Putting Adverse Drug Events Into Perspective

Abstract

We have become all too familiar with the dark side of the industrial model of medicine in which physicians become vendors, patients are covered lives generating revenue streams, and providing care for the sick is described in terms of "medical loss ratios." However, the 3 articles in this issue ofJAMAthat deal with the prevention of adverse drug events (ADEs)^1-3illustrate that a "systems" approach to thinking about health care services can also be used for nobler purposes. See also pp 301, 307, and 312. Traditionally, hospital care has been seen as a series of separate and unrelated interactions between health care professionals and individual patients. Viewed from the perspective of the physician (as things once were), "the health care professional" was usually the doctor, with the importance of other actors such as nurses and pharmacists rarely appreciated. The industrial vision of medicine has brought with it, along