Should Doctors Stop Talking About Gun Violence Because Medical Errors Cause More Deaths? No.

Gun Nation is abuzz with the publication of an article in the British Medical Journal which finds an alarmingly high rate of U.S. hospital deaths due to medical errors.  Now why would the pro-gun noise machine care one way or the other about an article in a medical journal?  Because it’s been an article of faith amongst the gun faithful that physicians should stop wasting their time talking about gun violence when the number of people killed each year by firearms is just a fraction of the number who die due to medical mistakes.  And since the BMJ article states that medical errors account for anywhere between 200,000 and 400,000 avoidable deaths each year, and annual gun homicides only count around 11,000, why can’t doctors take care of really ill patients properly before they start making so much fuss about guns?

docs versus glocks           Marion Hammer, former NRA President who spearheaded Docs versus Glocks in Florida, says that docs should “do no harm” and keep their political opinions out of the examining room.  And in pushing for the gag law, Hammer distributed a document that listed ‘medical misadventures’ as three times more likely to result in deaths than accidental shootings.  Other sources, like media that promote natural healing, paint an even grimmer picture, with one expose claiming that guns kill 31,940 Americans each year (homicide/suicide/accidents) but the medical system accounts for783,936 deaths! By the way, this particular website also published a story that said the San Bernardino shooting had all the “signs” of a staged government operation, and this story rolled out more than 31,000 times.  Hmmmmm.

The problem is that the British Medical Journal isn’t an adjunct of the Area 51 gang, so when they publish something about morbidity from medical errors, it needs to be taken seriously, particularly if what they say ends up being injected one way or another into the gun violence debate.  Now let me make it clear that I’m not a physician and I have no medical training of any kind.  But I know how to read the King’s English and I can figure out whether data in a peer-reviewed journal aligns with the facts and conclusions on which the article is based.  In the case of the BMJ, I not only read the article detailing mortality rates from medical errors in U.S. hospitals, I also closely read the articles on which the BMJ article was based. Let’s start first with the BMJ.

In 2013, 611,000 Americans died from heart disease, 585,000 died from cancer and 251,000 died from medical error, this last being the third most common cause of death.  Since the medical profession doesn’t actually have specific medical errors as coded events in the ICD-10 coding system used almost universally as the primary indicator of health, the figure noted above is a best-guess estimate based on specific studies of in-patient outcomes throughout the U.S. The most comprehensive study from Medicare records, gave the total mortality for doctor errors as slightly more than 195,000 per year from 2000 through 2002, of which 75% of all deaths were attributed to something known as ‘failure to rescue,’ which means a diagnostic error leading to improper (or no) treatment, leading to the patient’s death.

But failure to rescue in a clinical context may have little, if anything to do with decisions made by physicians themselves. Many such deaths are attributable to mistakes in managing patient information, particularly for elderly patients who tend to suffer from multiple conditions requiring intensive and complicated care. A necessary treatment is omitted or delayed, vital signs begin to decompose, the patient is dying but his physician may be far removed from the scene.

To compare the ‘responsibility’ of physicians for patient deaths to the ‘responsibility’ of a gun owner who lets his gun get into the wrong hands, is to make a comparison with no basis in fact. But since when did Gun Nation respond to the issue of gun violence with any facts at all?

 

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