The Data We Don’t Talk About

Medical errors are not a fringe issue. Some widely cited analyses, including work from Johns Hopkins University, have estimated that preventable medical harm may contribute to hundreds of thousands of deaths annually in the United States — though the exact figure remains debated. What is not in dispute is the broader pattern: preventable harm in healthcare is more common than most people realize.

Research published in BMJ Quality & Safety suggests that roughly one in 20 patients experiences preventable harm in medical care. Meanwhile, the Centers for Disease Control and Prevention reports that one in 31 hospital patients has at least one healthcare-associated infection.

Even the most serious errors, such as wrong-site or wrong-procedure surgeries, still occur thousands of times each year in the U.S.

Most of these incidents never make headlines. They are not dramatic. They are incremental: a missed detail, a delayed response, a breakdown in communication. Small failures that compound.

It’s also important to keep this in perspective. Healthcare systems have evolved significantly over the past two decades, with structured safety protocols, checklists and oversight mechanisms designed specifically to reduce error. Many potential mistakes are identified and corrected before they ever reach the patient. In that sense, the story of modern healthcare is not just about risk: it’s also about the systems quietly working to prevent it.

Where Things Actually Go Wrong

Hospitals are designed to manage complexity. But complexity itself is a source of risk. The most common breakdowns don’t happen because of a lack of expertise. They happen at the seams:

• Transitions between care teams and shift changes
• Incomplete or fragmented patient histories
• Assumptions based on prior diagnoses
• Time pressure in acute settings
• Lack of clear ownership over decisions

Communication failures are a leading contributor to serious adverse events, according to The Joint Commission. In other words, the issue is often not what clinicians know—it’s how information moves.

As Dr. Michael D. Grinn, a triple board-certified cardiothoracic anesthesiologist, explains:

“This recent incident was clearly a sentinel event within the operating room, and staff other than the surgeon should have said something. Most medical professionals in the OR would be able to identify the difference between a spleen and a liver and should have put an immediate stop to the procedure.

The entire team is ultimately responsible for patient safety, but cultural norms can prevent staff from feeling they can intercede. In some hospitals, the surgeon dictates the pace and depth of the procedure—and that can limit others from speaking up.”

Standard safeguards, like pre-procedure “time outs,” are designed to ensure alignment before a case begins. But protocols only work when people feel empowered to enforce them. When communication breaks down — or hierarchy overrides judgment — risk has a way of slipping through.

The Gap Between System and Patient

Healthcare in the United States is quite advanced. It is also quite fragmented. Patients move between primary care physicians, specialists, hospitals, imaging centers and pharmacies, often without a single, unified view of their care. Each handoff introduces the potential for misalignment. In finance, risk is modeled, monitored and actively managed. In healthcare, it is often assumed away. That assumption is where problems begin.

What Patients Can Do to Reduce Risk

Patients can’t control every outcome. But they can meaningfully reduce the likelihood of error—especially in non-emergency situations—by approaching care more deliberately.

1. Start With the Right Hospital
Not all hospitals perform equally. Tools like The Leapfrog Group assign safety grades based on factors like infection rates, staffing and error prevention practices. Similarly, Hospital Compare (from Medicare) allows patients to compare hospitals on quality measures and outcomes.

2. Ask One Simple Question: “What Else Could This Be?”
Diagnostic anchoring is common. This question forces reconsideration and can surface alternative possibilities before a plan is set in motion.

3. Confirm the Plan—Out Loud
Before any procedure or major decision, ask:
“What exactly are you doing, and why?”
Clarity at this moment can prevent downstream errors.

4. Keep Your Own Medical Summary
Do not rely on the system to connect every detail across providers. A concise, up-to-date summary of conditions, medications and prior procedures can reduce gaps in understanding.

5. Slow Things Down When You Can
Many errors occur in urgency. If a situation is not immediately life-threatening, taking time to ask questions or seek a second opinion can materially improve outcomes.

6. Know the Escalation Path
Ask who to contact if something changes or doesn’t feel right. Uncertainty during transitions is where problems tend to accelerate.

A More Realistic View of Safety

The goal is not to create fear. It is to create awareness. Hospitals save lives every day. The vast majority of care delivered is appropriate and effective. But the system is not infallible — and treating it as such can lead to blind spots. Healthcare risk is not just about rare, catastrophic events. It is about the accumulation of small decisions, interactions and assumptions that shape outcomes over time. In that sense, healthcare is not so different from financial planning. Risk is not eliminated. It is managed—by those who understand where it lives.