Thursday, December 9, 2010

1,000 lives per day or 45 lives every hour

In the wake of the recent studies confirming our suspicions that we are no better off today than a decade ago as far as the safety of our healthcare system is concerned, I have been doing a lot of thinking and writing about this issue. The other day I blogged about the fact that there are no simple solutions, yet we must pursue change. Today, this e-mail from really stopped me in my tracks:
Dear friends,
Climate negotiations can seem quite abstract sometimes.

I'm here in CancĂșn, Mexico, where UN delegates from around the world spend hours debating details of complex regulations.  Sometimes it seems that everyone has forgotten a crucial fact: the climate is changing much faster than these negotiations are moving. 

Meanwhile, out in the real world, climate impacts are all too visible. Since the negotations began 10 days ago, climate disasters have struck all over the world: flooding in Australia, Venezuela, the Balkans, Columbia, India; wildfires in Israel, Lebanon, Tibet; freak winter storms in Europe and the United States. These events have been devastating--hundreds are dead, and hundreds of thousands have been affected.
To put it in the context of our healthcare system, the unnecessary mortalities and morbidities are happening faster than our quality improvements are moving! In other words, if there are approximately 400,000 avoidable deaths annually attributable to healthcare encounters, this means that every day we delay implementing a viable solution we lose over 1,000 lives per day or about 45 lives every hour or 1 life every 1 and 1/2 minutes! In the time that it took me to write this post, 20 patients have lost their lives unnecessarily. Are any of them your loved ones?

All these lives come with stories, all these lives are loved by someone, and all these lives cannot just be written off as sacrificial lambs in the name of a growing bureaucracy that cannot move the meter. We can wring our collective hands and say that we wish we knew how to stop this gushing bleed. Yet, we continue to conduct business as usual, increasing revenues and testing and interventions and cognitive loads and questionable evidence. Ultimately, should eleven years of doing the same thing and getting the same woefully inadequate result encourage us to continue in the same direction, or should we just come to a full stop for a moment?

I realize that medicine cannot stop -- illness will not stop. But the lifestyle that feeds the gluttonous homicidal machine of healthcare can be altered. A combination of prevention, reduction of interventions of questionable effectiveness and safety, more time for doctors to think about their patients and make decisions together -- this is the path. It is not easy, but neither is losing a partner, a brother or a child to the very idol at whose altar we have come to worship and atone for all of our individual and societal bad choices. Today is the day. Who is with me?  


  1. I hear you and am with you Marya. While we make progress in medicine and technology we also need to progress as a culture. And this applies to not only the field of health care but across the board, to every industry. When I go to college classrooms I am struck at the apathy students have towards what is being taught and their own sense of purpose. Professors are equally apathetic towards students apathy. It is like everyone is on auto pilot, asleep.

    I would love to be part of a collective that is tapping into the collective wisdom of what is possible to bring mindful change in our healthcare, education, and business. And most importantly take actions to bring the changes at every level of our social fabric.

    I have started to learn new collaborative learning and thinking models like Open Space technology and World Cafe which can be used to organize large scale brainstorming and to transfer that collective thinking into actions we can take.

    Building tribes with a common vision and collaborative thinking and action is what I am focusing on now. What are your ideas for bringing change? Do you see any possibilities of collaboration?

  2. Shalini, I completely agree with you that we are looking at a systemic problem. Unfortunately, as I saw someone quote in reference to our technology advances and how to integrate them into our lives sensibly, it is like trying to fix a car that we are in while it's moving. This is so true of this treadmill that we have created. If we could just stop ling enough to take a look around and assess mindfully what we are doing to ourselves...

    I am all for collaborations and building. What I need to learn more about is how to build a social action movement around some of these issues. Your input is always appreciated.

  3. The flaw in an otherwise great column is that the climate is not now suddenly changing and that somehow new and improved weather-related disaster are not happening.

    Alarmist thinking aside, the climate hasn't really ever been stable nor has the weather ever really been universally benign. My home state of Michigan was under ice numerous times, to include in recent geologic history. What caused it and when will it happen again?

    Weather disasters has pummeled mankind round the globe since, well, the entire history of mankind.

    Even the Bible is replete with stories of nature gone wild (from Noah's flood to the plagues of Egypt). Look at the death toll from historic disasters, such as floods and cyclones and note how long ago they occured -- when one assumes the world's climate was nice and cool and stable.

    For example, China lost 1-2.5 million in a flood in 1931. They lost nearly as many in another flood in 1887 (900K-2 million). A great cyclone 40 years ago took a half-million lives, while 300,ooo were lost in 1839 to the same cause.

    The deadliest storm in U.S. history was a century ago.

    At some point, the mass hysteria and endless pots of money to dubious climate research and professional activism will abate. People will feel a little silly afterwards for a time, and then go find something else to panic about.

  4. Dear Anonymous,

    Thanks for your comment. While I radically disagree with your assessment of climate science, I am happy that you are joining this discussion. The point of my post is that we need to stop talking and start doing, even in the absence of the perfect evidence. And this is true for both, climate change and healthcare.