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Wrong Diagnosis, Treatment
Leape is a board member of the NPSF, which was founded by the American Medical Association in June of this year to improve health care safety. AMA leaders say it's time to bring the issue out into the open, rather than living in constant fear that any admission of error will launch a flood of malpractice lawsuits.
     Leape's own research has shown that the tally of medical mistakes made each year could reach 3 million, with total costs as high as $200 billion.
     The survey found that 40 percent of the people who had experienced a medical mistake pointed to misdiagnoses and wrong treatments as the problem. Medication errors accounted for 28 percent of mistakes. And 22 percent of respondents reported slip-ups during medical procedures.
     Half of the errors occurred in hospitals, and 22 percent in doctors' offices.

What Causes Errors
When asked what may have caused their doctors to make such errors, patients cited carelessness, stress, faulty training and bad communication. Three out of four believe the best solution to the problem would be to bar health care workers with bad track records.
     But Leape disagreed, arguing that punishment simply encourages people to cover up their errors. "We need to shift emphasis away from individuals," he said. "Errors are not the disease, they're the symptoms of the disease."
     Instead, he said, poorly designed health care systems may be largely to blame. Doctors and nurses often work double shifts, making them more prone to error. And in this age of computer technology, Leape noted, the hand-written drug prescription should be a relic of the past.
     In fact, prescription errors may be among the easiest to avoid. Within five years, most hospitals, clinics and pharmacies should be using computerized drug tracking programs that allow a doctor or pharmacist to know exactly what drug is being called for. Bad penmanship should not be a risk factor for patients.

Changes in Anesthesiology
Such a system would also keep track of other drugs a patient is taking, and raise a red flag at the risk of dangerous drug interactions. It would also alert the doctor if a patient was allergic or sensitive to medications.
     California anesthesiologist David Gaba told ABC News that in the last 10 years, his field has become an example of what can be done. Medical students regularly practice anesthesia on electronic mannequins, honing their skills before they administer drugs to patients.
     There are also new checklists, safety procedures, dosage meters and other safeguards, Gaba says. The result is that anesthesia has gone from being a high-risk specialty—in terms of liability—to being about average.