Analysis Of Gawande, When Doctors Make Mistakes

Medical error is the third leading cause of death in the US, right behind heart disease and cancer. More than 200,000 people die annually as a result of diagnostic mistakes and negligence by healthcare professionals (Washingtonpost, 2016). In the healthcare industry, even the smallest mistakes and oversight could lead to severe consequences for both the patient and professionals. A healthcare professional would be held liable for any discrepancies that causes harm. The following case will analyze the ethical issue and negligence that lead to the death of an elderly woman.

In”Overkill”, Atul Gawande, General Surgeon, talks us through an act of habit where doctors are over doing many practices, in a more precise description overkilling. It may even we seen as a follow-up of a previous article he wrote, the Cost Conundrum, where covers half of what is written in this article, which includes medical care, health costs and possibly an ill-fated motivation towards patient care. Gawande, gives us many examples of the miss happenings in the health care profession, further categorized as over testing, over diagnosis, and even over treatment. Though he might have not expressed so in extent, he is consistent with including a patient, Mrs. E throughout the article. Mrs. E, is the perfect example of what I will further

"Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error…" (John Hopkins Medicine). This soaring number has caused medical errors to become the third leading cause of death in the United States. For many people, medicine seems foreign and unknown. People who have lost loved ones due to medical error desperately look for a reason, and many times that blame falls upon doctors. Media has put a negative connotation on doctors as well, causing their reputation to plummet whenever a hospital procedure turns badly. A renown surgeon and author, Atul Gawande, uses his knowledge and experience to give people a new perspective on medicine. In the article "When Doctors Make Mistakes," Gawande uses rhetorical appeals: ethos, pathos, and logos to prove the need for a change in the medical systems and procedures. He analyzes how the public looks at doctors, giving a new perspective to enlighten the reader that even the best doctors can make mistakes.

According to the Institute of Medicine, “At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors” (Kohn et al.). Despite the unfortunate consequences, medical errors provide an important foundation for medicine. An immense uncertainty envelopes the medical field, and frequent leaps must be made. Some of these ventures are prosperous; however, many render unsuccessful. In Complications, Atul Gawande crafts an alluring view of the medical unknown using tales of his personal medical mistakes. Through the use of ethos, logos, and pathos, Atul Gawande argues that medicine’s vast uncertainty has beneficial influence upon society.

Gawande’s purpose in Better: A Surgeon’s notes on Performance is to show that in the medical field, following protocols is not always what is best for the patients.

Blendon, R. DesRoches, C. Brodie, M., Benson, J. Rosen, A., & Schneider, A. (2002). Views of practicing physicians and the public on medical errors. New England Journal of Medicine. 347, 1933-1940.

Quality health care is an issue in America for everyone, despite our numerous tests and advances in technology. In his article, “Overkill,” Atul Gawande argues against a common assumption that our healthcare system is the best because of these medical advances. In fact, Gawande claims that our health care provides much unnecessary care that often causes harm and that costs a lot . He follows that claim by redefining “low-value care” as “no-value care” and provides considerable scientific data along with his own experience with his own patients to support his claim. He also states logical reasons by referring to expert authorities who critique our health care by viewing it from an economic perspective: like talking about information asymmetry where a doctor is more informed than the patient, thus the doctor has more power over the patient. All of these emphases strongly defend his controversial claim. But what stands out most is how Gawande uses several stories showing vastly different outcomes, depending on how informed the patient and doctor are including offering non invasive treatments. We need to explore how his unusual storytelling strategy exposes how surgeons and patients should care more about quality than the mere quantity of tests and what alternatives are available to change the unnecessary over testing and over-diagnosis which prevent good health care.

In the medical field, precision is of the utmost importance when it comes to successfully ensuring that the job is done. Even the slightest mistake can be lethal, making communication vital in the medical field. A group of doctors and nurses must communicate and act like a single unit to complete the procedure. In “When Doctors Make Mistake”, the author, Atul Gawande, recalls a case where his team worked on a specific crash victim and the breathing tube could not fit in the trachea. Due to a lack of communication, one of the staff members tried to force the tube down the trachea causing more damage. In the essay, Gawande assesses the situation and agrees with his team to bring in a specialist to solve the

1. Dr. Gawande explains that in his training as a surgeon, he has struggled with the fear of not being able to fix a problem for a patient, even when he knows the odds are not good. If you were Dr. Gawande’s patient, what would you like him to know about your hopes for how he would handle a difficult situation like this?

Throughout our lives, we are plagued by the notion of ‘ethics’ or morals - the basis of our everyday behavior. The medical field is no exception, with doctors constantly reminded of the ethical duties they must carry out for each of their patients. An example of unethical doctors is demonstrated in Daniel Keyes’s short story, Flowers for Algernon. The story features Charlie Gordon, a man with an intellectual disability who strives to become smarter. He is a candidate for a new surgical procedure that is used to triple one’s intelligence which was directed by Dr. Strauss and Dr. Nemur. Although the procedure holds promise for helping a vast amount of people, Dr. Nemur and Dr. Strauss acted unethically by selecting Charlie to undergo the operation because they did not finish testing the procedure and because Charlie was unable to make a proper decision.

In Atul Gawande's mind blowing speech about doctors dramatically improving their practices using something as simple as a checklist. Dr. Gawande gives many thoughts and ideas concerning experience from history to show the audience that doctors and medical practices have changed a lot over history. Doctors also have had many setbacks and many things that should be changed to further improve their practices. Dr. Gawande begins by explaining how medicine first started and how many patients were incorrectly being diagnosed and cared for. He opens the idea that medicine has changed a lot throughout the beginning of time. Also, currently doctors still have a lot of challenges they face in modern medicine. He explains the first diagnosis of medicine and the early times in treating patients. He explains that medicine has come a long way now having over 6000 drugs that can be prescribed. He explains how much society has come together to study and look at Health Care. By the end of the 20th-century 15 doctors were needed in the operating room to serve a patient with the exact same problem 20 years ago. Gawande uses the word specialists a lot as a primary focus to show that not everybody is a doctor but a specialist in their own area. Gawande then opens a big a topic on how 40% of disease patients receive incomplete or inappropriate care. And at the same time, surgeries cost insane amounts nowadays then past prices. Now in his speech, he introduces the term pit crew this sets up the

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

As described by Dr. Atul Gawande in his book Complications, medicine “is an imperfect science, an enterprise of constantly changing knowledge… fallible individuals” making medicine different from other scientific fields

Life is lived under the assumption that every decision that is made is correct. Fallacies and cognitive biases are usually never taken into account. Since, life is lived in the present rather than the past. By addressing the example given in William Langewieshe’s Columbia’s Last Flight and in Atul Gawande‘s When Doctors Make Mistakes.

Father believes that “error happens because health care institutions and their system are very complicated and imperfect. And there are good people out there who try to do good job, but still mistakes happen which is why they need better support and better systems”.