This article is similar to Death by Medicine but goes further in its explanation.

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Overuse: The Problem with Medicine

Iatrogenic Injury: Definition--Physician caused injury or death

Did you know doctors are 9,000 times more likely to kill you than a gun owner? You might feel doubtful but view the following information.

All these are deaths per year:
* 12,000--unnecessary surgery in hospitals
* 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 in hospitals
These total to 225,000 deaths per year from these iatrogenic causes.

Keep in mind these numbers:
- Are lower and more conservative than some other reports. Because there is no compulsion for hospitals or doctors to report iatrogenic complications fewer than 10% of medical mistakes are reported to hospital authorities. The patients or their families are never told that doctors caused the injuries.
- Only account for deaths during hospital care.
- Are for deaths only and do not include negative effects associated with disability or discomfort.

It is estimated that 1 in every 200 patients in our hospitals has an iatrogenic death annually. Airlines have a better rate for lost luggage than hospitals have with lives. Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings. This might be tolerated if it resulted in better health, but does it? Of 13 countries in a recent comparison, the U.S. ranks an average of 12th (second from the bottom) for 16 available health indicators. The poor performance of the U.S. was once again confirmed by a World Health Organization study, which used different data and ranked the U.S. as 15th among 25 industrialized countries.

As shown in Table 1, the estimated total number of iatogenic deaths--that is, deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures--in the U.S. annually is 783,936. These include hospitals, nursing homes, and outpatient care. It is evident that the American medical system is itself the leading cause of death and injury in the U.S. By comparison, approximatedly 699,697 Americans died of heart disease in 2001, while 553,251 died of cancer. If you estimate this number over 10 years it is more than 7.8 million iatrogenic deaths, which is more than all the casualties from all the wars fought by the U.S. throughout history. This number of deaths per year is equivalent to six jumbo jets crashing every day!

Increased Death Rates Related to Number of Doctors
A major paper by Australian researchers asks a question that should never have needed to be asked. The report, Will More Doctors Increase or Decrease Death Rates? conducted by the Center for Health Program Evaluation in Australia, refers to Australian statistics but the information is relevant to American and other countries as well. The hypothesis: An increase in the doctor supply is associated with an increase in death rates. Why may this hypothesis be true?

Health Care and Adverse Events
One possibility of why medical care may increase death rates is the large number of adverse events associated with it. The report mentions a 1995 study in which close to 17% of 14,000 hospital admissions were associated with an adverse event. Of those, 51% were considered preventable, in close to 14% the disability was permanent and in almost 5% the patient died. That is 8 people for every 1000 admissions that die from error.

Dependency on Medical Care
Another possibility, which the researchers call "the dependency hypothesis," is the notion that the more doctors available, the more dependent people are on medical care to maintain their health. In turn, they place less weight on lifestyle factors that can have a greater affect on health. This is one of the major prevailing thoughts in America, and one of the major reasons why so many people are facing chronic illnesses. Doctors are certainly necessary and useful at times, but ultimately the responsibility for your health is your own.

Cognitive Dissonance, or Conflicting Beliefs
Another interesting concept explored in the report is that of cognitive dissonance. This is the unsettling state that occurs when a person has conflicting beliefs or opinions. Cognitive dissonance affects most everyone, but in regard to health care many people understand that certain lifestyle choices are better for their health, yet may not want to make the "right" choices because they are less pleasurable in the present. In order to resolve the conflict of knowing intellectually what the healthy lifestyle choices are while having a desire to live a self-indulgent life, the researchers say people "adopt an exaggerated confidence in the efficacy of medical care and its ability to offset the harmful effects of self-neglect."

Failure to Inform Patients on Health Truths
The Journal of the American Medical Association (JAMA) article that states doctors as the third leading cause of death reveals the state of the health care system in the United States. Dr. Starfield, who published the article, did not feel that doctors were the third leading cause of death, but thought they were the number one cause of death because of their failure to inform patients about the truth of health. This might be a bit harsh as even if people understand the health truths they still have freedom of choice and can choose to use sugar, soda, and drugs (legal and illegal) to compromise their health and longevity.

Nevertheless, the Australian researchers concluded that their hypothesis that an increase in the doctor supply is associated with an increase in death rates needs to be seriously contemplated. This isn't only true in Australia, but probably in many modernized countries.

This point is further solidified by other countries' medical systems. Time and again, it has been shown that when doctors strike death rates dramatically decrease. For example, in Israel in 1973 doctors went on strike reducing their daliy patient contact from 65,000-7,000. The strike lasted 30 days. According to the Jerusalem Burial Society, the Israeli death rate dropped fifty percent during that month. There had not been such a significant drop in mortality since the last doctor's strike 20 years before.

In Bogota, Columbia the doctors struck for 52 days and the death rate dropped 35%. In Los Angeles County, CA in 1976 the doctors went on a work slowdown to protest rising malpractice premiums. That coincided with an 18% drop in the death rate.

It's time to rethink our health care sytem! We need to start focusing on taking care of health instead of managing disease.

Table 1: Estimated Annual Mortality and Economic Cost of Medical Intervention

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References:
Death by Medicine by Gary Null, PhD; Carolyn Dean, MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD. You can read their entire article at www.lef.org

Journal of the American Medical Association. 2000 Jul 26; 284(4)483-5

"Why Death Rates Decrease When Doctors Go On Stike" by Dr. Joseph Mercola with Racael Droege from May 26, 2004 www.mercola.com. To view the Australian Report click here.

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