Press Report: Sept. 2002, OUTCRY Magazine

Paralleling the CIA and FBI Problems with Medical Errors: Can the Coming Disaster be Averted?

 On June 6, 2002 President Bush went on the air to tell the nation how he would reorganize the government by creating the department of homeland security to protect the nation from a possible mass attack from terrorists. He admitted that errors were made but he did not believe anybody could have stopped what happened on September 11, 2001 when thousands died from terrorists attack using planes as flying bombs. President Bush stressed that government must be reorganized to secure the homeland and protect the citizens. He urged the local communities to work with federal agencies and everybody should be vigilant to report any suspicious activities “We face urgent need!” Said President Bush. “We must act on every lesson and we must act with the support of Congress. We will not blink in the face of terror.”

 What Actually Happened

Based on the pieces of evidence released, what happened on September 11, 2001 was not due to failure of intelligence, but due to failure of action. With careful analysis of what happened, it becomes evident that such situation happens all the time. The failure was not by accident, it happened because of the way the system was set up. For example, the Enron and WorldCom situations where many people lost their money occurred because of the lies told to the stockholders. There were people within the companies who sounded the alarm bell, but nobody listened and the big-shots used their power to silence the workers. Similarly in the FBI and CIA situation, besides the fact that they were not talking to each other due to arrogance of power, there were people who sounded the alarm bell, again the big-weed overruled the workers requests. Looking at the health care and the continuation of medical errors, the situation is no different. In some cases, what happened on September 11, 2002 is about to happen in the health care industry with more disastrous outcome and more deaths. The common element in these three cases cited is the lack of response to the requests of people working on the frontline. Similarly, this is what is happening in the health care right now causing medical errors to continue at the expense of patients’ welfare.

 Why Medical Errors Continue

One thing we need to be clear about, we are not a society or systems of “proactive intervention,” we are more of “a crisis response intervention.” We do not fix it until it breaks and are not supposed to argue with a winner even if that winner may eventually bring some disastrous results! This is the primary reason we may not be able to avert the next disaster.

 Since 1977, I declared war on medical errors. People not only did not listen, the intention was criminalized as though I was doing something wrong by raising questions about treatment failures and patient preventable deaths from medical errors. When the first book Overcoming the Invisible Crime came out in 1993, it was dismissed as anecdotal. In 1999 Institute of Medicine’s report confirmed what was raised in the book regarding a broken health care system. If the institute of Medicine report was correct about 44,000 to 98,000 people die yearly because of medical errors, since 1993 an estimate of 264,000 to 588,000 patients might have died due to medical errors. Could we have saved some of those people? Certainly, we could have saved some of them if action had followed the report. The sad part today despite all these noise being made about medical errors, the situation has not changed because of the complexity of the problems.

 Protecting the Nation

If we want to solve problems which is the common intention of the three situations cited above, we must start listening more to those workers at the frontline. How can we protect the nation when our frontline defense during a mass attack is broken into many fragments? Most people understand well that the defense of this nation is not going to be with guns and missiles alone. An effective health care system is the frontline of defense during a mass attack. Our main objective during an attack is to reduce the number of deaths. We must fix the systemic problems in most of our health care institutions. If we fail, we can expect a giant disaster if we are attacked, God forbid! Paralleling the CIA and FBI problems with medical errors - can the coming disaster be averted?

 Those who refused to learn from history are doomed to repeat the same mistake. After seeing what is happening this year on the international front, I’m not so sure that man is capable of rational thinking especially when blinded by heightened emotions of self-interest.

 New Book: 101 Ways to Prevent Medical Errors