Doctors Are The Third Leading Cause of Death in the US, Causing 250,000 Deaths Every Year
by Dr. Joseph Mercola (Published 3/15/2000 ) at http://www.jesus-is-savior.com/Health_Concerns/doctors_are_third_leading_cause_of_death.htm
http://www.chattanoogahealth.com/Articles/2135/1/Doctors_May_Be_Third_Leading_Cause_of_Death.aspx
Dr. Mercola is a licensed Osteopathic physician and board-certified in family medicine. He served as the chairman of the family medicine department at St. Alexius Medical Center for five years and has been trained in both traditional and natural medicine.
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.
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 describes 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.
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
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.
