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Internal Bleeding : The Truth Behind America’s Terrifying Epidemic of Medical Mistakes

The authors of this book are two experienced doctors who ask the question “Many more people die from medical errors than airline crashes or terrorism; why aren’t we treating medical mistakes as a similar epidemic and responding with equal vigor and alarm?” The answer they decide is manyfold. Patients don’t fully understand medical errors, often aren’t told about them, and are generally in a poor position to respond to them. Doctors are sometimes unaware they’ve made them, don’t feel singularly responsible for them, and already are paying hefty insurance to deal with them.

The authors argue that medical mistakes in this age of advanced medicine are often systemic errors rather than a blatant mistake made by one person To drive this point home they rattle off many horrifying stories where one accidental name switch or lack of final check against a patient record left patients dead, wounded, with the wrong limb amputated, or permanently damaged. They discuss the various kinds of errors that happen, detail what some hospitals have done to try to fix the problems and outline some of their own solutions. Their overarching plan is to split malpractice claims into two schools: gross negligence claims where one person can be proven to be at fault and who gets sued in the same fashion as in the present system, and a no fault type of claim where the “system” is found to be at fault and the patient makes a claim against the more general medical profession which has a pool of money to deal with such lawsuits. The authors claim this will lessen malpractice trials, not cause good doctors to have to stop practicing due to one punitive claim, and remove the lawyers [and their 40% cut of the settlements] from the equation. It’s a compelling argument and one that I don’t feel particularly qualified to critique, but it seemed well thought out and well-supported without all of the regular hand-waving that usually accompanies more histrionic accounts of medical maladies.