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Physicians, Public Not Overly
Concerned About Medical Errors
[To appear in the Jan. 15 issue of AJHP]
BETHESDA, MD, 06 January 2003 —
National efforts to reduce
medical errors could be hindered by perceptions among
physicians and the public that improving safety is not as
important as other issues that affect health care today.
A recent survey of 831 practicing physicians and 1207
members of the public found that 5% of physicians and 6% of
the public view medical errors as one of the nation’s most
important health issues.1 Of note, 35% of the
physicians and 42% of the nonphysician respondents said that
they or a family member had been a victim of a medical error
at some time.
Of the physicians surveyed, 29% said that the costs
associated with malpractice insurance and lawsuits are the
most pressing current national health issue; 27% named the
cost of health care as the most important national health
issue. Coming in third, cited by 22% of the physician
respondents, were problems with insurance companies and
health plans.
Members of the public were likewise more concerned about
the costs of care than with medical errors. Of public
respondents, 38% said that the cost of medical care is the
most important health issue they face today, and 31% were
concerned about the high cost of prescription drugs.
When asked to choose from a list the number that best
estimates how many patients die each year from preventable
medical errors, most physicians and patients selected either
5,000 or 50,000 patient deaths. Just 9% of physicians and 7%
of the public estimated that 100,000 medical errors result
in death each year, a figure that approximates the annual
number of deadly errors cited in a landmark report from the
Institute of Medicine (IOM).2
According to the recent survey, described in the New
England Journal of Medicine, at least half of the
physicians and 65% or more of the public respondents
believed that understaffing of nurses and overwork, stress,
or fatigue of health care professionals are important causes
of medical errors.
Seventy-two percent of the public, but 37% of physicians,
said that a major cause of errors is the fact that
physicians do not have enough time to spend with patients.
The failure of health care professionals to work together as
a team was cited as a critical cause of errors by 67% of the
public and 39% of physicians.
The public and physicians differed in what they
considered to be effective ways to reduce medical errors.
Forty percent of the public and half as many physicians said
that including pharmacists on hospital rounds is a very
effective way to reduce medical errors.
Most of the responding physicians indicated that two
error-reduction remedies can be very effective—increasing
the number of nurses who work in hospitals and requiring
hospitals to develop systems that prevent medical errors.
While public respondents endorsed these two remedies, at
least half also indicated that additional workplace
strategies, such as giving physicians more time to spend
with patients, improving the training of health care
professionals, relying exclusively on intensivists to direct
treatment in intensive care units, and reducing physicians’
work hours to prevent fatigue, can be very effective at
reducing medical errors.
Physicians and the public also diverged sharply in their
views of the effectiveness of error reporting to reduce
medical mishaps. Seventy-one percent of the public and 23%
of the physicians strongly supported requiring hospitals to
report all serious medical errors to a state agency.
Sixty-two percent of the public and 21% of physicians said
that encouraging voluntary state-operated error-reporting
systems can be very effective methods to reduce errors.
Perhaps not surprisingly, 3% of physicians and half of
public respondents said that suspending the licenses of
health care professionals who make errors is an effective
way to improve safety. The report’s authors noted that the
public’s strong support of punishing individuals for medical
errors directly contradicts IOM’s view that errors should be
regarded as institutional systems failures, not personal
failures.
The report’s authors, whose work was supported by the
Kaiser Family Foundation, concluded that national groups
committed to error reduction must make an effort to promote,
especially to physicians, the idea that current strategies
designed to reduce medical errors can be very effective.
- Blendon RJ, DesRoches CM, Brodie M et al. Views of
practicing physicians and the public on medical errors.
N Engl J Med. 2002; 347:1933-40.
- Kohn LT, Corrigan JM, Donaldson MS, eds. To err is
human: building a safer health system. Washington, DC:
National Academy Press; 1999.
—Kate Traynor
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