from: http://www.mercola.com/2000/jul/30/doctors_death.htm
Doctors Are The Third Leading Cause of Death in
the US, Causing 250,000 Deaths Every Year
This week's issue of 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.
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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 Vol 284 July 26,
2000
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.
Related Articles:
Medical Mistakes Kill 100,000 per year
US Health Care System Most Expensive in the World
Author/Article Information
Author Affiliation: Department of Health Policy and
Management, Johns Hopkins School of Hygiene and Public
Health, Baltimore, Md. Corresponding Author and Reprints:
Barbara Starfield, MD, MPH, Department of Health Policy
and
Management, Johns Hopkins School of Hygiene and Public
Health, 624 N Broadway, Room 452, Baltimore, MD
21205-1996 (e-mail: [email protected]).
REFERENCES
1. Schuster M, McGlynn E, Brook R. How good is the
quality of health care in
the United States?
Milbank Q. 1998;76:517-563.
2. Kohn L, ed, Corrigan J, ed, Donaldson M, ed. To Err Is
Human: Building a
Safer Health System. Washington, DC: National Academy
Press; 1999.
3. Starfield B. Primary Care: Balancing Health Needs,
Services, and
Technology. New York, NY: Oxford University Press; 1998.
4. World Health Report 2000. Available at:
http://www.who.int/whr/2000/en/report.htm. Accessed June
28, 2000.
5. Kunst A. Cross-national Comparisons of Socioeconomic
Differences in
Mortality. Rotterdam, the Netherlands: Erasmus
University; 1997.
6. Law M, Wald N. Why heart disease mortality is low in
France: the time lag
explanation. BMJ. 1999;313:1471-1480.
7. Starfield B. Evaluating the State Children's Health
Insurance Program:
critical considerations.
Annu Rev Public Health. 2000;21:569-585.
8. Leape L.Unecessarsary surgery. Annu Rev Public Health.
1992;13:363-383.
9. Phillips D, Christenfeld N, Glynn L. Increase in US
medication-error deaths
between 1983 and 1993. Lancet. 1998;351:643-644.
10. Lazarou J, Pomeranz B, Corey P. Incidence of adverse
drug reactions in
hospitalized patients. JAMA. 1998;279:1200-1205.
11. Weingart SN, Wilson RM, Gibberd RW, Harrison B.
Epidemiology and
medical error. BMJ. 2000;320:774-777.
12. Wilkinson R. Unhealthy Societies: The Afflictions of
Inequality. London,
England: Routledge; 1996.
13. Evans R, Roos N. What is right about the Canadian
health system?
Milbank Q. 1999;77:393-399.
14. Guyer B, Hoyert D, Martin J, Ventura S, MacDorman M,
Strobino D.
Annual summary of vital statistics1998. Pediatrics.
1999;104:1229-1246.
15. Harrold LR, Field TS, Gurwitz JH. Knowledge, patterns
of care, and
outcomes of care for generalists and specialists. J Gen
Intern Med.
1999;14:499-511.
16. Donahoe MT. Comparing generalist and specialty care:
discrepancies,
deficiencies, and excesses. Arch Intern Med.
1998;158:1596-1607.
17. Anderson G, Poullier J-P. Health Spending, Access,
and Outcomes:
Trends in Industrialized Countries. New York, NY: The
Commonwealth Fund;
1999.
18. Mold J, Stein H. The cascade effect in the clinical
care of patients. N
Engl J Med. 1986;314:512-514.
19. Shi L, Starfield B. Income inequality, primary care,
and health indicators.
J Fam Pract.
1999;48:275-284.
Return To Table of Contents Issue #164
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