doctored to death.

October 21, 2002

This information is a followup of the Institute of Medicine report which hit the

papers in December of last year, but the data was hard to reference as it was

not in peer-reviewed journal. Now it is published in JAMA which is the most

widely circulated medical periodical in the world.

The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and

Public Health and she desribes how the US health care system may contribute to

poor health.

ALL THESE ARE DEATHS PER YEAR:

12,000 -- unnecessary surgery 8

7,000 -- medication errors in hospitals 9

20,000 -- other errors in hospitals 10

80,000 -- infections in hospitals 10

106,000 -- non-error, negative effects of drugs 2

These total to 250,000 deaths per year from iatrogenic causes!!

What does the word iatrogenic mean? This term is defined as induced in a patient

by a physician's activity, manner, or therapy. Used especially of a complication

of treatment.

Dr. Starfield offers several warnings in interpreting these numbers:

First, most of the data are derived from studies in hospitalized patients.

Second, these estimates are for deaths only and do not include negative

effects that are associated with disability or discomfort.

Third, the estimates of death due to error are lower than those in the IOM

report.1

If the higher estimates are used, the deaths due to iatrogenic causes would

range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes

the third leading cause of death in the United States, after deaths from heart

disease and cancer. Even if these figures are overestimated, there is a wide

margin between these numbers of deaths and the next leading cause of death

(cerebrovascular disease).

Another analysis 11 concluded that between 4% and 18% of consecutive patients

experience negative effects in outpatient settings,with:

116 million extra physician visits

77 million extra prescriptions

17 million emergency department visits

8 million hospitalizations

3 million long-term admissions

199,000 additional deaths

$77 billion in extra costs

The high cost of the health care system is considered to be a deficit, but seems

to be tolerated under the assumption that better health results from more

expensive care.

However, evidence from a few studies indicates that as many as 20% to 30% of

patients receive inappropriate care.

An estimated 44,000 to 98,000 among them die each year as a result of medical

errors.2

This might be tolerated if it resulted in better health, but does it? Of 13

countries in a recent comparison,3,4 the United States ranks an average of 12th

(second from the bottom) for 16 available health indicators. More specifically,

the ranking of the US on several indicators was:

13th (last) for low-birth-weight percentages

13th for neonatal mortality and infant mortality overall 14

11th for postneonatal mortality

13th for years of potential life lost (excluding external causes)

11th for life expectancy at 1 year for females, 12th for males

10th for life expectancy at 15 years for females, 12th for males

10th for life expectancy at 40 years for females, 9th for males

7th for life expectancy at 65 years for females, 7th for males

3rd for life expectancy at 80 years for females, 3rd for males

10th for age-adjusted mortality

The poor performance of the US was recently confirmed by a World Health

Organization study, which used different data and ranked the United States as

15th among 25 industrialized countries.

There is a perception that the American public " behaves badly " by smoking,

drinking, and perpetrating violence. " However the data does not support this

assertion.

The proportion of females who smoke ranges from 14% in Japan to 41% in

Denmark; in the United States, it is 24% (fifth best). For males, the range is

from 26% in Sweden to 61% in Japan; it is 28% in the United States (third best).

The US ranks fifth best for alcoholic beverage consumption.

The US has relatively low consumption of animal fats (fifth lowest in men

aged 55-64 years in 20 industrialized countries) and the third lowest mean

cholesterol concentrations among men aged 50 to 70 years among 13 industrialized

countries.

These estimates of death due to error are lower than those in a recent

Institutes of Medicine report, and if the higher estimates are used, the deaths

due to iatrogenic causes would range from 230,000 to 284,000.

Even at the lower estimate of 225,000 deaths per year, this constitutes the

third leading cause of death in the US, following heart disease and cancer.

Lack of technology is certainly not a contributing factor to the US's low

ranking.

Among 29 countries, the United States is second only to Japan in the

availability of magnetic resonance imaging units and computed tomography

scanners per million population. 17

Japan, however, ranks highest on health, whereas the US ranks among the

lowest.

It is possible that the high use of technology in Japan is limited to

diagnostic technology not matched by high rates of treatment, whereas in the US,

high use of diagnostic technology may be linked to more treatment.

Supporting this possibility are data showing that the number of employees per

bed (full-time equivalents) in the United States is highest among the countries

ranked, whereas they are very low in Japan, far lower than can be accounted for

by the common practice of having family members rather than hospital staff

provide the amenities of hospital care.

Journal American Medical Association 2000 Jul 26;284(4):483-5

DR .MERCOLA'S COMMENT:

Folks, this is what they call a " Landmark Article " . Only several ones like this

are published every year. One of the major reasons it is so huge as that it is

published in JAMA which is the largest and one of the most respected medical

journals in the entire world.

I did find it most curious that the best wire service in the world, Reuter's,

did not pick up this article. I have no idea why they let it slip by.

I would encourage you to bookmark this article and review it several times so

you can use the statistics to counter the arguments of your friends and

relatives who are so enthralled with the traditional medical paradigm. These

statistics prove very clearly that the system is just not working. It is broken

and is in desperate need of repair.

I was previously fond of saying that drugs are the fourth leading cause of death

in this country. However, this article makes it quite clear that the more

powerful number is that doctors are the third leading cause of death in this

country killing nearly a quarter million people a year. The only more common

causes are cancer and heart disease.

This statistic is likely to be seriously underestimated as much of the coding

only describes the cause of organ failure and does not address iatrogenic causes

at all.

Japan seems to have benefited from recognizing that technology is wonderful, but

just because you diagnose something with it, one should not be committed to

undergoing treatment in the traditional paradigm. Their health statistics

reflect this aspect of their philosophy as much of their treatment is not

treatment at all, but loving care rendered in the home.

Care, not treatment, is the answer. Drugs, surgery and hospitals are rarely the

answer to chronic health problems. Facilitating the God-given healing capacity

that all of us have is the key. Improving the diet, exercise, and lifestyle are

basic.

Effective interventions for the underlying emotional and spiritual wounding

behind most chronic illness are also important clues to maximizing health and

reducing disease.

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