American deaths due to medical errors, was The Truth Fairy

July 7, 2004

Just the first two articles picked off of a Medline search with the above

subject as the query. This is the number quoted each year now for several years

in epidemiological and CDC reports that I've seen. Dartmouth Medical School

questions these stats but does not discredit them. Since 1999 these annual

numbers in the U.S. have not been refuted in any papers I've seen. Perhaps Phil

Rogers who is good at literature searches can find something that refutes these

numbers.

Respectfully,

Emmanuel Segmen

To err is human--the fallible physician.

S D J Med 2004 Jan;57(1):9-11 (ISSN: 0038-3317)

Harris MH

A 1999 report published by the Institute of Medicine shocked our nation's

citizens and health care providers. This report, entitled To Err is Human:

Building a Safer Health System, suggested that as many as 98,000 people die each

year in the United States as a result of medical errors, making medical errors

the 8th-leading cause of death. By comparison, Americans are much less likely to

die from motor vehicle accidents, breast cancer, or AIDS. More Americans die

annually from medication errors alone than from workplace injuries. Not all

errors are fatal ones, of course. An error may cause only temporary problems or

disability, or may have no consequence at all. Errors may be due to mistakes

made by individual health care providers, or may be due to faulty or inefficient

processes in organizations and other health care delivery systems. This

editorial will focus on the inevitability of physician fallibility, two causes

of individual provider errors, and suggestions for strategies that should be

considered by health care providers in an attempt to reduce errors. Next month

we will look at the efforts made by hospitals in order to improve patient

safety, and how these efforts impact physician practice.

Preventing errors in healthcare: a call for action.

Hosp Top 2003 Summer;81(3):5-12 (ISSN: 0018-5868)

Al-Assaf AF; Bumpus LJ; Carter D; Dixon SB

MPH Degree Program, University of Oklahoma Health Sciences Center,

Oklahoma City, Oklahoma, USA.

Medical errors cause up to 98,000 people to die annually in the

United States. They are the fifth leading cause of death and cost the United

States dollar 29 billion annually (Kohn 1999). Medical errors fall into 4 main

categories: diagnostic, treatment, preventative, and other. A review of

literature reveals several proposed solutions to the medical error problem. One

solution is to change the system for reporting medical errors. This would allow

for the tracking of errors and provide information on potential problematic

areas. A National Center for Patient Safety is proposed, which would set

national goals towards medical errors. Another solution is the setting of

performance standards among individual entities of healthcare delivery, such as

hospitals and clinics. Another solution involves implementing a culture of

safety among healthcare organizations. This would put the responsibility of

safety on everyone in the organization. A change in education is yet another

proposed solution. Informing medical students about errors and how to deal with

them will help future physicians prevent such errors. The final solution

involves improvements in information technology. These improvements will help

track errors, but also will prevent errors. A combination of these solutions

will change the focus of the healthcare industry toward safety and will

eventually lead to billions in savings, but more importantly, the saving of

lives.

_______

-

Chinese Medicine

Tuesday, July 06, 2004 4:04 PM

Re:The Truth Fairy (the dragons treatment)

Chinese Medicine , Hugo Ramiro

<subincor> wrote:

> Hi Jason...

>

> --- wrote:

> > that Steve quoted, I am hard pressed to find any

> > 'real' evidence. I.e.

> > check out the above link (I am just investigating

>

> > Gary null says: The total number of iatrogenic

> > deaths shown in the

> > following table is 783,936. then quotes other high

> > death rates (of

> > course being quoted lower that the above stat). Most

> > importantly there

> > is no source for his stat, it somehow appears out of

> > thin air. If one

> > checks the footnote that follows this stat one of

> > course does not find

> > it.

>

> I think you might not have spent enough time with the

> document. I found the following references for the

> stat you quote. I consider myself a die-hard realist,

> so if I don't see it happen it doesn't exist for me

> whether reference exists for it or not.

>

> The first three sources listed in the table (rest are

> available in the complete ref list) are:

> 1. Lazarou J, Pomeranz B, Corey P. Incidence of

> adverse drug reactions in hospitalised patients. JAMA.

> 1998;279:1200-1205.

> 49. Suh DC, Woodall BS, Shin SK, Hermes DeSantis ER.

> Clinical and economic impact of adverse drug reactions

> in hospitalised patients. Ann Pharmacother. 2000

> Dec;34(12) 1373-9

> 6. Thomas et al., 2000; Thomas et al., 1999.

> Institute of Medicine.

>

> Don't know if these are valid.

Hugo,

They are not valid, because they do not at all support the kind of

numbers that gary null (or steve) is suggesting. I.e. It is true the

1st documents the incidence of adverse drug reactions in hospitals

(which is of course a real phenomenon), but like I said this has

nothing to do with the initial statistic quote. The second source says

nothing also. the 3rd source was not found, but an excerpt was found

that says:

" Between 44,000-98,000 Americans die from medical errors annually

(Institute of Medicine, 2000; Thomas et al., 2000; Thomas et al., 1999) "

This is far from the 783,936 that gary purports. This is just further

evidence that there is more BS out there than .

So, thanx for trying to find evidence for (in my mind) bogus stats,

but this is IMO mud slinging. If anyone has other sources please

present them, but read them first to see if they actually have

anything to do with the quoted stat.. and if I actually missed

something in your sources, I will be happy to admit that I am wrong.

But either way his stat is not properly sourced anyway, because it is

impossible to find.

Respectfully,

-

July 7, 2004

Chinese Medicine , " Emmanuel Segmen "

<susegmen@i...> wrote:

> Just the first two articles picked off of a Medline search

with the above subject as the query. This is the number quoted each

year now for several years in epidemiological and CDC reports that

I've seen. Dartmouth Medical School questions these stats but does

not discredit them. Since 1999 these annual numbers in the U.S. have

not been refuted in any papers I've seen. Perhaps who is

good at literature searches can find something that refutes these

numbers.

Emmanuel,

Thanx for putting in a little time to corraborate what I am talking

about. IF someone can refute these, let us know. 98,000 is much

different than 780,000 making it according to the article the 8th

leading cause not the #1 cause. Also when these sources are questions

(i.e dartmouth) I would bet money that they think they should be lower

not higher. Looking forward to more information...

-

July 7, 2004

Hi Jason,

Even when Dartmouth or the CDC discusses these numbers, they tend not to use the

terms " medical error " . They tend to say deaths that occur under the care of an

MD using the normal standards of treatment and care. So for me if the numbers

were only half the 98,000 ... down to 49,000 per year ... gee, that's pretty

bad. That makes MDs about as dangerous as highway accidents. Of course, it's

all in the numbers. MDs see hundreds of millions of people in the U.S. The

same number of people drive cars. So is it reasonable to assume there would be

the same order of magnitude of deaths? Is driving a car about as safe as seeing

an MD ... or the converse? Then I'd have to ask myself if hundreds of millions

of people went to see CM practitioners would there be the same magnitude of

death? I sense the answer would be: no. Acupuncture needles and Chinese herbs

can't hurt you as badly as 3,000 to 6,000 lb objects nor as badly as WM

pharmaceuticals.

This is a pretty unscientific inquiry, so I think I'll cease and desist at this

point. It could easily turn into a Jerry Springer Show episode. :-)

It is, however, always a pleasure to speak with you from time to time. I hope

you are well and having a good summer.

Respectfully,

Emmanuel Segmen

-

Chinese Medicine

Wednesday, July 07, 2004 6:32 AM

Re: American deaths due to medical errors, was The Truth Fairy

Chinese Medicine , " Emmanuel Segmen "

<susegmen@i...> wrote:

> Just the first two articles picked off of a Medline search

with the above subject as the query. This is the number quoted each

year now for several years in epidemiological and CDC reports that

I've seen. Dartmouth Medical School questions these stats but does

not discredit them. Since 1999 these annual numbers in the U.S. have

not been refuted in any papers I've seen. Perhaps who is

good at literature searches can find something that refutes these

numbers.

Emmanuel,

Thanx for putting in a little time to corraborate what I am talking

about. IF someone can refute these, let us know. 98,000 is much

different than 780,000 making it according to the article the 8th

leading cause not the #1 cause. Also when these sources are questions

(i.e dartmouth) I would bet money that they think they should be lower

not higher. Looking forward to more information...

-

July 7, 2004

Doctors Are The Third Leading Cause of Death in the US, Causing 250,000

Deaths Every Year

This article in the Journal of the American Medical Association (JAMA) is the

best article I have ever seen written in the published literature documenting

the tragedy of the traditional medical paradigm.

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 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.

In a message dated 7/7/2004 6:33:35 PM Eastern Daylight Time,

susegmen writes:

Chinese Medicine , " Emmanuel Segmen "

<susegmen@i...> wrote:

> Just the first two articles picked off of a Medline search

with the above subject as the query. This is the number quoted each

year now for several years in epidemiological and CDC reports that

I've seen. Dartmouth Medical School questions these stats but does

not discredit them. Since 1999 these annual numbers in the U.S. have

not been refuted in any papers I've seen. Perhaps who is

good at literature searches can find something that refutes these

numbers.

Emmanuel,

Thanx for putting in a little time to corraborate what I am talking

about. IF someone can refute these, let us know. 98,000 is much

different than 780,000 making it according to the article the 8th

leading cause not the #1 cause. Also when these sources are questions

(i.e dartmouth) I would bet money that they think they should be lower

not higher. Looking forward to more information...

-

July 8, 2004

The following article is based on the landmark study done by Bruce Pomeranz and

his team who took the never-before tried track of studying the number of deaths

that occur when their are no medical errors and everything goes as prescribed.

The one fact that is never mentioned is that Bruce Pomeranz is one of North

America's leading acupuncture researchers. In other words - it took someone who

understands that there are often viable alternatives to conventional drug

therapy to do a study that shows just how dangerous prescription drugs are. Dr.

Pomeranz deserves a great deal of credit both for his acupuncture research and

this attention-demanding study. - Matt Bauer.

Drug Reactions Linked To 100,000 Deaths

April 15, 1998

CHICAGO (UPI) - More than 100,000 hospital patients may die each

year from bad reactions to medicines designed to help them.

Canadian researchers say adverse drug reactions may rank as high

as the fourth as a leading cause of death in the United States.

Scientists also say the problem has been underestimated and doctors and

hospitals need to increase their reporting of such reactions.

Neuroscientist Bruce Pomeranz says, " There are 100,000 deaths a

year in the United States from properly prescribed, properly administered drugs.

That's a very astounding number. "

He says, " On top of that, there are 2 million 200,000 severe injuries a year.

That's even more astounding. It's a huge, huge number of serious drug

reactions. "

In a study in Wednesday's Journal of the American Medical Association, Pomeranz

and a research team from the University of Toronto pooled data from 39 studies

on dangerous drug reactions published between 1966 and 1996.

They estimated that in 1994, 2.2 million hospital patients had serious drug

reactions and that as many as 106,000 people died from them.

This figure would put adverse drug reactions just behind heart disease, cancer

and stroke as a cause of death.

The researchers also made a more conservative estimate of about

75, 000 deaths, which would still make it the sixth leading cause of death.

Pomeranz says, " Up to now, nobody had any idea the number was so

big. "

He says the frequency of these events was consistent through the

decades, " which was surprising because drugs have changed considerably over the

years. "

In another, unpublished study, Pomeranz suggests that the problem is a global

one. A review of data from 22 countries has shown " the same picture as the U.S. "

he says.

The scientists define adverse drug reactions as reactions to drugs that send or

keep patients in the hospital, or that lead to permanent disability or death.

The researchers did not count reactions caused by

mistakes made by doctors and patients, drug abuse or intentional overdose.

But, he says, he is hoping that increased awareness of the problem will lead to

more monitoring, and more participation in programs to report these reactions to

the FDA. Doctors currently underreport drug reactions, he says, and he does not

know why.

Dr. David Bates of the Brigham and Women's Hospital and Harvard

Medical School in Boston, says that the rate of ADRs, about 6.7 percent in the

study, is similar to what he has found during his five years

investigating the issue.

He says, " I was surprised at the large number of deaths. "

He adds that it is important to view these results with caution, because the

study design, in which the researchers combined data from several small studies,

may not produce accurate results.

In an accompanying editorial, Bates says, " These data suggest that health care

practitioners may miss or pass over many ADRs (adverse drug reactions) that

occur, even among fatal events. "

Bates says, " Routine systems to detect these reactions find only a small

percentage of them. " He says hospitals need to develop better

systems to monitor the frequency of these reactions.

He says patients also need to be made aware of these problems, and should know

when they are feeling something that may signal a drug

reaction that they should report to their doctor.

Bates says that new drugs may improve the situation, as pharmaceuticals that

have the benefits, but minimize the risks.

In a statement, Alan F. Holmer, the president of the Pharmaceutical Research and

Manufacturers of America, a Washington, D.C.-based trade group, says that the

study " should not be taken out of context. "

He says, " The public should be confident that the benefits of medicine far

outweigh the risks and should contact their doctor or pharmacist with any

questions. "

Pomeranz says that his intention was not to scare people away from taking their

medicines.

He says, " This is not to say that drugs don't have wonderful benefits. "

-

Emmanuel Segmen

Chinese Medicine

Wednesday, July 07, 2004 3:19 PM

Re: Re: American deaths due to medical errors, was The Truth

Fairy

Hi Jason,

Even when Dartmouth or the CDC discusses these numbers, they tend not to use

the terms " medical error " . They tend to say deaths that occur under the care of

an MD using the normal standards of treatment and care. So for me if the

numbers were only half the 98,000 ... down to 49,000 per year ... gee, that's

pretty bad. That makes MDs about as dangerous as highway accidents. Of course,

it's all in the numbers. MDs see hundreds of millions of people in the U.S.

The same number of people drive cars. So is it reasonable to assume there would

be the same order of magnitude of deaths? Is driving a car about as safe as

seeing an MD ... or the converse? Then I'd have to ask myself if hundreds of

millions of people went to see CM practitioners would there be the same

magnitude of death? I sense the answer would be: no. Acupuncture needles and

Chinese herbs can't hurt you as badly as 3,000 to 6,000 lb objects nor as badly

as WM pharmaceuticals.

This is a pretty unscientific inquiry, so I think I'll cease and desist at

this point. It could easily turn into a Jerry Springer Show episode. :-)

It is, however, always a pleasure to speak with you from time to time. I hope

you are well and having a good summer.

Respectfully,

Emmanuel Segmen

-

Chinese Medicine

Wednesday, July 07, 2004 6:32 AM

Re: American deaths due to medical errors, was The Truth

Fairy

Chinese Medicine , " Emmanuel Segmen "

<susegmen@i...> wrote:

> Just the first two articles picked off of a Medline search

with the above subject as the query. This is the number quoted each

year now for several years in epidemiological and CDC reports that

I've seen. Dartmouth Medical School questions these stats but does

not discredit them. Since 1999 these annual numbers in the U.S. have

not been refuted in any papers I've seen. Perhaps who is

good at literature searches can find something that refutes these

numbers.

Emmanuel,

Thanx for putting in a little time to corraborate what I am talking

about. IF someone can refute these, let us know. 98,000 is much

different than 780,000 making it according to the article the 8th

leading cause not the #1 cause. Also when these sources are questions

(i.e dartmouth) I would bet money that they think they should be lower

not higher. Looking forward to more information...

-

July 8, 2004

Hi Emmanuel

Great post on horrific stats. I have a copy of the following article

in my waiting room. Not sure if this link has already appeared on

this thread or not so excuse the repetition if this is so. Everyone

should read this as it's from the esteemed JAMA--Journal of the

American Medical Association. One public health specialist back in

2000 wrote this and busted the entire industry (will acupuncture

ever be an " industry " ? eeeeekkk!!!) If I remember correctly, there

was a bit of a flurry on the news and then......silence. People

don't think, by and large, that there exists a real alternative

which is effective and cheap. Here's the link.

http://jama.ama-assn.org/cgi/content/full/284/4/483

Maybe we should all consider having a copy in our waiting rooms

(unless you work with an MD ;-).

Regards, Shanna

Chinese Medicine , " Emmanuel

Segmen " <susegmen@i...> wrote:

> Hi Jason,

>

> Even when Dartmouth or the CDC discusses these numbers, they tend

not to use the terms " medical error " . They tend to say deaths that

occur under the care of an MD using the normal standards of

treatment and care. So for me if the numbers were only half the

98,000 ... down to 49,000 per year ... gee, that's pretty bad. That

makes MDs about as dangerous as highway accidents. Of course, it's

all in the numbers. MDs see hundreds of millions of people in the

U.S. The same number of people drive cars. So is it reasonable to

assume there would be the same order of magnitude of deaths? Is

driving a car about as safe as seeing an MD ... or the converse?

Then I'd have to ask myself if hundreds of millions of people went

to see CM practitioners would there be the same magnitude of death?

I sense the answer would be: no. Acupuncture needles and Chinese

herbs can't hurt you as badly as 3,000 to 6,000 lb objects nor as

badly as WM pharmaceuticals.

>

> This is a pretty unscientific inquiry, so I think I'll cease and

desist at this point. It could easily turn into a Jerry Springer

Show episode. :-)

>

> It is, however, always a pleasure to speak with you from time to

time. I hope you are well and having a good summer.

>

> Respectfully,

> Emmanuel Segmen

>

> -

>

> Chinese Medicine

> Wednesday, July 07, 2004 6:32 AM

> Re: American deaths due to medical errors, was

The Truth Fairy

>

> Chinese Medicine , " Emmanuel

Segmen "

> <susegmen@i...> wrote:

> > Just the first two articles picked off of a Medline

search

> with the above subject as the query. This is the number quoted

each

> year now for several years in epidemiological and CDC reports

that

> I've seen. Dartmouth Medical School questions these stats but

does

> not discredit them. Since 1999 these annual numbers in the U.S.

have

> not been refuted in any papers I've seen. Perhaps

who is

> good at literature searches can find something that refutes these

> numbers.

>

> Emmanuel,

>

> Thanx for putting in a little time to corraborate what I am

talking

> about. IF someone can refute these, let us know. 98,000 is much

> different than 780,000 making it according to the article the 8th

> leading cause not the #1 cause. Also when these sources are

questions

> (i.e dartmouth) I would bet money that they think they should be

lower

> not higher. Looking forward to more information...

>

> -

>

July 8, 2004

Chinese Medicine , " Emmanuel Segmen "

<susegmen@i...> wrote:

> Hi Jason,

>

> Even when Dartmouth or the CDC discusses these numbers, they tend

not to use the terms " medical error " . They tend to say deaths that

occur under the care of an MD using the normal standards of treatment

and care. So for me if the numbers were only half the 98,000 ...

down to 49,000 per year ... gee, that's pretty bad. That makes MDs

about as dangerous as highway accidents.

I totally agree...

>Of course, it's all in the numbers. MDs see hundreds of millions of

people in the U.S. The same number of people drive cars. So is it

reasonable to assume there would be the same order of magnitude of

deaths? Is driving a car about as safe as seeing an MD ... or the

converse? Then I'd have to ask myself if hundreds of millions of

people went to see CM practitioners would there be the same magnitude

of death? I sense the answer would be: no. Acupuncture needles and

Chinese herbs can't hurt you as badly as 3,000 to 6,000 lb objects nor

as badly as WM pharmaceuticals.

Well this is a loaded statement / question... MD's are seeing very

many critical care / er patient's. They are giving medications that

are very strong (many times) to try to save lives... Now this isn't

always the case as for my friend's friend's MOM who just died going in

for a typical knee surgery due to a wrong drug... Yes that sucks, but

they do save lives also. How many more people would actually die if

all those critical care people went to CM docs. Probably the majority

of them, because we have a very limited training, especially in

critical situations... E thanx for your input…

-

July 8, 2004

Chinese Medicine , " Matt Bauer "

<acu.guy@g...> wrote:

> The following article is based on the landmark study done by Bruce

Pomeranz and his team who took the never-before tried track of

studying the number of deaths that occur when their are no medical

errors and everything goes as prescribed. The one fact that is never

mentioned is that Bruce Pomeranz is one of North America's leading

acupuncture researchers. In other words - it took someone who

understands that there are often viable alternatives to conventional

drug therapy to do a study that shows just how dangerous prescription

drugs are. Dr. Pomeranz deserves a great deal of credit both for his

acupuncture research and this attention-demanding study. - Matt Bauer.

>

> Drug Reactions Linked To 100,000 Deaths

Matt thanx for your input... Once again this 100,000 number pops up

and is similar to what the medical journal's have found... but, it is

far from the #1 killer in America - as propertied on this list a few

days ago. But even with this article one cannot reference the stats

making it completely useless.

-

July 8, 2004

Chinese Medicine , Musiclear@a... wrote:

> Doctors Are The Third Leading Cause of Death in the US, Causing 250,000

> Deaths Every Year

> This article in the Journal of the American Medical Association

(JAMA) is the

> best article I have ever seen written in the published literature

documenting

> the tragedy of the traditional medical paradigm.

Looks interesting, but I could not find it on medline, could you

please supply a citation. (I did every search you can think of with

the informtion you gave above- could not find anything ) I would

love to read it especially about them including the 106,00 people that

die to non-error... Thanx in advance,

-

> 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 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.

> In a message dated 7/7/2004 6:33:35 PM Eastern Daylight Time,

> susegmen@i... writes:

> Chinese Medicine , " Emmanuel Segmen "

> <susegmen@i...> wrote:

> > Just the first two articles picked off of a Medline search

> with the above subject as the query. This is the number quoted each

> year now for several years in epidemiological and CDC reports that

> I've seen. Dartmouth Medical School questions these stats but does

> not discredit them. Since 1999 these annual numbers in the U.S. have

> not been refuted in any papers I've seen. Perhaps who is

> good at literature searches can find something that refutes these

> numbers.

>

> Emmanuel,

>

> Thanx for putting in a little time to corraborate what I am talking

> about. IF someone can refute these, let us know. 98,000 is much

> different than 780,000 making it according to the article the 8th

> leading cause not the #1 cause. Also when these sources are questions

> (i.e dartmouth) I would bet money that they think they should be lower

> not higher. Looking forward to more information...

>

> -

>

July 8, 2004

I did finally find the JAMA article, for others that are interested:

Vol. 284 No. 4, July 26, 2000

commentary

Is US Health Really the Best in the World?

Barbara Starfield, MD, MPH

this is where the basic stat is released in the opening paragraph :

In addition, with the release of the Institute of Medicine (IOM)

report " To Err Is Human, " 2 millions of Americans learned, for the

first time, that an estimated 44,000 to 98,000 among them die each

year as a result of medical errors.

the rest is below...

thanx everyone...

-

JAMA. 2000;284:483-485. --- In

Chinese Medicine , Musiclear@a... wrote:

> Doctors Are The Third Leading Cause of Death in the US, Causing 250,000

> Deaths Every Year

> This article in the Journal of the American Medical Association

(JAMA) is the

> best article I have ever seen written in the published literature

documenting

> the tragedy of the traditional medical paradigm.

> 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 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.

> In a message dated 7/7/2004 6:33:35 PM Eastern Daylight Time,

> susegmen@i... writes:

> Chinese Medicine , " Emmanuel Segmen "

> <susegmen@i...> wrote:

> > Just the first two articles picked off of a Medline search

> with the above subject as the query. This is the number quoted each

> year now for several years in epidemiological and CDC reports that

> I've seen. Dartmouth Medical School questions these stats but does

> not discredit them. Since 1999 these annual numbers in the U.S. have

> not been refuted in any papers I've seen. Perhaps who is

> good at literature searches can find something that refutes these

> numbers.

>

> Emmanuel,

>

> Thanx for putting in a little time to corraborate what I am talking

> about. IF someone can refute these, let us know. 98,000 is much

> different than 780,000 making it according to the article the 8th

> leading cause not the #1 cause. Also when these sources are questions

> (i.e dartmouth) I would bet money that they think they should be lower

> not higher. Looking forward to more information...

>

> -

>

July 8, 2004

Hi Shanna,

It's possible to read the full text of this JAMA article by selecting a " guest "

membership. Many journals like New England Journal of Medicine work this way.

As a guest you can read the full text of any article that is more than 6 months

old. The article is fully referenced. The beauty of the references in the

footnotes is that the articles have hyperlinks associated with them so you can

go back to the original article.

JAMA is a wonderful journal to read as it has a bit of this TCM group " feel " to

it. Back in the 1980s I was a member of the AMA in Bexar County, Texas, not too

far way from you. I got to read an article by a 92 year old physician who

dispelled the myth of using the Heimlich maneuver on adults when inversion of

the body over a stool or chair seat works a lot better. I've taught this to my

own students who agree that aspirating a food particle is hard to dislodge via

the Heimlich maneuver. It's easy to dislodge with inversion, and you can do it

by yourself while applying percussions to the chest.

I think Jason was referring more specifically to the IOM research and their

referencing. My own understanding from reliable sources such as the CDC is that

the number of deaths per year is in the 90,000 to 100,000 range. These deaths

are not " medical error " but deaths by medical treatment under the direct care of

an MD treating with the normal standard care. As you may recall CM

practitioners had to endure the scrutiny of the governments of the US, UK,

Canada and others in the late 1990s due to 2 deaths by aristolochic acid through

the misuse and improper identification of Chinese herbs. If people had taken

the time to read the scientific literature, the two main research papers from

Germany and Japan referenced Chinese research all the way back to the 1980s

where the term Chinese Herbal Nephropathy (CHN) was coined. All studies

indicate that normal use of CM herb never led to CHN in any of the studies. CHN

came about due to misuse of herbal extracts for non-medical treatments ...

weightloss. In the late 1990s, I wrote letters to Robert Moore of the FDA about

this who eventually agreed that at least we should properly identify the herbs.

Robert Moore never gave in to the fact that these herbs administered for

appropriate CM treatment protocols did not cause CHN.

Thanks for your presentation! My cohort of MD friends readily agree that the

death rate is around 90,000 to 100,000 per year. WM is potent stuff, and people

die by " friendly fire " . You can't fault the MDs for practicing with such potent

tools ... that's their training. In fact you might endear yourself to an MD

colleague by posting any JAMA article to your office door. You can fault the

American healthcare system for not attending to real epidemiological issues. We

are the last industrialized nation not to have national healthcare. HMOs are

" risk management " institutions .... not unlike Las Vegas's main industry. MDs

are in a double bind. They wished there was national healthcare when they were

medical students so they could train for free. Now that many of them owe half a

million dollars, they're afraid of national healthcare.

Respectfully,

Emmanuel Segmen

-

shannahickle

Chinese Medicine

Wednesday, July 07, 2004 9:21 PM