1/6/2003

Physicians, Public Not Overly Concerned About Medical Errors

Kate Traynor

National efforts to reduce medical errors could be hindered by perceptions among physicians and the public that improving safety is not as important as other issues that affect health care today.

A recent survey of 831 practicing physicians and 1207 members of the public found that 5% of physicians and 6% of the public view medical errors as one of the nation’s most important health issues.1 Of note, 35% of the physicians and 42% of the nonphysician respondents said that they or a family member had been a victim of a medical error at some time.

Of the physicians surveyed, 29% said that the costs associated with malpractice insurance and lawsuits are the most pressing current national health issue; 27% named the cost of health care as the most important national health issue. Coming in third, cited by 22% of the physician respondents, were problems with insurance companies and health plans.

Members of the public were likewise more concerned about the costs of care than with medical errors. Of public respondents, 38% said that the cost of medical care is the most important health issue they face today, and 31% were concerned about the high cost of prescription drugs.

When asked to choose from a list the number that best estimates how many patients die each year from preventable medical errors, most physicians and patients selected either 5,000 or 50,000 patient deaths. Just 9% of physicians and 7% of the public estimated that 100,000 medical errors result in death each year, a figure that approximates the annual number of deadly errors cited in a landmark report from the Institute of Medicine (IOM).2

According to the recent survey, described in the New England Journal of Medicine, at least half of the physicians and 65% or more of the public respondents believed that understaffing of nurses and overwork, stress, or fatigue of health care professionals are important causes of medical errors.

Seventy-two percent of the public, but 37% of physicians, said that a major cause of errors is the fact that physicians do not have enough time to spend with patients. The failure of health care professionals to work together as a team was cited as a critical cause of errors by 67% of the public and 39% of physicians.

The public and physicians differed in what they considered to be effective ways to reduce medical errors. Forty percent of the public and half as many physicians said that including pharmacists on hospital rounds is a very effective way to reduce medical errors.

Most of the responding physicians indicated that two error-reduction remedies can be very effective—increasing the number of nurses who work in hospitals and requiring hospitals to develop systems that prevent medical errors.

While public respondents endorsed these two remedies, at least half also indicated that additional workplace strategies, such as giving physicians more time to spend with patients, improving the training of health care professionals, relying exclusively on intensivists to direct treatment in intensive care units, and reducing physicians’ work hours to prevent fatigue, can be very effective at reducing medical errors.

Physicians and the public also diverged sharply in their views of the effectiveness of error reporting to reduce medical mishaps. Seventy-one percent of the public and 23% of the physicians strongly supported requiring hospitals to report all serious medical errors to a state agency. Sixty-two percent of the public and 21% of physicians said that encouraging voluntary state-operated error-reporting systems can be very effective methods to reduce errors.

Perhaps not surprisingly, 3% of physicians and half of public respondents said that suspending the licenses of health care professionals who make errors is an effective way to improve safety. The report’s authors noted that the public’s strong support of punishing individuals for medical errors directly contradicts IOM’s view that errors should be regarded as institutional systems failures, not personal failures.

The report’s authors, whose work was supported by the Kaiser Family Foundation, concluded that national groups committed to error reduction must make an effort to promote, especially to physicians, the idea that current strategies designed to reduce medical errors can be very effective.

  1. Blendon RJ, DesRoches CM, Brodie M et al. Views of practicing physicians and the public on medical errors. N Engl J Med. 2002; 347:1933-40. 
  2. Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building a safer health system. Washington, DC: National Academy Press; 1999.

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