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. 

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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
                            7,000 -- medication errors in hospitals
                            20,000 -- other errors in hospitals
                            80,000 -- infections in hospitals
                            106,000 -- non-error, negative effects of drugs

                        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 2000 Jul 26;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). 
 
 

                        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.