Will Medicine Ever Become Safer?

Hello and welcome. I am Dr. George Lundberg and this is At Large at Medscape.

Hospitals are dangerous places. I no longer work in a hospital, and I try never to go to hospitals even to visit, unless, of course, I or my family were to become really sick and would obviously stand to benefit from hospitalization. I feel almost the same about surgicenters, free-standing emergency rooms, and urgent care facilities.

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In 1999, the Institute of Medicine published the sentinel report To Err is Human, ^[2] still a best-seller. They pegged the annual number of American hospital deaths secondary to errors and adverse effects of treatment to be 44,000 to 98,000. In an interview earlier this year, I asked Lucian Leape whether that number still held. He said no, it was much larger. I asked whether we had made any progress. He said yes, but only in narrow fields.

In 2013, a new report^[3] in the Journal of Patient Safetyestimated American hospital deaths following adverse events at 210,000 to 440,000 per year. Medicare patients are reported to die at a rate of 180,000 per year from or with nosocomial infections and other medical care-related problems

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