We spent a lot of time discussing how 400,000 people are killed in the US by medical error each year. This number is astonishing, astronomical and unforgivable. Much of this discussion centered on how the medical system fails patients and doesn’t protect them. But I’m not sure we have a medical “system”. In the United States healthcare isn’t the same everywhere, there are few guidelines to follow. We have a system where most practitioners operate in a silo on their own. Without a true “medical system” how can we ever expect to codify safety changes and protect Americans when they enter the healthcare system? Can a system fail you if it doesn’t exist?