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Iatrogenisis/Medical Misadventure

• Disease or illness induced by medical treatment or diagnosis. A major source comes from medical error.

• Costs to society

o Correcting the bad result

o The patient’s productivity

• A 1984 New York study found that only 1% of treatments had resulted in error due to physician negligence, whereas 3.7% had resulted in error.

• Risk Factors

o Age

▪ The older one is, the more likely they are to sustain an adverse event.

o Type of Institution

▪ Government hospital patients sustain 50% more adverse events than patients in non-profit institutions, and 3 times more than those in proprietary hospitals.

▪ Non-teaching hospitals sustain less than teaching hospitals, yet non-teaching hospitals have more negligence.

• It is important to note that physicians are not infallible, as no human being is infallible. Furthermore, by revealing a mistake he or she has made, the physician might be placing his or her entire career on the line.

• Approaches to Quality Improvement

o Professional ethics and socialization (traditional)

▪ Physicians are taught that they must be infallible – their entire practice must be error-free.

o Expand the role of the marketplace, using dissemination of quality information to consumers and buyers of health, on the theory that prudent buyers will reject lower quality providers.

o Improve the current modes of self-regulation of the medical profession and the industry, which include accreditation, medical staff privileges, and medical licensing actions.

o The process by which a patient sues for malpractice can be improved.

o The government can intervene by setting standards and demanding better processes nad outcomes.

• The Medical Approach to Error Prevention

o The Perfectibility Model

▪ The reasoning under this model is that if physicians and nurses could be properly trained and motivated, then no mistakes would...