TSA and MRSA

You’ve never heard of MRSA, the Medical Response Security Agency? That’s ’cause we don’t have one.

Or a Department of Hospital Security. You might think that we should have one. After all, Dr Sanjay Gupta, in a recent article in the New York Times, reports we have somewhere between 100,000 and 200,000 deaths in hospital annually, due to medical errors. That means doctors are killing 25 to 50 times as many Americans as died in 9/11,* and they are doing this every year, year in and year out. You would think that level of carnage would prompt some kind of official response, at least requiring the presence of a uniformed security officer in every patient’s room, or the enhanced questioning of every doctor after a diagnosis.

Why don’t we? Because we, as a people, recognize an astoundingly stupid idea when we hear one. Because we, as a people, have become accustomed to the fact that this happens and understand that while it’s worth working to reduce the numbers, merde arrive and it’s not worth the cost of that sort of pathological overreaction. Because we have an entrenched professional class, doctors, who would push back strongly if such an idea were ever proposed.

In the case of 9/11, the people of the US were stampeded by the fear-mongers into accepting an astoundingly stupid idea as wisdom, partly because such attacks are incredibly rare and thus hard to evaluate, and partly because there is no group of organized, respected, practitioners who can speak out on the topic. All we have are consumer advocates, which doesn’t have quite the ring of my son, the doctor.

What’s interesting are the parallels between TSA’s security theater, and some of the actions promoted by defensive medicine. So, many more tests are ordered than are necessary (in one survey, 24% more), and more drugs are prescribed, just in case. You see, Gupta gets it wrong when he says that defensive medicine has the goal of reducing error. Defensive medicine has the goal of reducing perceived culpability for medical errors, and thus minimizing the risk of lawsuits. Security theater.

What works in medicine is professionals acting together to promote best practices — checklists, M&M meetings, doctors giving up a certain amount of control and admitting that nurses might be able to spot an error. What will work in defense of the homeland (a Hitlerian term if ever there was one), are similar measures. Suppose the TSA resources were given to the FBI and police, so that they don’t have to manufacture terrorist cells, and can spend time making sure the ground staff aren’t bad guys. Suppose airlines, having armored the cockpit doors, go on to spending money on making aircraft bomb-proof, with blast resistant cargo containers and the like, rather than extracting an equivalent value in time and irritation from their customers. Suppose the mainstream media spent as much time explaining the relative threat (you are more likely to be killed by your furniture than by a terrorist) as they do hyping the nearly nonexistent one.

While we’re at it, suppose pigs can fly, and that someone just gave me a pony.

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*If you are a Republican, Newt Gingrich says we kill about 40,000 Americans a year, which is only ten times the number who died on 9/11, so that’s all right then.

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