There has recently been a lot of hype over a “new” study claiming that medical errors are the third leading cause of death in the US (this was really just a rehash of previous studies). Dr. Gorski has already done a fantastic job of explaining why that estimate is likely inaccurate, so I am going to focus on a slightly different issue that he only talked about briefly. Namely, even if the estimate is accurate (which its not), it would not support the conclusion that we should abandon modern medicine and switch to “alternative” medicines. In other words, many people try to use statistics like this to claim that modern medicine is actually dangerous and should be avoided, and that claim is extremely flawed for several reasons.
UPDATE 2019: New research has provided more evidence that the actual rate of deaths be medical errors is substantially lower than reported in the study I talked about here. I have updated the title of this post to better reflect that (it was originally “Medical errors may be the 3rd leading cause of death, but that’s not as bad as it sounds”). Dr. Gorski discussed the new research over at Science-Based Medicine.
First, as I recently explained in a different post, mortality rates in the US have been steadily decreasing with time, and that decrease is largely due to modern medicine. Yes, sanitation played a role back when we first switched to indoor plumbing and stopped letting raw sewage flow down our streets, but sanitation standards in the US haven’t changed appreciably in decades, yet the mortality rates continue to drop. So you clearly cannot give sanitation the credit for the continued decreases. To put this another way, modern medicine is obviously a good thing because of all the lives that it saves. If you stop and think about this for half a second, it should make perfect sense. Think of all the diagnostic tools, machines, procedures, etc. that we have today that we didn’t have a few decades ago.
Just to give one nice example, the first heart transplant was done in 1967, yet as of 2008, there were close to 2,000 heart transplants per year in the US, and that’s just one procedure for one organ. There are almost innumerable conditions that we can treat or prevent today that would have been fatal just a few decades ago, and just in case you aren’t convinced, think about this: if you were in a serious car accident, would you want to be treated in a modern hospital, using modern medical techniques, or would you want to be treated in a hospital from the 1950s that only used the techniques and medicines available then? I’m betting you’d pick the former (I’m also betting that you would want an actual hospital and actual doctors, not an uncertified clinic and a naturopath).
This brings me to my second major point. Yes, there are risks associated with seeking professional medical help, but there are also enormous risks too not getting help, and there are enormous benefits from getting help. To put this another way, you can’t make an argument based on a claim like, “medical errors are the third leading cause of death in the US” without also considering the number of people who are alive because of modern medicine. You have to consider the risks and the benefits, rather than just the risks.
Third, you also have to consider the fact that many of the people who are listed as “died from a medical error” also would have died if doctors had not tried to intervene. Let’s say, for example, that someone needs a heart transplant to live, and, during the surgery, a doctor screws up, and does something that kills the patient. That counts as death by medical error, but the patient still would have died even if the doctor didn’t do anything! In other words, this example (and many actual cases like it) are not situations where a healthy person walked into a hospital and was killed. Rather, they are situations where the person was at death’s door, and the doctors failed to save them. To be clear, I am not justifying medical mistakes, nor am I saying that we shouldn’t be trying to prevent them, but you need to understand that many of them are not adding to the total death toll.
To give a hypothetical example that will illustrate the point, imagine that there is a fatal condition that kills 1,000,000 people annually, and someone comes up with a treatment that cures 50% of patients, but kills the other 50%. It clearly would not make sense to argue that you should avoid the treatment because it kills 50% of its patients. Yes, it has a high death rate, but that death rate is still 50% lower than the death rate without the treatment. Even so, yes, many people do die while in hospitals, but the total death toll is still way lower than it would be without hospitals (Note: for my example, assume that this is a condition that kills you quite quickly, rather than a condition that you can live with for weeks or even years).
Finally, you may be thinking, “well, why not just switch to alternative medicines, I mean, what’s the harm?” First, most alternative medicines don’t work (or at least haven’t been tested and shown to work). So using something that either has been shown not to work or has never been tested rather than using something that has been shown to work is foolhardy. For example, by now everyone is probably familiar with the case of Ezekiel Stephan, the Canadian child who died when his parents tried to treat his meningitis with natural remedies rather than science-based medicine. This is only one among many such cases, and it clearly illustrates the dangers of avoiding medical treatments. Further, even for things like giving birth, the neonatal mortality rates are significantly lower for births at hospitals when compared to home births. So there are very real consequences to avoiding science-based medicine.
In short, science is not perfect, but it is still far better than anything else that we have. Although there are many deaths from medical errors, there are also countless millions of lives that are saved by medical successes. Further, the death rate from medical errors appears artificially high because they include many deaths that would have occurred even if the patient hadn’t sought medical help. So yes, there are many deaths for medical errors, and yes, we should be striving to correct the problems with our medical system, but it is absurd to suggest that we should throw out modern medicine altogether and return it the type of woo and snake oil that was prevalent in the dark ages. To use an old adage, you shouldn’t throw out the baby with the bath water.