But all in all, he says, it amounts to not enough.
"I'll put my chips on brute force, and that is regulation. We have a Federal Aviation Agency for aviation, and certainly patient safety is every bit as important as aviation safety. We need a federal patient safety agency to set standards and enforce them, and get this show on the road," he says.
He also noted that physician resistance has impeded patient safety. "The fact of the matter is…they've been skeptical about it and really haven't participated because they don't see it in their daily life. You say there's 100,000 preventable deaths a year and that's awful. But there are 800,000 doctors. That means the chance of any one physician having a death he or she caused is going to be once in eight years, and only if they recognize it…There's also doctors who feel they have a veto over safe practices. If they don't agree with something, they feel they don't have to follow it."
I asked Leape to elaborate on his remarks. And so he did, in a 45-minute interview this week.
We haven't kept up
HLM: You said that healthcare is safer today than it was 20 or 30 years ago, but not anywhere near as safe as it could be. What do you mean?
LL: When I started a long time ago, we had a few operations, a few antibiotics and a few other drugs, but that was about it. In the last half-century, we've made dramatic improvements in treatments, for example deaths from heart attacks alone dropped 50%. With artificial joints, people can walk without pain and limping. We have transplantation, and chemotherapy.
Unfortunately, every improvement has the potential for mistake in the use of it. We've introduced the opportunity for things to go wrong and we just haven't kept up. It's a constant battle to prevent errors. It's much more difficult to provide healthcare than to put a man on the moon.