When We Do Harm: A Doctor Confronts Medical Error

by Danielle Ofri MD

Overview

Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety.

Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation.

Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms.

While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.

Product Details

ISBN-13:	9780807003046
Publisher:	Beacon Press
Publication date:	09/21/2021
Pages:	272
Sales rank:	639,118
Product dimensions:	5.60(w) x 8.60(h) x 0.90(d)

About the Author

Danielle Ofri, MD, PhD, is a clinical professor of medicine at the New York University School of Medicine and has cared for patients at New York’s Bellevue Hospital for more than two decades. She is the author of several acclaimed books, including When We Do Harm; What Patients Say, What Doctors Hear; What Doctors Feel; and Singular Intimacies. Dr. Ofri is a regular contributor to the New York Times as well as to the New England Journal of Medicine and the Lancet. Her writings can be found at danielleofri.com and on Twitter (@danielleofri). She lives in New York City.

Table of Contents

CHAPTER ONE
Jumbo Jets Crashing

CHAPTER TWO
A Sea of Uncertainty

CHAPTER THREE
Making—or Missing—the Diagnosis

CHAPTER FOUR
The Fever

CHAPTER FIVE
Diagnostic Thinking

CHAPTER SIX
The Descent

CHAPTER SEVEN
For the Record

CHAPTER EIGHT
The Human Consequences

CHAPTER NINE
On the Clock

CHAPTER TEN
What You See

CHAPTER ELEVEN
I’ll See You in Court

CHAPTER TWELVE
Is There a Better Way?

CHAPTER THIRTEEN
Looking for Answers

CHAPTER FOURTEEN
Bringing Along Our Brains

CHAPTER FIFTEEN
The Reckoning

CHAPTER SIXTEEN
So What’s a Patient to Do?

CHAPTER SEVENTEEN
Getting It Right

Acknowledgments
Notes
Index

Editorial Reviews

What makes this book special is Ofri’s perceptive and compassionate nature; she sees her own patients as real people and is candid with readers about her concerns and vulnerabilities. . . . Thorough analysis of a challenging problem executed with a personal touch that makes it highly readable.”
—Kirkus Reviews, starred review

“An essential read for anyone involved or interested in the care of patients.”
—Booklist

“Anyone familiar with Dr. Danielle Ofri’s books or blogs knows that she is in the company of other physician writers who share a deep commitment to ensuring that humanity is always at the heart of healthcare. Her readers know, too, that she is a skilled and compassionate healthcare provider.”
—New York Journal of Books

“This book is a must read for anyone entering a hospital as a patient, and for family members and patient advocates. Doctors, nurses, and hospital administrators will also benefit. It should be required reading in nursing and medical schools.”
—Medium

“One of the leading physician-authors of our time, Danielle Ofri masterfully diagnoses the reasons for our pervasive problem of medical errors. Beyond a systematic dissection that every patient can understand, she provides solutions for how to get healthcare on track.”
—Professor Eric Topol, author of Deep Medicine

Praise for Dr. Danielle Ofri

“The world of patient and doctor exists in a special sacred space. Danielle Ofri brings us into that place where science and the soul meet. Her vivid and moving prose enriches the mind and turns the heart.”
—Jerome Groopman, author of How Doctors Think

“Danielle Ofri is a finely gifted writer, a born storyteller as well as a born physician.”
—Oliver Sacks, author of Awakenings

“With the meticulous care of Oliver Sacks and the deep humanism of Atul Gawande, Danielle Ofri . . . presents compelling evidence that even as doctoring appears to be dominated by technology, the human, affective relationship is at the very center of responsible practice.”
—Andrew Solomon, author of Far from the Tree

“[Ofri offers] taut, vivid prose. . . . She writes for a lay audience with a practiced hand.”
—Katie Hafner, New York Times

“Ofri adroitly balances presentation of her own experiences and those of others. . . . Her voice is one that deserves to be heard and listened to carefully, as what she describes carries great significance for all of us within the health care system, patients and healers alike.”
—Dennis Rosen, The Boston Globe

“Danielle Ofri has so much to say about the remarkable intimacies between doctor and patient, about the bonds and the barriers, and above all about how doctors come to understand their powers and their limitations.”
—Perri Klass, MD, author of A Not Entirely Benign Procedure

From the Publisher

04/01/2020

Ofri (New York Univ. Sch. of Medicine; What Patients Say, What Doctors Hear) investigates medical error, and explains it is possible to mitigate preventable harms. By analyzing case studies of patients who have experienced medical complications, Ofri, in an engaging and accessible way, makes a compelling argument that changes to the current medical system could have a substantial impact. Ofri's narrative is at its best when admitting that eliminating error is impossible, but she believes it is still worth trying. In lieu of blaming people, the author recognizes that errors are the result of many breakdowns in the health care system, and she advocates for change that will benefit both doctor and patient alike. Myriad behaviors can lead to error, and Ofri confirms one being a breakdown of communication. VERDICT Ofri's latest book is a must-read for those looking to gain a glimpse into the complex environment in which medical professionals work as well as those who may have experienced subpar medical treatment. Her ideas about mitigating harm can save lives and may leave you wishing she was overseeing your own health care.—Rich McIntyre Jr., UConn Health Sciences Lib.

Library Journal

★ 2020-01-16
A doctor examines the causes behind medical errors and how to minimize them.

Ofri is a clinical professor at NYU School of Medicine who has also treated patients at Bellevue Hospital for more than 20 years, and her popular books about medicine and the doctor-patient relationship include What Doctors Feel and What Patients Say, What Doctors Hear. In her latest, she combines extensive research with stories of patients who have been harmed and enhances the narrative with details of her own disconcerting experiences as a clinician. What makes this book special is Ofri’s perceptive and compassionate nature; she sees her own patients as real people and is candid with readers about her concerns and vulnerabilities. The heart of the narrative focuses on the cases of two patients who died while being hospitalized—one with leukemia and one with severe burns. Through Ofri’s research, it becomes clear that poor communication and technology played roles in their deaths. Sandwiched between accounts of the specifics of the medical care of these two men, the author looks broadly at errors in diagnosis, biases, malpractice suits, unsafe working conditions, impossible workloads, malfunctioning technology, and the impact of electronic medical records. Patients, of course, expect zero errors in their medical care; however, in our modern health care system, notes the author, a more realistic goal is not perfection but harm reduction. She recommends revamping the system to make it less possible for people to commit errors, and she lays out the concept of a necessary culture shift. In the final chapter, Ofri provides examples of what that shift would entail and some of the problems it would encounter. For patients, the author has a number of practical recommendations: Make sure every medical professional who touches you washes their hands; take your pill bottles with you; ask questions and take notes; and, if possible, have another person with you.

Thorough analysis of a challenging problem executed with a personal touch that makes it highly readable.

Kirkus Reviews