A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care

A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care is a 2013 report produced by John T. James, Ph.D., that estimates the number of incidences of patient harm or death caused by modern hospital care in the US. Overall, the report found that, between 2008 and 2011, "a lower limit of 210,000 deaths per year was associated with preventable harm in hospitals" but "the true number of premature deaths associated with preventable harm to patients was estimated at more than 400,000 per year". Further, "[s]erious harm seems to be 10- to 20-fold more common than lethal harm." Altogether, this would make medical accidents the third leading cause of death in the US, after heart disease and cancer. (The CDC's estimates currently place accidents at fourth. )

The study itself appears valid, and evidence that further and ongoing medical reform must be done. The report gained significant media attention, not least because it disparaged the medical profession. However, the report has been used by all too many people opposed to "allopathic" medicine as evidence that allopathic medicine is bad, and you should prefer whatever it is that they're pushing.

There are several problems with this view.

Types of Reporting
It is important to understand which statistics for patient harm are being utilized. A number of hospitals have been moving towards open reporting of events with the potential for patient harm. This often includes events that don't actually reach the patient or cause them harm. It can be anything from a scale that is not well labeled leading to the possibility of dosage errors, medication errors in transcriptions caught by pharmacists, to serious safety events leading to harm or death. They use open evidence-based approaches to identify, find and correct the cause for future patients. Often publishing research and quality improvement that show positive results for other facilities to emulate in order to improve patient care.

This system does not exist for alternative treatments. Harm is generally shown in news articles and lawsuits with little interest in building a similar systems. Alternative medical practitioners often disparage critics and those looking to shine a light on their practices.

Allopathic vs human error
All but one of the Predictable Adverse Events (PAEs) looked for are human errors. Equipment that was not sterilized properly. A surgeon's carelessness. Miscommunication between doctor and nurse. Lack of patient compliance. If anything, the study shows that we imperfect humans make the error, not the "allopathic" system behind it. Even if we assume that "naturopathic" medicine worked and we switched to an entirely naturopathic system, we'd see the same kind of issues.

There are some studies in effect for naturopathic treatments which show the same types of human error. This includes improperly placed needles going deeper than intended, puncturing major organs that needed to be surgically removed, needles accidentally being left in patients, and infections caused by reusing needles without sterilizing them.

Scale
Even some acupuncture proponents admit "more people use hospitals than acupuncture in the U.S.", though they argue "that doesn’t come close to touching the difference in death rate."

The problem here is that, unlike hospital deaths, which are increasingly well-reported, deaths from acupuncture or herbal medicine or faith healing or almost any alternative medicine have effectively no reporting system. It's entirely possible that alternative medicines kill at higher rates than allopathic medicines. Little is known due to the lack of regulation on supplements and treatments until regulators start looking into incidences of people being hospitalized at legitimate medical centers.