Get me outta here, Mommy, I'm scared! I don't want a biochip!

[Guest guest]

(TCM isn't Typical Capitalist Madness)

 

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 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

 

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).

 

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.

[Guest guest]

Thank you very much for putting together this great synopsis of very

scary stats. The next type of stats needed are figures on how much

money is speant on treating iatrogenic disorders. While a sad fact,

figures regarding costs get more attention than figures regarding

human suffering. With all the concern over the high cost of health

care, you would think they would want to know how much we spend

treating problems caused by previous treatment. Talk about not

working yourself out of a job. Matt

 

-- In Chinese Medicine , " ykcul_ritsym "

<ykcul_ritsym> wrote:

> (TCM isn't Typical Capitalist Madness)

>

> 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 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

>

> 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@j...).

>

> 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.