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The Third Leading Cause of Death?!

Ralph speaks to Dr. Michael Daniel, co-author of a study that identifies the third leading cause of death right behind heart disease and cancer. The answer may surprise you. And New York Times tech journalist, David Streitfeld, joins us to talk about why he’s a tech reporter who doesn’t use much tech.

Dr. Michael G.Daniel is a senior resident in internal medicine at Johns Hopkins Hospital. His research focuses on the delivery of healthcare, specifically working to improve patient safety, quality, and outcomes. Dr. Daniel was doing a research fellowship in patient safety with Dr. Martin Makary. The results of their work were summed up in the paper: Medical error—the third leading cause of death in the US.” 

“There’s tons of things that patients can do protect themselves from harm. One of the things is: bring your family and friends along with you. Bring other people who are paying attention and listening to what’s happening. Two: make sure you’re very clear on your own medications list… The third thing I would say is: speaking up. Ask questions. If they’re telling you something that doesn’t make sense, don’t let them leave the room until they have described why something is happening and what other options are available.” Dr. Michael Daniel, co-author of the Johns Hopkins study “Medical error—the third leading cause of death in the US.”

David Streitfeld is a veteran journalist, who has written about technology and other subjects for The New York Times. In 2013, he was part of a team that won a Pulitzer Prize for their penetrating look into business practices by Apple and other technology companies that illustrates the darker side of a changing global economy for workers and consumers. Today, he’s going to talk to us about his latest article, “When a Tech Reporter Doesn’t Use Much Tech.” 

“Fake news is a term I think we’re trying to stop using, this whole argument over what’s real, what’s not… is so depressing and so all-consuming out there that it gives another reason to return to books – real physical books – because it is too much of an effort to fake those.” David Streitfeld, New York Times tech reporter and author of “When a Tech Reporter Doesn’t Use Much Tech.”


  1. elisabeth solomon says:

    What would it take for Atul Gawande’s CHECKLIST to become a hospital practice for ALL hospitalized people in the u.s. ???

  2. elisabeth solomon says:

    Given the distractions medical staff face (from their own internal dialogs to all sorts of conversational interruptions including surprises),WITHOUT A CHECKLIST and regulations enforcing its use AND OVERSIGHT of same (Atul Gawande, MD) HOW will medical error deaths be minimized.

    • AmyInNH says:

      Someone I was talking to, while they took my blood for testing, put someone else’s name on the tubes, and it was something I spotted and told her she was doing.
      I noticed some places give [X] to the patient to confirm. Outpatient surgery, doc made an “X” on surgery site, while patient was awake to confirm.
      EVERYONE makes mistakes. Confirmation reduces error rates, persons having to do that mind, and tend to call it bureaucracy.
      All checklists, in defense work, constantly, and it works.

  3. Bruce K. says:

    Again, another fascinating show. This shoe touched on something I’ve been wondering about for a long time, which is what is society’s interest in collecting facts, reporting facts and/or spinning facts.

    For many decades we have had TV shows that spin our industries in a positive light, that doesn’t quite tell the true tale of things like war, the military, the police department, the medical industry and others. We have to deal with realities that cannot just flap in the wind with a capricious democratic audience.

    Is there an interest to us all to mythologize our society, to keep reality from people, and if there is, what is the limit to it. What happens in a situation like this medical industry report where people need to have confidence in our medical industry, but at the time same must somehow calculate the benefit to them personally when they interact with it.

    The problem is that most of our economy and most of our society relies on lies, myths, fake-facts to keep everything going until it gets good enough to justify itself? As Stephen Drucker talked about in the GMO industry, the thinking is that if Americans want to be at the cutting edge of technologies and have all these benefits that we have to be willing to be guinea pigs. A scary thought.

    Nice to hear Bernie Sanders mentioned.

    The thing is that Republicans say they want the government to run more like a business or more efficienct, but the reality is, as Thomas Frank write about in “The Wrecking Crew” that Republicans realize that if they make government work, there will be a demand for more government, so they deliberately appoint people who are loyalists or incompetents, to keep things not working.

    There is a complete disconnect in the Republican party, but even both parties. The Republicans constantly lie and dissemble about what they are doing, and what their visions is, – this is no way for our country to run, and it cannot and has not been running well and it is getting worse.

  4. Miles Longenbaugh says:


    The recent was show regarding the “Third Leading Cause of Death” was very enlightening and disturbing, but it also made me feel very hopeful because if we start to change the way we report deaths, then we can track medical errors, and if it we can track them, then we can have opportunities for improvement in patient safety. However, there was one key topic that was not covered in your show, that I feel without which, all the efforts to reform the death certificate process are meaningless. That topic is called “Just Culture” and it is the idea of creating a framework that ensures balanced accountability for both individuals and the organization responsible for designing and improving systems in the workplace, and has been a huge discussion point at Patient Safety Summits across the US over the last few years.

    I currently serve on the board of a municipal hospital district in Washington State and the topic of Just Culture compliance comes up all the time. There has to be a great, collaborative, non-retaliatory, work environment across the healthcare landscape that encourages people to report errors so that we can all learn from them and create safer patient outcomes.

    I would love to see a show where this topic is covered, or at least get your thoughts on this for a few minutes as a follow-up to your previous show. Keep up the great work.

    From the Great Northwest,


  5. J Emi Quadri says:

    Until they find a better ranking system, medical errors will continue to be covered up. If one were to do a root cause analysis of the reason there are so many medical errors in the US I am sure they would all share the common denominator: too few staff rendering direct care. It is also the Profit before Patient mentality which is the status quo in this country. That coupled with a ranking system that be be manipulated makes for a unsafe situation. Medical care reform in this country is needed.
    A Health Care Administrator

  6. Dale West says:

    To illustrate how high medical errors for humans can become just look at the level of medical errors in veterinary medicine. Veterinary medicine is a purely unregulated private sector medical field with no mandated reporting of medical errors, adverse drug reactions, research evidence based statistics, government inspections or centralized data collection. The lack of veterinary medical protocols and safety checklists in the industry is unethical & appalling. To me veterinary medicine is the “canary in the cage” warning for human medicine. For example, pet anesthetic deaths using the same modern inhalation anesthetics (sevoflurane, isoflurane) used for humans is conservatively estimated to be 10-20x higher, but there is no mandated reporting for proper tracking. Thus there is no incentive for improvement for medical errors.

  7. Robert Holman says:

    It’s no surprise that the AMA didn’t really respond to the article. If it were not for JAMA, the AMA would likely be irrelevant. Membership has continuously declined.