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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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
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.
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
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).
concluded that between 4% and 18% of consecutive patients
experience negative effects in outpatient
- 116 million
extra physician visits
- 77 million
- 17 million
emergency department visits
- 8 million
- 3 million
- $77 billion in
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.
from a few studies indicates that as many as 20% to 30% of
patients receive inappropriate care.
44,000 to 98,000 among them die each year as a result of
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
- 13th (last)
for low-birth-weight percentages
- 13th for
neonatal mortality and infant mortality overall 14
- 11th for
- 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
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
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.
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.
technology is certainly not a contributing factor to the US's
- 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.
however, ranks highest on health, whereas the US ranks among
- 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.
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
American Medical Association 2000 Jul
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
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.
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.
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.
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.
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.
interventions for the underlying emotional and spiritual
wounding behind most chronic illness are also important clues
to maximizing health and reducing disease.
Mistakes Kill 100,000 per year
Health Care System Most Expensive in the
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
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Table of Contents Issue #164