Kirkus review of “When We do Harm”

Kirkus Reviews

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.

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