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From
an article in the Journal of the American Medical Assoc. (JAMA)
and by Dr. Joseph Mercola, October, 2005 – Abridged
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.
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free newsletter.
This information is a follow up 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 describes how the
US health care system may contribute to poor health.
ALL THESE ARE DEATHS PER YEAR:
- 12,000 -- unnecessary surgery
- 7,000 -- medication errors in hospitals
- 20,000 -- other errors in hospitals
- 80,000 -- infections in hospitals
- 106,000 -- non-error, negative effects of drugs
These total 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.
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.
This might be tolerated if it resulted in better health, but
does it? Of 13 countries in a recent comparison, 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
- 11th for post neonatal 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 July 26,
2000;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.
Related Articles:
-
Medical Mistakes Kill 100,000 per year
US Health Care System Most Expensive in the World
Drug Induced Disorders
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: bstarfie@jhsph.edu).
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