Many of us probably know that the number-one killer in the U.S. is heart disease. Number two is cancer. But a new study from Johns Hopkins University says the third leading cause of death in this country is mistakes, errors made in hospitals or in the larger health care system. These numbers are actually well known to researchers.
Marty Makary is a cancer surgeon at Johns Hopkins. And what astonishes him is that these numbers are excluded from official health statistics. Because the CDC fails to keep track of these errors, he says it makes the root causes harder to tackle. I asked Dr. Makary to first explain why there are so many mistakes.
MARTY MAKARY: One of the most dangerous things that can happen to you in the emergency room is a patient handoff, that is, one nurse or doctor passing on your information to somebody else and missing a critical part of your care or concern that they have. And every doctor or nurse in America has seen it. And it's almost as if there is this silent endemic, but it's not disseminated or measured broadly.
It turns out that people die from the care that they receive not just from the disease or illness for which they present for care. And if you look in totality, it ranks as the third leading cause of death in the United States.
MARTIN: So you're saying the number three cause of death in America is mistakes.
MAKARY: Is people dying from the care that they receive, undertreatment, overtreatment, diagnostic errors, medication overdosing, falling through the cracks.
MARTIN: But are these always preventable mistakes?
MAKARY: So we're referring to these as preventable. We're never going to eliminate human errors from the practice of medicine. We're human beings as doctors. But we can engineer the hospital delivery so that the impact of our errors are minimized or caught with safety nets.
MARTIN: So why is this happening? I mean, as a patient, as someone hearing this, you think to yourself, this is horrible. This doesn't exactly instill a lot of faith in our country's health care system.
MAKARY: Well, we have a lot of stakeholders in medicine. But unfortunately, the patient is not one of the most vocal stakeholders in the United States. When egregious event happens to a patient, oftentimes there's a settlement. And every time, as a part of that settlement, is a gag rule that no patient or doctor can talk about anything related to that event for the rest of their life.
We need to create an open and honest culture about things that go wrong in medicine, just like aviation has created a culture where every pilot in the world will learn the lessons from a single crash with those results disseminated. We consider that to be part of public safety. And we can do the same in health care. We can learn the lessons and share them broadly with medical-legal protections and track medical mistakes in the same way we track cancer statistics in my own field of cancer surgery.
MARTIN: So that's what you want to change. You need it to be listed as a cause of death before you can get the attention on fixing these kinds of errors.
MAKARY: Absolutely. The most common causes of death list generated in our country's national health statistics, that list is a big deal. It informs all of our research funding, all of our public health campaigns. And to have a methodological flaw where the third leading cause of death, that is medical care gone wrong, is not even listed, it results in a tremendous under-recognition, underfunding and under appreciation of the magnitude of the problem from every level, from research priorities to public awareness among patients.
MARTIN: What can patients do to mitigate these risks?
MAKARY: Patients that do well are often empowered. They know the treatment options. They're asking every question. They know which pill they're taking. And they're right there with their loved one at the bedside because it turns out, 1 in 4 patients will have some form of medical error during the time of their hospitalization. It may not be consequential, but they are ubiquitous. And that's because we're human beings working in a messy system.
MARTIN: Marty Makary of Johns Hopkins medical school, thank you so much for talking with us.
MAKARY: Great to be with you, Rachel.