Modern medicine has achieved extraordinary successes in treating infections, managing chronic illness, repairing injuries and extending human life. Yet there is another side to medical practice that receives considerably less public attention: the illness, injury and sometimes death caused by medical treatment itself. The technical term is iatrogenic disease, derived from Greek roots referring to the physician and to something produced or brought about. It encompasses adverse drug reactions, surgical complications, hospital-acquired infections, diagnostic and treatment errors, and other harms arising from healthcare. Not all such harms are preventable, and not all involve professional negligence. Nevertheless, the scale of the problem in Australia is substantial, as the latest official statistics demonstrate.
According to the Australian Institute of Health and Welfare (AIHW), approximately 220,000 Australian hospitalisations in 2024–25 involved at least one of the hospital-acquired complications monitored under the national patient-safety framework. These included healthcare-associated infections, medication complications, surgical complications requiring an unplanned return to theatre, delirium and other conditions arising during hospital treatment. The recorded complication rate was 2.2 per 100 hospitalisations in public hospitals and 0.9 per 100 in private hospitals. These figures are not directly comparable because the hospitals treat different patient populations and undertake different types of procedures. Nevertheless, the overall numbers are difficult to dismiss as an insignificant side effect of an otherwise successful system.
The longer-term trend also deserves attention. The AIHW reports that the public hospital complication rate increased from 2.0 per 100 hospitalisations in 2020–21 to 2.2 in 2024–25, while the corresponding private hospital rate remained at 0.9. This is not evidence of a dramatic deterioration, but neither does it demonstrate that the problem is disappearing. Despite advances in medical technology, professional training, electronic records and patient-safety programmes, complications continue to affect large numbers of hospital patients.
A broader indicator published by the Productivity Commission in its Report on Government Services 2026 provides another perspective. In 2023–24, 6.6 per cent of separations from Australian public hospitals had a recorded adverse event, compared with 6.4 per cent in 2022–23. Such events include infections, falls causing injury, medication problems and complications involving medical devices. The indicator is broader than the AIHW's designated hospital-acquired complications measure, and some events may have occurred before the hospital admission. Nevertheless, it indicates the considerable burden of adverse events associated with hospital care.
Medication-related harm is particularly disturbing because pharmaceutical treatment is now central to the management of chronic disease, especially among older Australians who may be prescribed several medicines simultaneously. A systematic review of Australian studies, published in Drug Safety in 2022, estimated that at least 250,000 hospital admissions annually were medication-related, costing the healthcare system approximately $1.4 billion. The researchers estimated that around two-thirds of these admissions were potentially preventable. These figures were derived from earlier studies and national hospitalisation data, rather than representing a fresh count for 2026. They nevertheless provide a sobering indication of the magnitude of medication-related harm.
The causes are varied. Patients may receive an inappropriate medicine, an incorrect dose or a combination of drugs producing harmful interactions. Medicines may be continued after their original purpose has disappeared, or their effects may not be adequately monitored. Problems can also arise when patients move between hospitals, general practitioners, specialists and residential aged-care facilities. Changes in prescriptions, incomplete records and failures of communication create opportunities for serious mistakes. In 2025, the Australian Commission on Safety and Quality in Health Care released a national framework intended to reduce medication errors during these transitions, acknowledging the importance of this persistent safety problem.
Hospital-acquired infections constitute another major source of iatrogenic harm. The Australian Commission reported in its 2023–24 annual report that approximately 81,000 healthcare-associated infections occur in Australia each year. Such infections can prolong hospitalisation, require additional treatment and sometimes contribute to death. The irony is evident: a patient enters hospital seeking treatment for one condition and may acquire another illness through the very environment intended to restore health. Infection-control procedures, including hand hygiene, sterilisation and careful use of invasive devices, can reduce the risks, but cannot eliminate them entirely.
There is also the less easily quantified problem of unnecessary medical intervention. A diagnostic test may produce a false positive, leading to further investigations, anxiety and invasive procedures. An operation may offer only marginal benefits while exposing a patient to significant risks. A medicine prescribed for a relatively minor condition may cause adverse effects more serious than the original complaint. This is why the distinction between necessary and unnecessary intervention is fundamental to good medicine. The appropriate question is not merely whether a treatment can be administered, but whether its likely benefits exceed its potential harms for the particular patient.
The problem becomes especially important in an ageing population. Older patients are more likely to have several chronic conditions, to receive multiple prescriptions and to experience changes in the way their bodies process medicines. Treatment decisions made by different specialists may be individually defensible yet collectively hazardous. Polypharmacy, particularly when medicines are prescribed without adequate review of the complete medication list, creates risks of interactions, falls, confusion and other adverse outcomes. Regular medication reviews and the careful withdrawal of unnecessary drugs can therefore be as important as prescribing additional treatments.
None of this establishes that doctors are generally careless or that medical treatment should be avoided. Many patients experience complications precisely because they are seriously ill and require difficult, high-risk interventions. Some adverse outcomes are unavoidable even when treatment is exemplary. Nor should the official figures be interpreted as a count of deaths caused by doctors. The available Australian statistics measure different categories of adverse events and complications, not a single national total of deaths attributable to medical error. Claims that iatrogenic disease is one of Australia's leading causes of death require separate evidence and careful definitions.
But these qualifications should not obscure the central problem. The Australian health system generates a considerable burden of treatment-associated illness and injury, part of which is potentially preventable. Moreover, the official figures cannot capture every adverse outcome. Some complications develop after discharge, some are managed outside hospitals, and others are not identified or recorded as consequences of treatment. The AIHW itself acknowledges limitations in the hospital data, including difficulties identifying adverse events that emerge after patients have left hospital.
The economic consequences are considerable, but the human costs are more important. A medication error may transform an independent older person into someone requiring prolonged care. A hospital-acquired infection may turn a routine procedure into weeks of additional treatment. A preventable fall or surgical complication may permanently reduce a patient's quality of life. These outcomes can be devastating for individuals and families, even when they never become the subject of litigation or public controversy.
The institutional response should therefore extend beyond compensation and disciplinary procedures. Medical systems need effective monitoring, transparent reporting, independent investigation of serious adverse events, and a culture in which practitioners can acknowledge mistakes without automatically facing punitive consequences for honest reporting. Equally important is a willingness to question unnecessary intervention and to recognise that restraint can sometimes be the most appropriate medical decision. The familiar principle primum non nocere, commonly expressed as "first, do no harm", remains relevant even though all effective medical treatment involves some degree of risk.
For patients, the lesson is not to abandon conventional medicine or substitute untested remedies. It is to become informed participants in decisions affecting their health. Patients can reasonably ask whether a proposed treatment is necessary, what benefits are expected, what serious adverse effects are possible, whether alternatives exist and what might happen if treatment is deferred. Those taking multiple medications can request regular reviews, particularly following hospital discharge or a change in their medical circumstances.
The Australian figures reveal an uncomfortable truth about modern healthcare. Medicine is capable of remarkable achievements, yet the institutions delivering it can also produce serious harm. The problem is not adequately addressed by celebrating medical progress while treating adverse outcomes as unfortunate exceptions. When hundreds of thousands of hospitalisations involve complications or medication-related problems, patient safety must remain a central measure of healthcare quality.
The proper response is neither uncritical faith in medical authority nor wholesale rejection of medical science. It is an insistence upon evidence, accountability, careful clinical judgment and the recognition that medical intervention is not automatically beneficial simply because it is medically possible. A health system should be judged not only by the diseases it treats and the lives it saves, but also by the avoidable suffering it causes in the course of doing so.
https://www.trialsitenews.com/a/iatrogenic-contributing-factors-to-disease-2cbfd547