Seeking medical care can put people at risk of harm, making patient safety an important topic for journalists on the health beat. In this section of the AHCJ website, we intend to help you find story ideas and provide you with resources needed to add depth and context to your reporting on this critical issue.
The concept of patient safety has evolved since the 1999 publication of a landmark report, “To Err is Human,” by what’s now called the National Academy of Medicine. That well-regarded report sparked greater interest in tracking how often doctors and nurses inadvertently harm patients, such as by prescribing the wrong medicine or botching a surgery.
Estimates vary on how often these kinds of harms occur, reflecting in part different ways of calculating harm. A 2016 paper in the BMJ offered a rough mean estimate of 251,454 U.S. deaths due to medical errors as a starting point for discussions and further research. Federal reports focused on people enrolled in Medicare have found notable rates of medical errors, such as an estimated 13.5% of people covered by the giant health programs suffering adverse events during their hospital stays.
We’ll help you find and use websites and other data sources that judge the quality of medical care provided by hospitals, doctors and nurses. But there’s also growing awareness of how the structure of the U.S. medical system, which tilts toward à la carte payments, increases the chances for harm. Simply put, doctors in private practice and health care organizations make more money if they perform more procedures and run more tests. In recent years, there’s been a drive to try to spark more careful consideration of medical care.
The American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative, for example, offers many resources written in simple language to help people understand why certain treatments should be avoided. These include materials intended to help reduce use of narcotic painkillers in an effort to address the national opioid epidemic.
JAMA Internal Medicine’s “Less is More” series documents ways that overuse of medical care harms patients as well as wastes money. A case study published in October 2021 as part of JAMA Internal Medicine’s “Teachable Moments” series, for example, documented a case of a 70-year-old man who was sent to the cardiologist for a risk assessment before a hip procedure. Although the patients had no known cardiovascular disease nor history of cardiac symptoms before testing, he wound up undergoing heart procedures that resulted in a surgical complication. This case underscored questions raised by previous research about cardiac testing for patients with low heart risk before an elective orthopedic procedure known as arthroplasty, wrote Ravi Chopra, M.D., Ph.D., and his co-authors in the JAMA Internal Medicine paper.
AHCJ also intends to help its members monitor the work of the organizations that people count on to protect them from harm in the medical system. In a sense, we need to be the watchdogs for the watchdogs. We need to report on how well or poorly government organizations such as the Food and Drug Administration (FDA) and state medical boards are doing in protecting people from risky products and dangerous medical professionals.
We ask all journalists and others who visit these pages to send us ideas, questions and suggestions. In particular, we invite you to share your successes with us and point us to good stories that you and other journalists have done when covering health reform. Also, we ask that you help us help you avoid the pitfalls of the not-so-good ideas.