass on the street each day, did not die of heart attack; she died of a pulmonary embolism, and that’s probably why she complained of shortness of breath when you examined her three months ago. An angiogram might have spotted it."

If we increase the rate of autopsies, the higher degree of accountability for doctors will lead to higher stress levels in the profession. The rate of suicide in physicians is already far above average. The US should be doing more autopsies, but we should increase them in a way that supports the profession, rather than giving our culture another way to point fingers at doctors and say "your mistake killed that person".

2 comments

In software development and system administration - automation, variables, and copy-paste (instead of retyping) can be used to remove the possibility for human error to occur. Instead of seeing the number "0x80007003" and accidentally retyping it as "0x80070003", we can just copy it, and paste it into the other system. Or have the systems talk to each other and take us out of the loop.

How do we remove opportunities for human error in medicine and health care?

I worked for a medical software company for a couple of years a little while ago. One of the major ingredients in the mandatory corporate beverage was the concept of "patient safety".

As a severe simplification, you can think of the transition from older medical processes to newer ones as like pulling all the string parameters, string parsing, and string building out of old code and replacing it with strictly typed data. In doing so, you remove all errors generated by improperly formatted strings.

That, and barcoding every damned thing in the hospital.

For instance, you barcode the patient's wrist tag, and you barcode everything going out of the hospital pharmacy. When the nurses go into a room to administer a patient's meds, they scan the patient, and scan the medication. The scanner bleeps either a "yes, proceed" or a "WHOA WHOA WHOA, RIGHT THERE! WRONG MED OR WRONG PATIENT!"

That last measure alone saves thousands of lives every year.[0]

[0] This statistic is entirely made up, but sounds about right.[1]

[1] Fine. Sort through it yourself. This ought to get you started:

https://scholar.google.com/citations?view_op=view_citation&h...

https://scholar.google.com/citations?view_op=view_citation&h...

The rate of suicide among physicians is mainly due to their higher success rate. They have a lower attempt rate compared to the population at large.