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August 9, 1995

Error in Medicine

Author Affiliations

Baltimore, Md

JAMA. 1995;274(6):459. doi:10.1001/jama.1995.03530060031021

To the Editor.  —Dr Leape's1 article on error in medicine offers a thoughtful and timely comment on a critical problem in health care. Unfortunately, one of the prescriptions may be dangerous medicine: the recommendation to simplify tasks to reduce errors.At first glance, the recommendation appears attractive. Some businesses have already adopted the practice of "dumbing down" jobs. Instead of training workers, the idea is to make the work so simple that people do not have to read, write, add, or even think. For example, to dumb down a dispensary, install electronic scanners. Dumb down fast-food jobs with pictures on cash register keys instead of numbers. Dumb down jobs in the billing office by imposing standard protocols so rigid that little independent judgment is required or even allowed. Dumbing-down employers opt out of investing in the workforce. They view training people as too expensive. Employers even have dumbed down

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