DRUG MORTALITY


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

Form mercola.com 

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: bstarfie@jhsph.edu).

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.

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Disclaimer - Newsletters are based upon the opinions of Dr. Mercola. They are not intended to replace a one-on-one relationship with a qualified health care professional and they are not intended as medical advice. They are intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

 

Properly prescribed drugs kill 100,000 to 130,000 people a year, and rank 4th as a leading cause of death in the U.S.! These dismal statistics do not include deaths from improper prescriptions or surgeries and unreported cases, which can significantly alter the negative statistics!

JAMA 1998; 280: 1569-1575, 1616-1619
  

Adverse reactions from drugs and surgery in hospitals are the 5th leading cause of death in the U.S.!

JAMA 1998; 279: 1200 and 1216
  

Blunders by doctors kill 40,000 a year in Britain, and are the third meeting cause of death in that country. This is the conclusion from studies that examine the records of 30,195 patients conducted by researchers at University College London.

www.mercola.com, December 27, 1999
  

Iatrogenic disease (caused by doctors) accounts for 11% of hospital intensive care admissions. French researchers conclude that “despite 25 years of experience with high-technology medicine, iatrogenic disease still has a negative impact on the health and resources of society.”

Archives of Int Med Jan 11, 1999;159:71-78
  

44,000 to 98,000 hospitalized Americans are killed every year from medical mistakes, which now ranked eighth as a leading cause of death in the US! This is reported in a study by the National Academy of Science's Institute of Medicine. Even the lower estimate exceeds the annual deaths from traffic accidents about (43,450), breast cancer (42, 300) or AIDS (16, 500). Note that the Institute of medicine statistics does not include deaths from errors outside of the hospitals.

“To Err is Human,” a report by the national academy of sciences Institute of medicine, November 30, 1999
  

THE NO. 1 RISK OF DYING FOR PEOPLE YOUNGER THAN 35 IS BEING TREATED BY A CONVENTIONAL DOCTOR. From the Center for Disease Control’s most current data from 1997, the highest risk of death for people between the age of 1 to 35 is under the category of “unintentional injection and adverse effects,” a euphemism for medical therapeutic errors.

quoting http://www.cdc.gov/ncipc/osp/states/10lc97.htm from www.mercola.com, December 5, 1999
  

Doctors Go on 'Strike' and Death Rates Plummet

Death rates in Israel have dropped considerably since physicians in public hospitals implemented a program of sanctions three months ago, according to a survey of burial societies.

The Israel Medical Association (IMA) began the action in March to protest against the government's proposed imposition of a new four-year wage contract for doctors. Since then, hundreds of thousands of visits to outpatient clinics have been canceled or postponed along with tens of thousands of elective operations. Emergency rooms, dialysis units, oncology departments, obstetric and neonatal departments, and other vital facilities have been working normally during the action.

The Jerusalem Post surveyed non-profit burial societies, which perform funerals for the vast majority of Israelis, and found that the number of funerals has fallen drastically.

According to one funeral parlor manager the same thing occurred in 1983, during a similar action by the IMA, which lasted 4 and a half months.

The only area of Israel which was found to not have a reduction in its death rate was the city of Netanya. It also just so happens that all of the doctors at the only hospital in this city have "no-strike" clauses in their contracts and are therefore unaffected by the action.

British Medical Journal 2000;320:1561

COMMENT: Well, here we have it again, definitive proof that traditional medicine overall kills more people than it saves. There is no question that traditional approaches for acute traumas (e.g., heart attack, stroke, accidents, etc.) are valuable and should not be abandoned. However, overall, when takes uses drug/surgical paradigm to address chronic illness, it is generally a prescription for disaster.

 

Related Articles:

Medical Mistakes Kill 100,000 Americans A Year

One Out of Every 10 Patients Admitted to the ICU Are There Because of Doctor-Realted Side Effects

If You Are Younger Than 45 --Your Number One Risk Of Dying Is Being Treated By A Doctor!

Blunders By Doctors Kill 40,000 people a Year In Britain

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