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Medicine is not the “third leading cause of death” in the US

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Medical errors are not the “third leading cause of death” in the US, despite the 2016 headlines that have now solidified into a popular myth, like excrement fossilizing. Is medicine dangerous? Bad things definitely happen in hospitals, and some of them are indeed preventable, and that’s tragic — no one disputes that. Medicine has many problems.

But are medical bloopers almost as deadly as cancer and heart disease? Good grief, not even close.

Where did this third-leading-cause myth come from?

This myth has a specific origin story: a sloppy estimate published in the British Medical Journal in 2016 (see Makary). It was not a “study” — it was an editorial, a dubious “analysis,” an expert opinion piece so deeply flawed that it cannot be taken seriously. Jonathan Jarry for the McGill Office for Science & Society:

“This ranking is an exaggeration that was arrived at by combining a small number of studies done in populations that were not meant to be representative of the entire U.S. population and that were not designed to prove a link between a medical error and death.”

Dr. David Gorski for

“How many deaths in the US are due to medical errors? The answer is: I don’t know! And neither do Makary and Daniels—or anyone else for sure. … It’s just not anywhere near plausible that one-third to over one-half of all inpatient deaths in the US are due to medical error. It just isn’t.”

Both Jarry and Gorski go into considerable detail about the actual statistics of medical errors. But the bottom line is that “third leading cause” is a garbage claim.

Speaking of preventable mistakes…

Oy, that horrendous headline! It was catnip for anyone with an axe to grind about “mainstream medicine.” It’s a textbook case of fear-mongering enabled by a single sensationalistic headline.

But this headline wasn’t on! It was published by the 🤬 British Medical Journal, one of the most prestigious medical journals in the world. So it was also a textbook case of self-sabotage, an unforced error, a mighty PR gaffe. A medical journal handed this win to the ideological enemies of scientific medicine on a silver platter.

This would have been a dangerous mistake at any time in the last thirty years. But it was particularly bad timing to fan the flames of fear, uncertainty, and doubt about science and medicine with a major global pandemic just around the next bend of history. Oops!

Jonathan Jarry’s recent piece on this inspired me to update my own page on the theme of medical errors, which has been around since … [checks] … yeah, 2012. The gist of this piece is reproduced at the top of that page, but goes on to discuss other facets of the topic.

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