#1 ·
(I don't expect anyone to pay attention to this, just like my last post about the New England Journal of Medicine. It's fine. But if you've got an ear for the truth, listen in..)
Does anyone actually know what the term "iatrogenic" means?
Essentially, it means "caused by a physician." For all the doctors-worshipers out there, here is a statistic—and this time, it isn't coming from a fancy British journal, but from an American one.
Did you realize that physicians and hospitals are the third leading cause of death in the USA?
The Journal of the American Medical Association (JAMA) is a publication of the American Medical Association (AMA). The core of this article (you can read the full piece below) highlights this specific statistic:
"the combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error include:
* 12,000 deaths/year from unnecessary surgery
* 7,000 deaths/year from medication errors in hospitals
* 20,000 deaths/year from other errors in hospitals
* 80,000 deaths/year from nosocomial infections in hospitals
* 106,000 deaths/year from nonerror, adverse effects of medications*
(these) 225,000 deaths per year constitutes the third leading cause of death in the USA, after deaths from heart disease and cancer."
Or, to put it simply:
"the combined consequences of mistakes and counter-indicated reactions occurring due to iatrogenic harm include:
* 12,000 annual deaths due to unnecessary surgeries
* 7,000 annual deaths from hospital medication errors
* 20,000 annual deaths from other hospital errors
* 80,000 annual deaths from hospital-acquired infections
* 106,000 annual deaths from the side effects of correctly prescribed medications*
(these) 225,000 deaths every year make up the third leading cause of death in the USA, following heart disease and cancer."
That is 225,000 victims of "medicine" every single year, right here in the USA. And let's not forget, this number only counts those who died; it doesn't account for the survivors—who are surely much more numerous—left struggling with permanent disabilities...
When two people die from something like SARS in Hong Kong or one person dies in Canada, the news cycles go crazy with headlines about a "mysterious plague" or a "global epidemic." Yet, when thousands die daily due to the fallout of modern "medicine," it doesn't even make the news, does it?
* Regarding that final figure: this doesn't refer to victims of wrongly prescribed drugs (for those, only 7,000 die in hospitals, which is the other number on the list). No, this refers to 160,000 victims of correctly prescribed medications—the lesser-known side effects of the chemicals currently sold under the label of "medicine"...
Anyway, here is the article. Enjoy:
===============================
Is US health Really The Best in The World?
Barbara Starfield, MD, MPH
JAMA. 2000;284:483-485.
Information concerning The deficiencies of US Medical Care Has been accumulating. The fact that more Than 40 million People have no health insurance is well known. 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, despite evidence from a few studies indicating that as many as 20% to 30% of patients receive contraindicated care.1 In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors.
The fact is that the US population does not have anywhere near the best health in the world. Of 13 countries in a recent comparison,3 the USA ranks an average of 12th (second from the bottom) for 16 available health indicators. Countries in order of their average ranking on the health indicators (with the first being the best) are Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium, the USA, and Germany. Rankings of the USA on the separate indicators3 are:
Ranked 13th for low birth weight percentages
Ranked 13th for both neonatal and overall infant mortality rates
Ranked 11th for postneonatal mortality
Ranked 13th for years of potential life lost, excluding external factors
Ranked 11th for one-year life expectancy in women, and 12th for men
Ranked 10th for fifteen-year life expectancy in women, and 12th for men
Ranked 10th for forty-year life expectancy in women, and 9th for men
Ranked 7th for sixty-five-year life expectancy in women, and 7th for men
Ranked 3rd for eighty-year life expectancy in women, and 3rd for men
Ranked 10th for age-adjusted mortality
The lackluster performance of the USA was recently backed up by the World Health Organization using a different set of metrics. By looking at things like disability-adjusted life expectancy, survival rates for children up to age five, actual patient experiences within the medical system, social disparities in healthcare access, and how much families have to pay out-of-pocket regardless of their needs, this report placed the USA at 15th out of 25 industrialized nations.4 Essentially, the data showing the USA's weak standing globally is solid and doesn't just shift based on which yardstick you use. People often try to explain away this poor performance without pointing the finger at the healthcare system itself. The common narrative is that Americans simply "live poorly"—smoking too much, drinking too much, or being too violent. However, the data tells a different story, at least when compared to others. For instance, female smoking rates vary wildly, from 14% in Japan to 41% in Denmark; in the USA, it sits at 24%, which actually puts us fifth best. For men, the range goes from 26% in Sweden to 61% in Japan, while the USA comes in at 28%, making us third best.
Alcohol consumption follows a similar pattern: the USA ranks fifth. So, while heavy smoking and drinking are obviously bad for you, they aren't the reason the USA lags behind on these specific health markers. Even when you strip away deaths caused by external factors like car accidents or violence, our stats for years of potential life lost remain the worst among the 13 countries studied.3 We know diet plays a massive role in mortality rates across different nations,5 but the USA actually has relatively low animal fat consumption (ranking fifth lowest for men aged 55-64 among 20 industrialized nations) and the third lowest average cholesterol levels for men aged 50 to 70 among 13 industrialized countries.6
The true reason for the relatively poor health outcomes in the USA is almost certainly a complicated, multi-layered issue. Looking strictly at the healthcare system, it’s very possible that our historical failure to build a robust primary care foundation has played a part. There is a mountain of evidence3 highlighting the benefits provided by strong primary care. Interestingly, of the seven countries at the top of the global health rankings, five possess strong primary care infrastructures. While many argue that better access—specifically universal insurance—is the silver bullet, evidence suggests that access only really pays off when it actually leads to receiving primary care.3, 7 Furthermore, the healthcare system itself might be hurting people through unintended consequences. For example, US estimates8-10 regarding the cumulative impact of medical errors and adverse effects—those resulting from iatrogenic harm that isn't necessarily tied to a blatant mistake—include:
12,000 deaths annually from unnecessary surgeries
7,000 deaths annually from hospital medication errors
20,000 deaths annually from various other hospital errors
80,000 deaths annually from hospital-acquired infections
106,000 deaths annually from non-error-related adverse drug reactions
Altogether, this accounts for 225,000 deaths every year due to iatrogenic causes. There are three important things to keep in mind here. First, most of this information comes from studies focused on hospitalized patients. Second, these numbers represent deaths alone and don't count all the adverse effects involving long-term disability or general suffering. Third, these figures are actually more conservative than what was found in the IOM report.1 If we look at the higher estimates, deaths from iatrogenic causes could be anywhere between 230,000 and 284,000. Regardless, 225,000 deaths a year makes this the third leading cause of death in the USA, trailing only heart disease and cancer. Even if these numbers are a bit high, there is still a significant gap between this figure and the next major cause of death, cerebrovascular disease.
(continued in the next post, or rather, in response to this one)
Does anyone actually know what the term "iatrogenic" means?
Essentially, it means "caused by a physician." For all the doctors-worshipers out there, here is a statistic—and this time, it isn't coming from a fancy British journal, but from an American one.
Did you realize that physicians and hospitals are the third leading cause of death in the USA?
The Journal of the American Medical Association (JAMA) is a publication of the American Medical Association (AMA). The core of this article (you can read the full piece below) highlights this specific statistic:
"the combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error include:
* 12,000 deaths/year from unnecessary surgery
* 7,000 deaths/year from medication errors in hospitals
* 20,000 deaths/year from other errors in hospitals
* 80,000 deaths/year from nosocomial infections in hospitals
* 106,000 deaths/year from nonerror, adverse effects of medications*
(these) 225,000 deaths per year constitutes the third leading cause of death in the USA, after deaths from heart disease and cancer."
Or, to put it simply:
"the combined consequences of mistakes and counter-indicated reactions occurring due to iatrogenic harm include:
* 12,000 annual deaths due to unnecessary surgeries
* 7,000 annual deaths from hospital medication errors
* 20,000 annual deaths from other hospital errors
* 80,000 annual deaths from hospital-acquired infections
* 106,000 annual deaths from the side effects of correctly prescribed medications*
(these) 225,000 deaths every year make up the third leading cause of death in the USA, following heart disease and cancer."
That is 225,000 victims of "medicine" every single year, right here in the USA. And let's not forget, this number only counts those who died; it doesn't account for the survivors—who are surely much more numerous—left struggling with permanent disabilities...
When two people die from something like SARS in Hong Kong or one person dies in Canada, the news cycles go crazy with headlines about a "mysterious plague" or a "global epidemic." Yet, when thousands die daily due to the fallout of modern "medicine," it doesn't even make the news, does it?
* Regarding that final figure: this doesn't refer to victims of wrongly prescribed drugs (for those, only 7,000 die in hospitals, which is the other number on the list). No, this refers to 160,000 victims of correctly prescribed medications—the lesser-known side effects of the chemicals currently sold under the label of "medicine"...
Anyway, here is the article. Enjoy:
===============================
Is US health Really The Best in The World?
Barbara Starfield, MD, MPH
JAMA. 2000;284:483-485.
Information concerning The deficiencies of US Medical Care Has been accumulating. The fact that more Than 40 million People have no health insurance is well known. 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, despite evidence from a few studies indicating that as many as 20% to 30% of patients receive contraindicated care.1 In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors.
The fact is that the US population does not have anywhere near the best health in the world. Of 13 countries in a recent comparison,3 the USA ranks an average of 12th (second from the bottom) for 16 available health indicators. Countries in order of their average ranking on the health indicators (with the first being the best) are Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium, the USA, and Germany. Rankings of the USA on the separate indicators3 are:
Ranked 13th for low birth weight percentages
Ranked 13th for both neonatal and overall infant mortality rates
Ranked 11th for postneonatal mortality
Ranked 13th for years of potential life lost, excluding external factors
Ranked 11th for one-year life expectancy in women, and 12th for men
Ranked 10th for fifteen-year life expectancy in women, and 12th for men
Ranked 10th for forty-year life expectancy in women, and 9th for men
Ranked 7th for sixty-five-year life expectancy in women, and 7th for men
Ranked 3rd for eighty-year life expectancy in women, and 3rd for men
Ranked 10th for age-adjusted mortality
The lackluster performance of the USA was recently backed up by the World Health Organization using a different set of metrics. By looking at things like disability-adjusted life expectancy, survival rates for children up to age five, actual patient experiences within the medical system, social disparities in healthcare access, and how much families have to pay out-of-pocket regardless of their needs, this report placed the USA at 15th out of 25 industrialized nations.4 Essentially, the data showing the USA's weak standing globally is solid and doesn't just shift based on which yardstick you use. People often try to explain away this poor performance without pointing the finger at the healthcare system itself. The common narrative is that Americans simply "live poorly"—smoking too much, drinking too much, or being too violent. However, the data tells a different story, at least when compared to others. For instance, female smoking rates vary wildly, from 14% in Japan to 41% in Denmark; in the USA, it sits at 24%, which actually puts us fifth best. For men, the range goes from 26% in Sweden to 61% in Japan, while the USA comes in at 28%, making us third best.
Alcohol consumption follows a similar pattern: the USA ranks fifth. So, while heavy smoking and drinking are obviously bad for you, they aren't the reason the USA lags behind on these specific health markers. Even when you strip away deaths caused by external factors like car accidents or violence, our stats for years of potential life lost remain the worst among the 13 countries studied.3 We know diet plays a massive role in mortality rates across different nations,5 but the USA actually has relatively low animal fat consumption (ranking fifth lowest for men aged 55-64 among 20 industrialized nations) and the third lowest average cholesterol levels for men aged 50 to 70 among 13 industrialized countries.6
The true reason for the relatively poor health outcomes in the USA is almost certainly a complicated, multi-layered issue. Looking strictly at the healthcare system, it’s very possible that our historical failure to build a robust primary care foundation has played a part. There is a mountain of evidence3 highlighting the benefits provided by strong primary care. Interestingly, of the seven countries at the top of the global health rankings, five possess strong primary care infrastructures. While many argue that better access—specifically universal insurance—is the silver bullet, evidence suggests that access only really pays off when it actually leads to receiving primary care.3, 7 Furthermore, the healthcare system itself might be hurting people through unintended consequences. For example, US estimates8-10 regarding the cumulative impact of medical errors and adverse effects—those resulting from iatrogenic harm that isn't necessarily tied to a blatant mistake—include:
12,000 deaths annually from unnecessary surgeries
7,000 deaths annually from hospital medication errors
20,000 deaths annually from various other hospital errors
80,000 deaths annually from hospital-acquired infections
106,000 deaths annually from non-error-related adverse drug reactions
Altogether, this accounts for 225,000 deaths every year due to iatrogenic causes. There are three important things to keep in mind here. First, most of this information comes from studies focused on hospitalized patients. Second, these numbers represent deaths alone and don't count all the adverse effects involving long-term disability or general suffering. Third, these figures are actually more conservative than what was found in the IOM report.1 If we look at the higher estimates, deaths from iatrogenic causes could be anywhere between 230,000 and 284,000. Regardless, 225,000 deaths a year makes this the third leading cause of death in the USA, trailing only heart disease and cancer. Even if these numbers are a bit high, there is still a significant gap between this figure and the next major cause of death, cerebrovascular disease.
(continued in the next post, or rather, in response to this one)