3. .

5. Laparoscopic Colectomy
Cooper M, et al., BMJ 2014.

6. Laparoscopy Rate by Surgeon
% Colectomy Operations Performed Laparoscopically

8. 210,000 deaths

9. Causes of Death in the U.S.
Heart disease 597,689
Cancer 574,743
Variation , ,000
Respiratory diseases 138,080
Makary MA, Daniel M. Medical Error: The third leading cause of death in the U.S., Johns Hopkins University, 2015

11. Individual Responsibilities
A Model for Reducing Patient Harm
System Responsibilities
Individual Responsibilities 1
Institute safety triggers to alert staff
Facilitate a culture of speaking up
Knowledge of Remedies
Skill to intercept harm
Make errors
more visible
Make remedies available
Support clinician needs 2
Clinical skill
Sound judgment
Respond to
error (Rescue)
Error awareness
Calling for help 3
Foster a culture of safety
Engineer hard stops for prevention
Make errors
less frequent
Source: Makary M, Daniel M Medical Error-The third leading cause of death in the U.S.. BMJ 2016

13. What percent of Medical Care is Unnecessary?
% Respondents
Lyu H et al, Unpublished data, Johns Hopkins University School of Medicine

14. Xu T, et al. AGA 2015

17. Proportion of Medical Care that is Unnecessary
National Survey of 2,106 Physicians
Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, et al. (2017) Overtreatment in the United States. PLOS ONE 12(9)

18. 22% of prescription medications 25% of medical tests 11% of procedures
Proportion of Medical Care that is Unnecessary
National Survey of 2,106 Physicians
22% of prescription medications
25% of medical tests
11% of procedures
20% OF ALL MEDICAL CARE
Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, et al. (2017) Overtreatment in the United States. PLOS ONE 12(9)

21. $20 Obamacare
FUTURE Hospital (ICU, ER and OR only)
OPTIMIST

22. Thank You Facebook.com/DrMartyMakary Twitter: @DrMartyMD