Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Who does not like autopsies and why?

George Lundberg, MD
Physician
March 4, 2012
Share
Tweet
Share

Autopsies establish truth, detect change, provide hard data, instruct learners, and promote justice. Yet, they seem poorly valued in modern America except in many TV crime shows like “CSI.”

Dr. Donna Hoyert of the CDC, in August 2011, profiled the dramatic changes in American autopsy rates, noting that while forensic autopsies remain common, hospital autopsies for patients with diseases, especially in the elderly, have almost disappeared.

In evaluating medical quality, I often ask: “How do you evaluate the quality of care given to your sickest patients, the ones who die?”

Unless the answer “by autopsy” comes back quickly, I instantly fault that institution or agency.

Sadly, I rarely do get that answer.

Who does not like autopsies and why?

  1. Pathologists don’t like autopsies because they can be unpleasant, smelly, time-consuming, unappreciated, often not specifically paid for, and they take time away from other tasks viewed as more important, appreciated, pleasant, and lucrative.
  2. Clinicians do not like autopsies because it is uncomfortable to face a family that has lost a loved one. The physician must confront a level of failure because of the death, a tarnishing of the doctor-as-god image. Autopsy surprises might lead to an unhappy family, quality assurance committee concerns, possible litigation, and even a report to the state medical board.
  3. Hospital administrators do not like autopsies because they prefer not to dwell on unfavorable results of hospitalization. They claim difficulty finding the money to pay for them and can never make a profit from autopsies. They often have little medical or scientific background that would encourage curiosity and they tend to do mostly what licensing and accrediting agencies require; these remain strangely silent.
  4. Third-party payers do not like autopsies because they are an expense, and are performed on people who are already dead.
  5. Families of patients do not like autopsies because they are ill-informed about their value, afraid that it might cost them money, and some feel that the deceased person has already been through too much of an ordeal in dying.

So, it has devolved to a few leading physicians like Harvard’s Atul Gawande in The New Yorker and the popular media to recurrently raise the question of why don’t we have more autopsies.

The award winning news outlet ProPublica is issuing a series of remarkable reports by investigative journalists about how we as a society and as a profession handle death. See all of them, free of charge.

Regardless of their current low valuation, the autopsy remains the essence of modern clinical science. It is the one place where truth can be sought, found, and told without conflicts of interest.

Could any hospital have a serious patient safety initiative without a substantial autopsy rate? No, it could not. Maybe that is one of the reasons why the patient safety movement has failed to prevent serious medical errors in so many hospitals.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

To survive with cancer, you need to accept that you are going to die

March 3, 2012 Kevin 20
…
Next

4 possible scenarios for the future of primary care

March 4, 2012 Kevin 8
…

ADVERTISEMENT

Tagged as: Specialist

Post navigation

< Previous Post
To survive with cancer, you need to accept that you are going to die
Next Post >
4 possible scenarios for the future of primary care

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by George Lundberg, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Pathologists face a stark career choice

    George Lundberg, MD
  • a desk with keyboard and ipad with the kevinmd logo

    A culture of cover-up has slowed the patient safety movement

    George Lundberg, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Do drugs aid and abet genius or does genius lead to drugs?

    George Lundberg, MD

More in Physician

  • Why some doctors age gracefully—and others grow bitter

    Patrick Hudson, MD
  • The hidden incentives driving frivolous malpractice lawsuits

    Howard Smith, MD
  • Mastering medical presentations: Elevating your impact

    Harvey Castro, MD, MBA
  • Marketing as a clinician isn’t about selling. It’s about trust.

    Kara Pepper, MD
  • How doctors took back control from hospital executives

    Gene Uzawa Dorio, MD
  • How art and science fueled one woman’s path to medicine

    Amy Avakian, MD
  • Most Popular

  • Past Week

    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Recent Posts

    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • What the research really says about infrared saunas

      Khushali Jhaveri, MD | Conditions
    • How the cycle of rage is affecting physicians—and how to break free

      Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dedicated hypermobility clinics can transform patient care

      Katharina Schwan, MPH | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Recent Posts

    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • What the research really says about infrared saunas

      Khushali Jhaveri, MD | Conditions
    • How the cycle of rage is affecting physicians—and how to break free

      Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dedicated hypermobility clinics can transform patient care

      Katharina Schwan, MPH | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Who does not like autopsies and why?
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...