> The whole death by medical error thing is also of uncertain evidence. See: https://www.mcgill.ca/oss/article/critical-thinking-health/m...

I've read the McGill article before; what it fails to mention is that the analysis has been performed multiple times by multiple parties and the results have repeatedly converged on the same point: somewhere between tens of thousands of human beings to one hundred fifty thousand human beings (at the very least) have their lives cut short because someone messed up. These statistics are for the US alone. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070928/ https://effectivehealthcare.ahrq.gov/products/diagnostic-err...

And more often than not, their colleagues who spot the mistake don't report it, a fact that's neatly labelled as a "disclosure gap" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793994/

It is perfectly reasonable to argue that the estimates are wrong. In that case, the solution is quite simple. Record data on misdiagnosis and physician failure, but that's a solution that the AMA has opposed (while talking about the ethical duty of disclosing medical error, of course).

> The AMA and the American Hospital Association vehemently opposed an attempt by President Bill Clinton to create a mandatory reporting system for serious errors. The groups launched a multimillion-dollar advertising campaign that said mandatory reporting would drive medical errors underground. From 2000 to 2002, they spent $81 million on lobbying efforts, according to campaign statistics collected by the Center for Responsive Politics.

> Mandatory reporting was dead on arrival.

https://www.kxan.com/investigations/a-long-time-before-congr...

There is no other civilian profession where death at this wide a scale is acceptable. Or, is taken as a matter of due course.

There is no other civilian profession where this has been the norm for centuries.

Every time a plane crashes, we perform investigations, improve, and fix. Every time there's a loss of crew on a human-rated spacecraft (or a loss of an autonomous vehicle), there's an investigation to fix what happened. Every time a bridge or a building collapses due to structural deficiencies, there's an effort to study what went wrong and how to fix it.

These reflexive investigations are pervasive everywhere. Except medicine.

Every single time the veil has been lifted, there has been something deeply ugly underneath. For example, doctors are the reason why so many women end up falling prey to Goop, because medical professionals fail — at a systemic level — to take their concerns seriously. The problem exists everywhere from the GP level to surgery,

> While associations were consistent across most subgroups, patient sex significantly modified this association, with worse outcomes for female patients treated by male surgeons (compared with female patients treated by female surgeons: aOR, 1.15; 95% CI, 1.10-1.20) but not male patients treated by female surgeons (compared with male patients treated by male surgeons: aOR, 0.99; 95% CI, 0.95-1.03) (P for interaction = .004).

https://www.researchgate.net/profile/Angela-Jerath/publicati...

For non-technical readers,

https://www.health.harvard.edu/blog/women-and-pain-dispariti...

https://healthjournalism.org/blog/2018/11/women-more-often-m...

https://www.smithsonianmag.com/smart-news/western-medicines-...

https://www.nytimes.com/2022/03/28/well/live/gaslighting-doc...

The problem is fractal and replicates across societal out-groups (and to a lesser degree for in-groups). For example, doctors saying things like, "black people have thicker skins,"

https://www.aamc.org/news-insights/how-we-fail-black-patient...

https://batten.virginia.edu/about/news/black-americans-are-s...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/

Pick your out-group for a given society and you'll find systemic medical failure. The in-group is rarely much better off; they're still subject to the same capriciousness, merely to a lesser degree. See: the systemic failure of doctors to diagnose heart disease, https://www.bhf.org.uk/informationsupport/heart-matters-maga...

> It looked at NHS data over nine years, which involved 243 NHS hospitals, and about 600,000 heart attack cases. Around one third, 198,534 patients, were initially misdiagnosed.

If you're on the receiving end of care, it becomes very clear, very quickly that there's something wrong with the picture.

When a field is this deficient, radical reform is necessary to save lives.