I am a retired neurosurgeon who spent five years as a hospital chief of staff. This involved overseeing the safety of patients, a difficult and often thankless task. What I write was inspired by what I experienced during those five years.
This website is devoted to my writing activities, including my blog posts and several publications since the spring of 2012. The publications began with a blog called "Axis of Logic" in which I singled out the main promoter of a method for reducing medical errors called the systems approach, a Harvard professor, Lucian Leape. This was quickly picked up by another author who questioned Dr. Leape about my criticisms and the latter did not reply. Then came an article in Skeptic Magazine that was also published in a newsletter by the health care section of Public Citizen. Its main thrust was that systems--an engineering method-- was not working in medicine in spite of its being heralded as the panacea for harm to patients and that errors were probably becoming more common in spite of most American hospitals trying hard to adopt systems methods.
In March of 2014, the Sunday LA Times, a paper with a circulation of over a million published an oped of mine entitled "When Medical Errors Kill". It emphasized that 2% of physicians are responsible for half the payouts in American medical malpractice cases. This did not sit well with two engineering professors, one from Australia and another from MIT. They said in the British Medical Journal Quality and Safety that bad performers were irrelevant. This an important part of systems dogma which says that removing inept workers produces no improvement in safety. The evidence for this is sparse and shaky. The work they cited as evidence was 60 years old and involved European truck drivers and English factory workers, not present day doctors.
We are at an impasse. Several leaders in medicine realize that things are not improving after 16 years. However, very few are willing to give up the pursuit of systems methods.