Avoidable errors

There were two stories on avoidable medical errors last night when I was watching the news.  The obvious one was on statistics from the District Health Boards on errors made in hospitals. These were up last year, though we don’t know whether it was better reporting or more errors.  On this topic, the best person to read is US surgeon Atul Gawande, especially his book The Checklist Manifesto.  As he points out, doctors do the wrong thing a lot more than they did a century ago, because there are so many more things they have to do right — medicine is getting more and more complicated.   It’s also helpful context to remember that avoidable errors in driving cause about 300 deaths and 6000 serious injuries per year in New Zealand.

The other story was on avoidable public health errors: the rate of infectious disease in New Zealand and its relationship to poverty and ethnicity. There are a lot of different diseases involved, but the most dramatic example is rheumatic fever.   Rheumatic fever is a nasty and almost completely preventable complication of  streptococcal throat infections, and in industrialized nations with modern healthcare systems it just shouldn’t be happening.   In the US, rheumatic fever is sufficiently obscure that it showed up in an episode of House, and even then it was just due to the patient not taking prescribed antibiotics properly.   There are major NZ initiatives to reduce rheumatic fever,  but this is the sort of medical statistic that should be in the news, because public awareness and public pressure on government is helpful in getting the problem fixed (rather than just getting it hidden, as is the risk with hospital errors).