The AdvoKayte Podcast.
S2 Ep2: Beyond Dr. Death: Why America’s Healthcare System Keeps Failing Patients
Aired on June 17th, 2026

Podcast Summary (44m:57s). 

Patient Safety and Systemic Accountability by Design
Are medical mistakes caused by bad people or a bad system?

Broken systems create failures. That’s the conclusion of Matt Austin, a Patient Safety Expert at John Hopkins with a Ph.D in Industrial and Systems Engineering. Matt applies his skills as an engineer to improving the quality and safety of healthcare delivery in hospitals and other care settings. He spent 12 years working in the airline industry before switching to healthcare.

Much of the science of patient safety is drawn from the airline and nuclear industries, where there’s not a lot of room for mistakes because the cost of any errors can be catastrophic. When mistakes do happen, they are thoroughly investigated and documented. These efforts have not only made flying at 35,000 ft one of the safest modes of mass transportation, they tend to improve passenger safety year over year. Imagine how this dedication to quality and safety can help change our healthcare system for the better.

“Those industries have taught us a lot in healthcare about how we need to think about errors, how we need to prevent errors, how we need to investigate errors.”, Matt Austin said, noting that with over 4,000 hospitals operating in 50 states in the US, standardization in safety and investigation protocols is a greater challenge than in industries that have clear mandates from federal authorities.

Regulation, Investigation, and Accountability. 

In this episode, Kay and Matt explore the differences and similarities of high-risk industries when it comes to regulation, investigation, and accountability.

For instance, while medical malpractice incidents naturally vary from patient to patient, there are different legislative and legal bodies in different states. On the other hand, a plane crash and the subsequent investigative and legal processes are generally understood the same way by everyone. It is much easier to get one set of legislators to understand a problem and take corrective action when there are standardized procedures for investigation than to get 50 sets of legislators to agree to honor conclusions drawn from 50 different legal frameworks.

They also cover how the business of a for-profit healthcare system leaves doctors, nurses, and other health care providers tired, burnt out, and frustrated. Matt notes how, with the proper introduction of new technologies and relatively minor changes, the safety and efficiency of our healthcare systems could improve dramatically for both patients and practitioners. “We’ve found ways of designing things so that mistakes can’t be made”

“Is it bad people or bad systems that cause errors?” Matt asks, “I think bad people are a pretty small minority of the harm that occurs in healthcare. We haven’t designed systems in ways that let healthcare workers deliver the best care all the time in every situation.”

This is a fascinating episode that takes a deep dive and a deeply honest look at how the failings of parts of the system can cause breakdowns throughout the greater healthcare system. Looking at healthcare from an engineer’s perspective reveals a number of stress points along with research-driven solutions that could ease or transform those stress points. The ultimate point is to create healthcare systems that can be investigated, reported on, and ultimately, improved on as reliably and consistently as the airline or nuclear industries.