Doctors Are The Third Leading Cause of
Death in the US, Causing 250,000 Deaths Every Year
Journal American Medical Association July 26, 2000;284(4):483-5
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.
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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