Copyright USA Today Information Network Dec 12, 2002

Health & religion

More than one-third of practicing physicians and 40% of the public have experienced a medical error in the care that they or a family member received as patients, a survey reports today.

Among those who have experienced or seen a medical error -- defined as a mistake that results in death, disability or requiring additional treatment -- 18% of physicians and 24% of the public said the mistake caused "serious health consequences."

The survey could add to the growing concern about the incidence of medical errors in the USA. That concern reached a peak with a report issued in 1999 by the Institute of Medicine, which estimated that as many as 98,000 people die from medical errors each year.

"This survey provides strong documentation that medical errors represent a problem that affects a significant number of people," says Drew Altman, president and CEO of the Kaiser Family Foundation, which conducted the survey with the Harvard School of Public Health.

"The fact that so many physicians report personal experiences with errors corroborates what we heard from the public."

One-third of the doctors said they had seen a medical error in the past year.

A majority of physicians who had seen an error expected to see another at the same medical institution within a year; 15% said another tragedy is "very likely."

The survey, which appears in today's New England Journal of Medicine, says neither the public nor physicians believe medical errors are as common as estimated in the Institute of Medicine's 1999 report, "To Err is Human." A majority of the 831 physicians and 1,207 adults who answered the nationwide survey last spring said they believe that fewer than 50,000 deaths are caused by medical error each year.

Both groups ranked medical errors below concerns about costs, insurance and access as major problems facing health care. Only 5% of physicians and 6% of the public identified medical errors as a top concern.

Doctors said malpractice insurance costs, lawsuits and health care costs are their top concerns. The public said health care costs and, in particular, the cost of prescription drugs are the biggest problems facing health care.

Both groups said that the medical errors were rarely revealed to families and that families rarely sued when told of the errors.

Beyond that, there is little agreement between the public and doctors on proposals to prevent errors. For instance:

* 62% of the public said reports of serious errors should be released publicly; 14% of physicians agreed that the reports should be released.

* 71% of the public said requiring hospitals to report errors to a state agency would be very effective; 23% of doctors agreed.

* 50% of the public supported suspending licenses of health professionals who make medical errors; 3% of physicians agreed.

* 66% of the public said it would be very effective to reduce the work hours of physicians in training; 33% of physicians agreed.

One of the striking findings of the study, says Robert Blendon, a professor of health policy at the Harvard School of Public Health, is that "physicians disagree with national experts on the effectiveness of many of the proposed solutions to the problem of medical errors."

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Where doctors and patients place blame

According to the Kaiser/Harvard survey, practicing physicians blame medical errors on:

* Nursing shortage, 53%

* Overworked, stressed or fatigued health care workers, 50%.

The public blames medical errors on:

* Physicians not having enough time with patients, 72%.

* Overworked, stressed or fatigued health care workers, 70%.

* Health care workers not working or communicating as a team, 67%.

* Nursing shortage, 65%.

The margin of error was 3.5 percentage points for the physician arm of the survey and 2.6 percentage points for the public.

Source: Harvard School of Public Health/ Kaiser Family Foundation "Medical Errors: Practicing Physicians and Public Views"