The Unknown Costs of Medical Malpractice
The simple truth is that nobody knows how many people in the US die each year from medical malpractice. The best estimates we have range from about 100,000 to about 440,000 per year. But even if we accept a median figure of 200,000–250,000 deaths per year, it would mean that medical malpractice is the third leading cause of death in the United States, surpassed only by heart disease and cancer.
Even these numbers may be too low, because all of these studies have focused on hospital settings, and a 2012 report by the Department of Health and Human Services (PDF) found that hospital reporting systems do not report 86% of instances of harm caused to patients by their medical care. Moreover, a growing number of Americans are being diagnosed and treated in outpatient settings rather than in hospitals. An analysis published in JAMA (the Journal of the American Medical Association) claims that more than 40% of malpractice events occur outside of hospitals, that is, in clinics or a doctor's office—which means that these events have been greatly underreported.
Add it all up, and it's very likely that when combined, the actual number of malpractice instances per year, including non-lethal instances, is well over a million. Yet even this number could be a wild exaggeration or horrifying understatement: the truth is that we don't know. We don't have any better information because, amazingly, nobody has ever counted instances of malpractice.
Uncertainty Leads to Unreported Claims
Of course, this is somewhat understandable due to the nature of the problem—the HHS report found that many of those instances were not reported simply because the hospital staff did not recognize the mistake at the time. Moreover, medical records can contain errors, and some providers can be reluctant to report their mistakes, so discovering a case of malpractice can often require some detective work.
However, the fact remains that we do not know how many patients experience preventable harm. And that's what medical malpractice is: when lawyers and researchers use the term, they are talking about preventable medical errors. There are any number of things that can go wrong in medicine: symptoms can be misleading, treatments may be unsuccessful, or results may simply be disappointing. None of these amounts to malpractice. But there are also cases where medical professionals fail to do their job competently—that is, the professional diagnoses or treats a patient in a way that, in the same circumstances, no other competent doctor would. When this happens, and the patient is harmed by this failure, it is called malpractice.
In the studies mentioned above, most people didn't see the errors, or recognize them as such at the time. The researchers were able to discover most of these cases only by careful, expert examination of records well after the fact. Moreover, most patients had no way of knowing that their problems were preventable—they trusted the medical professionals to do their job competently, and lacked the training that would let them see that something had gone wrong.
The key point, however, is that many, if not most, malpractice cases are never reported, which means that an untold number of patients have suffered unnecessarily from physical and emotional pain, crippling medical bills, or lost earning capacity. Of course, it is unreasonable to expect a patient to know whether he or she has been the victim of malpractice—but it is also unreasonable for someone to suffer in silence. The reasonable solution is that when a patient is in doubt, he or she should seek advice from others, especially from those who have the experience and knowledge it takes to uncover the truth.