By Contributor on March 03, 2014

By Suzanne Gordon

As we celebrate National Patient Safety Awareness Week, we should ask ourselves why so many doctors are violating the Hippocratic Oath: “First Do No Harm.”

It’s what newly minted physicians promise when they graduate from medical school. But it’s a promise that too often goes unkept, with lethal consequences.

As many as 440,000 patients die each year from preventable mistakes. Shockingly, medical harm is the third leading cause of death in the United States, just behind heart disease and cancer.

One reason for this epidemic of patient harm is that hospitals and other health care institutions tolerate staff who routinely ignore proven safety procedures.

Fifty percent of health care workers don’t clean their hands, even though hand-cleaning is the most effective infection prevention mechanism.

Too many surgeons fail to implement checklists and timeouts that would assure they are operating on the right limb or organ.

Nurses are so harried that they don’t have time to make sure they are giving the right medication to the right person, in the right dose at the right time.

And too many lower-level hospital staff don’t challenge higher-level professionals who are about to make a mistake because they fear being reprimanded or even fired.

We know that more than 75 percent of medical errors and injuries result from poor communication and lousy teamwork. Yet, the health care industry (unlike the airline industry) does not routinely train staff at all levels in the basic skills of teamwork and communication.

Another reason so many people suffer from medical harm is that too many physicians are putting patients at risk by prescribing invasive treatments patients don’t even need.

For example, decades worth of studies document the dangers of mammograms to women between 40 and 49 with no risk of breast cancer, yet they are still part of routine screening programs.

Orthopedists are still recommending surgery for back pain even though studies have long documented that this often does more harm than good.

Or consider the cancers that result from unnecessary CT scans, which are doled out to patients who have no idea that a CT is not in fact one X-ray but a bundle of hundreds.

Finally, think of how many people are placed in jeopardy — and dollars misspent — when for-profit health care chains, like Hospital Corporation of America or Health Management Associates, push physicians to admit more patients who would be better treated on an outpatient basis.

Reducing the high number of deaths and injuries caused by medical error is not hard. The federal government has already developed a voluntary program (called TeamSTEPPS) to improve the quality and safety of patient care. Many hospitals have started to use it, with excellent results.

But more need to do so, and every medical facility should upgrade its own internal patient-safety standards.

Until that happens, Hippocrates’ injunction to doctors — “first do no harm” — will remain neatly framed, but too often ignored, on many a medical office wall.

Journalist Suzanne Gordon’s latest book is “Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety,” published by Cornell University Press. She is co-editor of the Culture and Politics of Health Care Work Series at Cornell University Press and can be reached at

Copyright Suzanne Gordon

Photo: Two Nurses Discussing Patient Notes At Nurses Station via Shutterstock



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By Wendell Berry

Manifesto: The Mad Farmer Liberation Front

Love the quick profit, the annual raise,
vacation with pay. Want more 
of everything ready made. Be afraid 
to know your neighbors and to die.
And you will have a window in your head.
Not even your future will be a mystery 
any more. Your mind will be punched in a card 
and shut away in a little drawer.
When they want you to buy something 
they will call you. When they want you
to die for profit they will let you know. 
So, friends, every day do something
that won’t compute. Love the Lord. 
Love the world. Work for nothing. 
Take all that you have and be poor.
Love someone who does not deserve it. 
Denounce the government and embrace 
the flag. Hope to live in that free 
republic for which it stands. 
Give your approval to all you cannot
understand. Praise ignorance, for what man 
has not encountered he has not destroyed.
Ask the questions that have no answers. 
Invest in the millennium. Plant sequoias.
Say that your main crop is the forest
that you did not plant,
that you will not live to harvest.

Say that the leaves are harvested 
when they have rotted into the mold.
Call that profit. Prophesy such returns.
Put your faith in the two inches of humus 
that will build under the trees
every thousand years.
Listen to carrion—put your ear
close, and hear the faint chattering
of the songs that are to come. 
Expect the end of the world. Laugh. 
Laughter is immeasurable. Be joyful
though you have considered all the facts. 
So long as women do not go cheap 
for power, please women more than men.
Ask yourself: Will this satisfy 
a woman satisfied to bear a child?
Will this disturb the sleep 
of a woman near to giving birth? 
Go with your love to the fields.
Lie easy in the shade. Rest your head 
in her lap. Swear allegiance 
to what is nighest your thoughts.
As soon as the generals and the politicos 
can predict the motions of your mind, 
lose it. Leave it as a sign 
to mark the false trail, the way 
you didn’t go. Be like the fox 
who makes more tracks than necessary, 
some in the wrong direction.
Practice resurrection.

Wendell Berry is a poet, farmer, and environmentalist in Kentucky. This poem, first published in 1973, is reprinted by permission of the author and appears in his “New Collected Poems” (Counterpoint).

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