Take a photo of a barcode or cover
4.09 AVERAGE
4.09 AVERAGE
This book was a really nice overview of the extent of medical error and the ways the system alleviates or perpetuates them. The author tied in some stories of her own and some cases, which helped make a rather academic topic more tangible and personal.
informative
slow-paced
4.5 stars
So many things can go wrong in modern medicine, from misdiagnosing a disease to administering the wrong medicine with disastrous results. While there's all kinds of research about medical error most of it concentrates on procedural errors in inpatient settings, such as doctors forgetting to wash their hands before approaching a patient's bed. The literature ignores that most medical care is given in outpatient settings (doctors' offices, acute care) and many, many errors take place when a doctor tries to figure out what's wrong with you in the first place.
Add in mistakes caused by the computerized charting system, exacerbated by poor hand offs, and ignored by know-it-all doctors and we have a mess. Ofri leads us through it all in her approachable, engaging, and beautifully written style.
Here are some things I learned:
- According to one study (everything is clearly end noted, by the way) over 80 percent of errors are related to a problem in doctor-patient communication. Ofri points out that nearly every error she reviewed for the book could have been prevented, or had its harm minimized, had there been better doctor-patient communication.
- Capitalism in health care messes up so much stuff. Electronic medical records started as a billing system. Diagnoses are connected directly to billing codes, and there is no billing code for uncertainty. If there's a set of interrelated problems the doctor has to pick one as the diagnosis, risking that later doctors won't grasp the complexity of the issue.
- Don't get me started on malpractice lawsuits.
- Procedural errors can be fixed with checklists, but diagnostic errors are cognitive errors, and "fixing" how a doctor thinks is much, much harder.
- Hospital culture matters. Do the nurses feel comfortable speaking up when they see something wrong? Are patients' families listened to or dismissed?
- Many proposed solutions assume slow, methodical thinking when much of what doctors do is in the moment, under time pressure.
I love Ofri's writing style - suspenseful narrative nonfiction when going through a case, introspective and insightful when discussing her own experience with error.
Make no mistake, many cases in this book are hard to read. A wife watching her husband die before her eyes without the medical staff doing anything to stop it. Mistreatment of a burn victim leading to his death, despite the efforts of nursing staff to get him better care. But the last couple of chapters give us hope, as well as concrete things a patient and their family can do to prevent medical error. Websites, professional organizations to contact, laws to be aware of, how to word requests to doctors, it's all here.
This is my favorite Ofri book to date, which is saying a lot. A must read if you have any kind of interest, and a natural follow-up to [b:The Checklist Manifesto|6667514|The Checklist Manifesto How to Get Things Right|Atul Gawande|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1312061594l/6667514._SY75_.jpg|6862414] as Gawande only scratches the surface.
So many things can go wrong in modern medicine, from misdiagnosing a disease to administering the wrong medicine with disastrous results. While there's all kinds of research about medical error most of it concentrates on procedural errors in inpatient settings, such as doctors forgetting to wash their hands before approaching a patient's bed. The literature ignores that most medical care is given in outpatient settings (doctors' offices, acute care) and many, many errors take place when a doctor tries to figure out what's wrong with you in the first place.
Add in mistakes caused by the computerized charting system, exacerbated by poor hand offs, and ignored by know-it-all doctors and we have a mess. Ofri leads us through it all in her approachable, engaging, and beautifully written style.
Here are some things I learned:
- According to one study (everything is clearly end noted, by the way) over 80 percent of errors are related to a problem in doctor-patient communication. Ofri points out that nearly every error she reviewed for the book could have been prevented, or had its harm minimized, had there been better doctor-patient communication.
- Capitalism in health care messes up so much stuff. Electronic medical records started as a billing system. Diagnoses are connected directly to billing codes, and there is no billing code for uncertainty. If there's a set of interrelated problems the doctor has to pick one as the diagnosis, risking that later doctors won't grasp the complexity of the issue.
- Don't get me started on malpractice lawsuits.
- Procedural errors can be fixed with checklists, but diagnostic errors are cognitive errors, and "fixing" how a doctor thinks is much, much harder.
- Hospital culture matters. Do the nurses feel comfortable speaking up when they see something wrong? Are patients' families listened to or dismissed?
- Many proposed solutions assume slow, methodical thinking when much of what doctors do is in the moment, under time pressure.
I love Ofri's writing style - suspenseful narrative nonfiction when going through a case, introspective and insightful when discussing her own experience with error.
There are days when I envy Sisyphus: at least it's the same stinking boulder he's pushing up the hill every day. For a doctor, it's a sea of boulders, any one of which - if missed - could come crashing down on one of my patients. Or on me, in the form of a lawsuit.
Make no mistake, many cases in this book are hard to read. A wife watching her husband die before her eyes without the medical staff doing anything to stop it. Mistreatment of a burn victim leading to his death, despite the efforts of nursing staff to get him better care. But the last couple of chapters give us hope, as well as concrete things a patient and their family can do to prevent medical error. Websites, professional organizations to contact, laws to be aware of, how to word requests to doctors, it's all here.
This is my favorite Ofri book to date, which is saying a lot. A must read if you have any kind of interest, and a natural follow-up to [b:The Checklist Manifesto|6667514|The Checklist Manifesto How to Get Things Right|Atul Gawande|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1312061594l/6667514._SY75_.jpg|6862414] as Gawande only scratches the surface.
emotional
informative
medium-paced
I'm fortunate that in my thirtysomething years on this planet I haven't required anything more serious than some antibiotics for strep, and the only time I've gone under the knife was for elective cosmetic surgery. My husband, likewise, is healthy as a horse (knock on all available wood). So I approached this book very much as an outsider with a general interest in, well, generally all things, and the premise sounded interesting. I was extremely surprised at how much I walked away with from this book, even having no ongoing medical conditions myself.
The book is structured in such a way that the author's points are mixed in with actual cases and examples emphasizing what she finds important. There's also two larger cases that span a good chunk of the book, one involving a patient named Jay and the other a burn victim named Glenn, that she uses to drive home points all throughout the book. I really liked this approach, and also appreciated the fact that everything was easy to understand and approachable.
The premise can be a little scary for some people, that mistakes can happen, but people are people and this is very hard to overcome. The author goes to great lengths explaining all the safeguards and thought processes in place to prevent mistakes from happening, and then also discusses all the ways these can be bypassed in the name of expedited care and overworked staff. The specific mistakes involved in the two larger cases (Jay's and Glenn's) are outlined at the very end of the book, and the author discusses how these mistakes and others can be avoided by the medical industry. Chapter 16 especially was good to read, as the author discusses what a patient can do to protect themselves, and also provides various resources to reach out to if negligent treatment is suspected.
All in all I enjoyed this book a ton and walked away with some valuable information that I'll hopefully carry with me as my husband and I get older.
The book is structured in such a way that the author's points are mixed in with actual cases and examples emphasizing what she finds important. There's also two larger cases that span a good chunk of the book, one involving a patient named Jay and the other a burn victim named Glenn, that she uses to drive home points all throughout the book. I really liked this approach, and also appreciated the fact that everything was easy to understand and approachable.
The premise can be a little scary for some people, that mistakes can happen, but people are people and this is very hard to overcome. The author goes to great lengths explaining all the safeguards and thought processes in place to prevent mistakes from happening, and then also discusses all the ways these can be bypassed in the name of expedited care and overworked staff. The specific mistakes involved in the two larger cases (Jay's and Glenn's) are outlined at the very end of the book, and the author discusses how these mistakes and others can be avoided by the medical industry. Chapter 16 especially was good to read, as the author discusses what a patient can do to protect themselves, and also provides various resources to reach out to if negligent treatment is suspected.
All in all I enjoyed this book a ton and walked away with some valuable information that I'll hopefully carry with me as my husband and I get older.
The basic question addressed in this book is whether medical error is as prevalent as is often reported and such a high cause of death. The statistic itself appears controversial as it’s not universally accepted as, say, heart failure or cancer as leading causes of fatality. The author, who is also a medical doctor, takes the reader through two rather heart wrenching cases, one of which was the husband of an ER nurse in which he received substandard care that ultimately wound up in a long medical malpractice suit. Ofri does a good job balancing the human and scientific side of the debate, calling out the over reliance on filling out checkboxes and ENR’s and is open to allowing more technology to enter into practice to counterbalance potential sources of doctor error.