Further Reading: Field Autopsy — Medicine

Tier 1: Verified Sources

Wootton, David. Bad Medicine: Doctors Doing Harm Since Hippocrates. Oxford University Press, 2006. The most comprehensive argument that medicine was net-harmful until the mid-19th century. Wootton's claim is provocative but well-evidenced. Essential reading for anyone interested in the structural history of medical error. This chapter draws heavily on Wootton's analysis.

Prasad, Vinayak, and Adam Cifu. Ending Medical Reversal: Improving Outcomes, Saving Lives. Johns Hopkins University Press, 2015. The definitive work on medical reversal — medical practices established on inadequate evidence that are later contradicted by rigorous trials. Prasad and Cifu estimate the reversal rate, analyze the structural causes, and propose solutions. Essential for understanding why medicine's correction infrastructure, for all its power, still fails.

Ioannidis, John P. A. "Why Most Published Research Findings Are False." PLoS Medicine, 2005. The landmark paper on the unreliability of published research. Ioannidis's statistical analysis of how study design, publication bias, and researcher degrees of freedom produce false findings applies directly to medicine's replication crisis.

Vaughan, Diane. The Challenger Launch Decision. University of Chicago Press, 1996. While focused on aerospace, Vaughan's concept of "normalization of deviance" has been widely applied to medical safety culture. Her framework helps explain how hospitals normalize risky practices (medication errors, procedural shortcuts) in ways that parallel NASA's normalization of O-ring erosion.

Carpenter, Daniel. Reputation and Power: Organizational Image and Pharmaceutical Regulation at the FDA. Princeton University Press, 2010. Essential for understanding the regulatory dimension of medical error — particularly the structural incentives that produce both under-regulation (opioid crisis) and over-regulation (Chapter 21's thalidomide pendulum).

McGinnis, J. Michael, et al. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. National Academies Press, 2013. The Institute of Medicine report that estimated approximately 30% of US healthcare spending was wasted on unnecessary or ineffective treatments. Provides the institutional context for understanding why medicine's error rate remains high despite its correction infrastructure.

Tier 2: Attributed Claims

Research on the "17-year gap" between evidence publication and widespread practice change has been documented in multiple studies, though the exact figure varies by condition and intervention. The number is widely cited in health services research as a rough estimate of therapeutic inertia.

The claim that Bayer could replicate only 20-25% of published preclinical findings was reported by Florian Prinz and colleagues in 2011. The Amgen figure (6 of 53 landmark studies replicated) was reported by C. Glenn Begley and Lee Ellis in 2012. Both figures have been widely discussed in the context of medicine's replication crisis, though the methodology of these internal assessments has been subject to some debate.

The "less than 1% addiction risk" claim that fueled opioid prescribing is traced to a brief letter by Jane Porter and Herschel Jick published in the New England Journal of Medicine in 1980. The letter, which was not a study, was subsequently cited over 600 times and used by pharmaceutical companies to support marketing claims about opioid safety.

  1. Start with Wootton (Bad Medicine) — for the full historical arc of medical error
  2. Then Prasad & Cifu (Ending Medical Reversal) — for the current state of medical error
  3. Then Ioannidis (2005) — for the statistical foundations of why medical research is unreliable
  4. Then Carpenter (Reputation and Power) — for the regulatory dimension
  5. Then McGinnis et al. (Best Care at Lower Cost) — for the institutional and economic context