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Malpractice Makes Perfect

Scott Shuger
Posted Tuesday, Nov. 30, 1999, at 6:55 AM ET

USA Today

, the Washington Post, and New York Times all lead with a prestigious independent medical organization's call for a new federal agency dedicated to minimizing medical mistakes, which, says the organization, are now killing between 44,000 and 98,000 people a year. The Los Angeles Times reefers this to a Page 3 story, leading instead with the naming in Northern Ireland Monday of a Protestant-Catholic power-sharing Cabinet, which could mean the true end of "The Troubles" in that country.

The papers explain the basic point of the medical error recommendations: most slip-ups occur not from individual ineptness but from structural flaws in the ways hospitals and caregivers function. An example both the NYT and the WP cite is prescribing the wrong drug because its name is very similar to the right one. Systematically noting and disseminating such possible confusions to physicians would reduce risk. All three leads make the point that medicine could benefit from following the tracking and notification procedures of other risky fields like aviation and nuclear power. The NYT notes that establishing such a system is thought to cost only slightly more than 1 percent of the $8.8 billion in health-care costs attributable to preventable medical injuries.

The biggest unclarity in the medical error coverage has to do with who would get to see the results of the proposed systematic error tracking. Just doctors, or potential patients too? USAT refers to reporting "without fear of punishment," which suggests a pretty tight lid. Both the NYT and WP suggest that the system envisioned would allow serious medical errors to be made known to the public but keep less serious ones confidential. But there's no discussion of whether this makes sense from the patient's point of view. A related point: There's already a data bank for sharing information about incompetent doctors. Surely it would be relevant to know if it functions similarly to what's being proposed now and to know if it has indeed helped make medicine safer.

The other significant wiggle room in the stories relates to the dimension of the medical error problem. USAT says it's the eighth-largest killer in the U.S. The WP suggests it's the fifth. How do the two papers get different results off the very same press release? Well, USAT goes with the low end estimate of error-based fatalities and the Post goes with the high end.

The NYT and LAT go high on their fronts with reports that Mexican and U.S. authorities have begun excavating sites in Mexico very near the Texas border believed to be a dumping ground for scores of Mexicans and Americans killed by drug traffickers within the past few years. The LAT says officials are expecting to find between 100 and 300 corpses. Both papers say that members of Mexican law enforcement are suspects in some of these murders. USAT blurbs the story inside.

The USAT off-lead and the top story in the Wall Street Journal business news index is that later this week, on the heels of a spate of problems with Boeing airliners, the FAA will start a thorough safety inspection of the company's manufacturing plants, focusing on quality control procedures. The Journal says the field audit comes after months of increasing tension between the agency and company.

The LAT fronts, and the WP and NYT stuff, the developing saga of that 5-year-old Cuban refugee boy plucked from the ocean near Miami on Thanksgiving morning. The boy, who saw his mother drown and then spent 24 hours adrift in an inner tube, is the object of an international tug of war. He is staying with relatives in Florida and has become, says the LAT, a poster child for anti-Castro exiles there, but his father, back in Cuba, wants him returned. The boy is said to want to remain in the U.S. The matter will probably end up in federal court.

The WSJ reports that the World Wrestling Federation, faced with advertiser pullouts, may be toning down its material. It quotes WWF minor domo Vince McMahon as saying viewers will soon see less aggression, less colorful language, and less sexuality. The biggest advertiser to pull out over content is Coke, which has a wait-and-see attitude about coming back. Another refugee from the sex and violence: the U.S. Army.

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Scott Shuger was a Slate senior writer and the original author of "Today's Papers." He died June 15, 2002.
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