Death by Medicine - 4

[Guest guest]

http://www.garynull.com/documents/iatrogenic/deathbymedicine/DeathByMedicine4.ht\

m#UNNECESSARY%20SURGICAL

 

Death by Medicine - 4

Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD

Debora Rasio MD, Dorothy Smith PhD

October 2003

 

Note: The information on this website is not a substitute for

diagnosis and treatment by a qualified, licensed professional.

 

previous next

 

UNNECESSARY SURGICAL PROCEDURES

 

Summary:

 

1974: 2.4 million unnecessary surgeries performed annually resulting in 11,900

deaths at an annual cost of $3.9 billion.73,74

 

2001: 7.5 million unnecessary surgical procedures resulting in 37,136 deaths at

a cost of $122 billion (using 1974 dollars).3

 

It’s very difficult to obtain accurate statistics when studying unnecessary

surgery. Dr. Leape in 1989 wrote that perhaps 30% of controversial surgeries are

unnecessary. Controversial surgeries include Cesarean section, tonsillectomy,

appendectomy, hysterectomy, gastrectomy for obesity, breast implants, and

elective breast implants.74

 

Almost thirty years ago, in 1974, the Congressional Committee on Interstate and

Foreign Commerce held hearings on unnecessary surgery. They found that 17.6% of

recommendations for surgery were not confirmed by a second opinion. The House

Subcommittee on Oversight and Investigations extrapolated these figures and

estimated that, on a nationwide basis, there were 2.4 million unnecessary

surgeries performed annually, resulting in 11,900 deaths at an annual cost of

$3.9 billion.73

 

In 2001, the top 50 medical and surgical procedures totaled approximately 41.8

million. These figures were taken from the Healthcare Cost and Utilization

Project within the Agency for Healthcare Research and Quality.13 Using 17.6%

from the 1974 U.S. Congressional House Subcommittee Oversight Investigation as

the percentage of unnecessary surgical procedures, and extrapolating from the

death rate in 1974, we come up with an unnecessary procedure number of 7.5

million (7,489,718) and a death rate of 37,136, at a cost of $122 billion (using

1974 dollars).

 

Researchers performed a very similar analysis, using the 1974 ‘unnecessary

surgery percentage’ of 17.6, on back surgery. In 1995, researchers testifying

before the Department of Veterans Affairs estimated that of 250,000 back

surgeries in the U.S. at a hospital cost of $11,000 per patient, the total

number of unnecessary back surgeries each year in the U.S. could approach

44,000, costing as much as $484 million.75

 

The unnecessary surgery figures are escalating just as prescription drugs driven

by television advertising. Media-driven surgery such as gastric bypass for

obesity “modeled” by Hollywood personalities seduces obese people to think this

route is safe and sexy. There is even a problem of surgery being advertised on

the Internet.76 A study in Spain declares that between 20 and 25% of total

surgical practice represents unnecessary operations.77

 

According to data from the National Center for Health Statistics from 1979 to

1984, there was a 9% increase in the total number of surgical procedures, and

the number of surgeons grew by 20%. The author notes that there has not been a

parallel increase in the number of surgeries despite a recent large increase in

the number of surgeons. There was concern that there would be too many surgeons

to share a small surgical caseload.78

 

The previous author spoke too soon - there was no cause to worry about a small

surgical caseload. By 1994, there was an increase of 38% for a total of

7,929,000 cases for the top ten surgical procedures. In 1983, surgical cases

totaled 5,731,000. In 1994, cataract surgery was number one with over two

million operations, and second was Cesarean section (858,000 procedures).

Inguinal hernia operations were third (689,000 procedures), and knee

arthroscopy, in seventh place, grew 153% (632,000 procedures) while prostate

surgery declined 29% (229,000 procedures).79

 

The list of iatrogenic diseases from surgery is as long as the list of

procedures themselves. In one study epidural catheters were inserted to deliver

anesthetic into the epidural space around the spinal nerves to block them for

lower Cesarean section, abdominal surgery, or prostate surgery. In some cases,

non-sterile technique, during catheter insertion, resulted in serious

infections, even leading to limb paralysis.80

 

In one review of the literature, the authors demonstrated “a significant rate of

overutilization of coronary angiography, coronary artery surgery, cardiac

pacemaker insertion, upper gastrointestinal endoscopies, carotid

endarterectomies, back surgery, and pain-relieving procedures.”81

 

A 1987 JAMA study found the following significant levels of inappropriate

surgery: 17% of cases for coronary angiography, 32% for carotid endarterectomy,

and 17% for upper gastrointestinal tract endoscopy.82 Using the Healthcare Cost

and Utilization Project (HCUP) statistics provided by the government for 2001,

the number of people getting upper gastrointestinal endoscopy, which usually

entails biopsy, was 697,675; the number getting endarterectomy was 142,401; and

the number having coronary angiography was 719,949.13 Therefore, according to

the JAMA study 17%, or 118,604 people had an unnecessary endoscopy procedure.

Endarterectomy occurred in 142,401 patients; potentially 32% or 45,568 did not

need this procedure. And 17% of 719,949, or 122,391 people receiving coronary

angiography were subjected to this highly invasive procedure unnecessarily.

These are all forms of medical iatrogenesis.

 

MEDICAL AND SURGICAL PROCEDURES

 

It is instructive to know the mortality rate associated with different medical

and surgical procedures. Even though we must sign release forms when we undergo

any procedure, many of us are in denial about the true risks involved. We seem

to hold a collective impression that since medical and surgical procedures are

so commonplace, they are both necessary and safe. Unfortunately, partaking in

allopathic medicine itself is one of the highest causes of death as well as the

most expensive way to die.

 

Shouldn’t the daily death rate of iatrogenesis in hospitals, out of hospitals,

in nursing homes, and psychiatric residences be reported like the pollen count

or the smog index? Let’s stop hiding the truth from ourselves. It’s only when we

focus on the problem and ask the right questions can we hope to find solutions.

 

Perhaps the word “healthcare” gives us the illusion that medicine is about

health. Allopathic medicine is not a purveyor of healthcare but of disease-care.

Studying the mortality figures in the Healthcare Cost and Utilization Project

(HCUP) within the U.S. government’s Agency for Healthcare Research and Quality,

we found many points of interest.13 The HCUP computer program that calculates

the annual mortality statistics for all U.S. hospital discharges is only as good

as the codes that are put into the system. In an email correspondence with HCUP,

we were told that the mortality rates that were indicated in tables and charts

for each procedure were not necessarily due to the procedure but only indicated

that someone who received that procedure died either from their original disease

or from the procedure.

 

Therefore there is no way of knowing exactly how many people died from a

particular procedure. There are also no codes for adverse drug side effects,

none for surgical mishap, and none for medical error. Until there are codes for

medical error, statistics of those people who are dying from various types of

medical error will be buried in the general statistics. There is a code for

“poisoning & toxic effects of drugs” and a code for “complications of

treatment.” However, the mortality figures registered in these categories are

very low and don’t compare with what we know from studies such as the JAMA 1998

study1 that said there were an average of 106,000 prescription medication deaths

per year.

 

WHY AREN'T MEDICAL AND SURGICAL PROCEDURES STUDIED?

 

In 1978, the U.S. Office of Technology Assessment (OTA) reported that, “Only

10%-20% of all procedures currently used in medical practice have been shown to

be efficacious by controlled trial. " 83 In 1995, the OTA compared medical

technology in eight countries (Australia, Canada, France, Germany, Netherlands,

Sweden, United Kingdom, and the United States) and again noted that few medical

procedures in the U.S. had been subjected to clinical trial. It also reported

that infant mortality was high and life expectancy was low compared to other

developed countries.84 Although almost ten years old, much of what was said in

this report holds true today. The report lays the blame for the high cost of

medicine squarely at the feet of the medical free-enterprise system and the fact

that there is no national health care policy. It describes the failure of

government attempts to control health care costs due to market incentive and

profit motive in the financing and organization of health care

including private insurance, hospital system, physician services, and drug and

medical device industries. Whereas we may want to expand health-care, expansion

of disease-care is the goal of free enterprise. “Health Care Technology and Its

Assessment in Eight Countries” is also the last report prepared by the OTA,

which was shut down in 1995. It’s also, perhaps, the last honest, in-depth look

at modern medicine. Because of the importance of this 60-page report, we enclose

a summary in the Appendix.

 

SURGICAL ERRORS FINALLY REPORTED

 

Just hours before completion of this paper, statistics on surgical-related

deaths became available. A October 8, 2003 JAMA study from the U.S. government’s

Agency for Healthcare Research and Quality (AHRQ) documented 32,000 mostly

surgery-related deaths costing $9 billion and accounting for 2.4 million extra

days in the hospital in 2000.85 In a press release accompanying the JAMA study,

the AHRQ director, Carolyn M. Clancy, M.D., admitted, “This study gives us the

first direct evidence that medical injuries pose a real threat to the American

public and increase the costs of health care.” 86 Hospital administrative data

from 20% of the nation’s hospitals were analyzed for eighteen different surgical

complications including postoperative infections, foreign objects left in

wounds, surgical wounds reopening, and post-operative bleeding. In the same

press release the study’s authors said that, “The findings greatly underestimate

the problem, since many other complications happen that are

not listed in hospital administrative data.” They also felt that, " The message

here is that medical injuries can have a devastating impact on the health care

system. We need more research to identify why these injuries occur and find ways

to prevent them from happening. " One of the authors, Dr. Zhan said that improved

medical practices, including an emphasis on better hand-washing, might help

reduce the morbidity and mortality rates. An accompanying JAMA editorial by

health-risk researcher Dr. Saul Weingart of Harvard’s Beth Israel Deaconess

Medical Center said, “Given their staggering magnitude, these estimates are

clearly sobering.”87

 

UNNECESSARY X-RAYS

 

When X-rays were discovered, no one knew the long-term effects of ionizing

radiation. In the 1950’s monthly fluoroscopic exams at the doctor’s office were

routine. You could even walk into most shoe stores and see your foot bones;

looking at bones was an amusing novelty. We still don’t know the ultimate

outcome of our initial escapade with X-rays.

 

It was common practice to use X-rays in pregnant women to measure the size of

the pelvis, and make a diagnosis of twins. Finally, a study of 700,000 children

born between 1947 and 1964 was conducted in thirty-seven major maternity

hospitals. The children of mothers who had received pelvic X-rays during

pregnancy were compared with the children of mothers who had not been X-rayed.

Cancer mortality was 40% higher among the children with X-rayed mothers.88

 

In present-day medicine, coronary angiography combines an invasive surgical

procedure of snaking a tube through a blood vessel in the groin up to the heart.

To get any useful information during the angiography procedure X-rays are taken

almost continuously with minimum dosage ranges between 460 - 1,580 mrem. The

minimum radiation from a routine chest X-ray is 2 mrem. X-ray radiation

accumulates in the body and it is well-known that ionizing radiation used in

X-ray procedures causes gene mutation. We can only obtain guesstimates as to its

impact on health from this high level of radiation. Experts manage to obscure

the real effects in statistical jargon such as, “The risk for lifetime fatal

cancer due to radiation exposure is estimated to be 4 in one million per 1,000

mrem.”89

 

However, Dr. John Gofman, who has been studying the effects of radiation on

human health for 45 years, is prepared to tell us exactly what diagnostic X-rays

are doing to our health. Dr. Gofman has a PhD in nuclear and physical chemistry

and is a medical doctor. He worked on the Manhattan nuclear project, discovered

uranium-2323, was the first person to isolate plutonium, and since 1960, he’s

been studying the effects of radiation on human health. With five scientifically

documented books totaling over 2800 pages, Dr. Gofman provides strong evidence

that medical technology, specifically X-rays, CT scans, mammography, and

fluoroscopy, are a contributing factor to 75% of new cancers. His 699-page

report, updated in 2000, “Radiation from Medical Procedures in the Pathogenesis

of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per

100,000 Population to here”90 shows that as the number of physicians increases

in a geographical area with an increase in the number of

X-ray diagnostic tests, there is an associated increase in the rate of cancer

and ischemic heart disease. Dr. Gofman elaborates that it’s not X-rays alone

that cause the damage but a combination of health risk factors including: poor

diet, smoking, abortions, and the use of birth control pills. Dr. Gofman

predicts that 100 million premature deaths over the next decade will be the

result of ionizing radiation.

 

In his book, “Preventing Breast Cancer,” Dr. Gofman says that breast cancer is

the leading cause of death among American women between the ages of forty-four

and fifty-five. Because breast tissue is highly radiation-sensitive, mammograms

can cause cancer. The danger can be heightened by a woman’s genetic makeup,

preexisting benign breast disease, artificial menopause, obesity, and hormonal

imbalance.91

 

Even X-rays for back pain can lead someone into crippling surgery. Dr. Sarno, a

well-known New York orthopedic surgeon, found that X-rays don’t always tell the

truth. In his books he cites studies on normal people without a trace of back

pain that have spinal abnormalities on X-ray. Other studies have shown that some

people with back pain have normal spines on X-ray. So, Dr. Sarno says there is

not necessarily any association between back pain and spinal X-ray

abnormality.92 However, if a person happens to have back pain and an incidental

abnormality on X-ray, they may be treated surgically, sometimes with no change

in back pain, or worsening of back pain, or even permanent disability.

 

In addition, doctors often order X-rays as protection against malpractice claims

to give the impression that they are leaving no stone unturned. It appears that

doctors are putting their own fears before the interests of their patients.

 

UNNECESSARY HOSPITALIZATION

 

Summary:

 

8.9 million (8,925,033) people were hospitalized unnecessarily in 2001.4

 

In a study of inappropriate hospitalization 1,132 medical records were reviewed

by two doctors. Twenty-three percent of all admissions were inappropriate and an

additional 17% could have been handled in ambulatory out-patient clinics.

Thirty-four percent of all hospital days were also inappropriate and could have

been avoided.93 The rate of inappropriate admissions in 1990 was 23.5%.94 In

1999, another study confirmed the figure of 24% inappropriate admissions

indicating a consistent pattern from 1986 to 1999,95 showing steady reporting of

approximately 24% inappropriate admissions each year. Putting these figures into

present-day terms using the HCUP database, the total number of patient

discharges from hospitals in the U.S. in 2001 was 37,187,641.13 The above data

indicate that 24% of those hospitalizations need never have occurred. It further

means that 8,925,033 people were exposed to unnecessary medical intervention in

hospitals and therefore represent almost 9 million potential

iatrogenic episodes.4

 

 

 

© 2003 Gary Null & Associates, Inc. (GNA)

 

 

 

 

NEW WEB MESSAGE BOARDS - JOIN HERE.

Alternative Medicine Message Boards.Info

http://alternative-medicine-message-boards.info

 

 

 

Free Pop-Up Blocker - Get it now