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Doctors Are The Third Leading Cause of Death in the US, Causing 250,000 Deaths Every Year http://www.jesus-is-savior.com/Health_Concerns/doctors_are_third_leading_cause_of_death.htm | | | | 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. If you want to keep updated on issues like this click here to sign up for my free newsletter. 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 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.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 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 July 26, 2000;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.
Return To Table of Contents Issue #164 |
Doctors Are the Third Leading Cause of Death in the U.S. Cause 250,000 Deaths Every Year By Joseph Mercola, D.O. http://www.naturodoc.com/library/public_health/doctors_cause_death.htm The U.S. health care system may contribute to poor health or death. According to Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health, 250,000 deaths per year are caused by medical errors, making this the third-largest cause of death in the U.S., following heart disease and cancer. Writing in the Journal of the American Medical Association (JAMA), Dr. Starfield has documented the tragedy of the traditional medical paradigm in the following statistics: | Deaths Per Year | Cause | | 106,000 | Non-error, negative effects of drugs2 | | 80,000 | Infections in hospitals10 | | 45,000 | Other errors in hospitals10 | | 12,000 | Unnecessary surgery8 | | 7,000 | Medication errors in hospitals9 | | 250,000 | Total deaths per year from iatrogenic* causes | * The term iatrogenic is defined as "induced in a patient by a physician's activity, manner, or therapy. Used especially to pertain to a complication of treatment."
Furthermore, these estimates of death due to error are lower than those in a recent Institutes of Medicine report. 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 U.S. Dr. Starfield offers several caveats in the interpretations of 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 the many 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 (cerebro-vascular disease). Another analysis11 concluded that between 4 percent and 18 percent 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 it 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 percent of patients receive inappropriate care. An estimated 44,000 to 98,000 among these patients die each year as a result of medical errors.2 This might be tolerable if it resulted in better health, but does it? Out 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 U.S. on several indicators was: -
13th (last) for low-birth-weight percentages -
13th for neonatal mortality and infant mortality overall14 -
11th for post-neonatal 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 U.S. was recently confirmed by a World Health Organization study which used different data and ranked the United States as 15th among 25 industrialized countries.
Lifestyle 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 percent in Japan to 41 percent in Denmark; in the United States, it is 24 percent (fifth best). For males, the range is from 26 percent in Sweden to 61 percent in Japan; it is 28 percent in the United States (third best). The U.S. ranks fifth best for alcoholic beverage consumption. The U.S. has relatively low consumption of animal fats (fifth lowest in men aged 55 to 64 years in 20 industrialized countries) and the third lowest mean cholesterol concentrations among men aged 50 to 70 years among 13 industrialized countries. Technology Lack of technology is certainly not a contributing factor to the low ranking of the United States. Among 29 countries, the U.S. 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 U.S. ranks among the lowest. It is possible that the high use of technology in Japan is limited to diagnostic technology that is not matched by high rates of treatment, whereas in the U.S., the 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. 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 of the American Medical Association, Vol. 284, July 26, 2000. It has been known that drugs are the fourth leading cause of death in the U.S. This makes it clear that the more frightening number is that doctors are the third leading cause of death in this country, killing nearly a quarter million people a year. These statistics are further confused because most medical coding only describes the cause of organ failure and does not identify iatrogenic causes at all. Japan seems to have recognized 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 become increasingly dangerous for chronic disease cases. Facilitating the God-given healing capacity by improving the diet, exercise, and lifestyle is the key. Effective interventions for the underlying emotional and spiritual wounding behind most chronic disease is critical for the reinvention of our medical paradigm. These numbers suggest that reinvention of our medical paradigm is called for. (NaturoDoc comments: This is a powerful indictment of conventional allopathic medical care. Articles published in JAMA are circulated in the largest and most respected peer review journal in the world. The major wire services did not carry this article, which is consistent with whose interests they represent.) References -
Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Q. 1998; 76:517-563. -
Kohn L, ed., Corrigan J, ed., Donaldson M, ed. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press, 1999. -
Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press, 1998. -
World Health Report 2000. Available at http://www.who.int/whr2001/2001/archives/2000/en/index.htm. Accessed June 28, 2000. -
Kunst A. Cross-National Comparisons of Socioeconomic Differences in Mortality. Rotterdam, the Netherlands: Erasmus University; 1997. -
Law M, Wald N. Why heart disease mortality is low in France: The time lag explanation. BMJ. 1999; 313:1471-1480. -
Starfield B. Evaluating the State Children's Health Insurance Program: critical considerations. Annual Rev. Public Health. 2000; 21:569-585. -
Leape L. Unnecessary surgery. Annual Rev. Public Health. 1992; 13:363-383. -
Phillips D, Christenfeld N, Glynn L. Increase in U.S. medication-error deaths between 1983 and 1993. Lancet, 1998; 351:643-644. -
Lazarou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998; 279:1200-1205. -
Weingart SN, Wilson RM, Gibberd RW, Harrison B. Epidemiology and medical error. BMJ. 2000; 320:774-777. -
Wilkinson R. Unhealthy Societies: The Afflictions of Inequality. London, England: Routledge; 1996. -
Evans R, Roos N. What is right about the Canadian health system? Milbank Q. 1999; 77:393-399. -
Guyer B, Hoyert D, Martin J, Ventura S, MacDorman M, Strobino D. Annual summary of vital statistics, 1998. Pediatrics. 1999; 104:1229-1246. -
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. -
Donahoe MT. Comparing generalist and specialty care: discrepancies, deficiencies, and excesses. Arch Intern Med. 1998; 158:1596-1607. -
Anderson G, Poullier J-P. Health Spending, Access, and Outcomes: Trends in Industrialized Countries. New York, NY: The Commonwealth Fund; 1999. -
Mold J, Stein H. The cascade effect in the clinical care of patients. N Engl J Med. 1986; 314:512-514. -
Shi L, Starfield B. Income inequality, primary care, and health indicators. J Fam Pract.1999; 48:275-284.
For reprints of the original JAMA article, contact: 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 Email: bstarfie@jhsph.edu Acknowledgement Thanks to Dr. Joseph Mercola's Optimal Wellness Center at mercola.com for permission to reprint this article. This article copyright 2001 by Joseph M. Mercola, DO. America's Healthcare System is the Third Leading Cause of Death
Barbara Starfield, M.D. (2000)
http://www.health-care-reform.net/causedeath.htm
Summary by Kah Ying Choo This Journal of the American Medical Association article illuminates the failure of the U.S. medical system in providing decent medical care for Americans. |  | |
In spite of the rising health care costs that provide the illusion of improving health care, the American people do not enjoy good health, compared with their counterparts in the industrialized nations. Among thirteen countries including Japan, Sweden, France and Canada, the U.S. was ranked 12th, based on the measurement of 16 health indicators such as life expectancy, low-birth-weight averages and infant mortality. In another comparison reported by the World Health Organization that used a different set of health indicators, the U.S. also fared poorly with a ranking of 15 among 25 industrialized nations. Although many people attribute poor health to the bad habits of the American public, Starfield (2000) points out that the Americans do not lead an unhealthy lifestyle compared to their counterparts. For example, only 28 percent of the male population in the U.S. smoked, thus making it the third best nation in the category of smoking among the 13 industrialized nations. The U.S. population also achieved a high ranking (5th best) for alcohol consumption. In the category of men aged 50 to 70 years, the U.S. had the third lowest mean cholesterol concentrations among 13 industrialized nations. Therefore, the perception that the American public’s poor health is a result of their negative health habits is false. Even more significantly, the medical system has played a large role in undermining the health of Americans. According to several research studies in the last decade, a total of 225,000 Americans per year have died as a result of their medical treatments: | |  | | • 12,000 deaths per year due to unnecessary surgery • 7000 deaths per year due to medication errors in hospitals • 20,000 deaths per year due to other errors in hospitals • 80,000 deaths per year due to infections in hospitals • 106,000 deaths per year due to negative effects of drugs
Thus, America's healthcare-system-induced deaths are the third leading cause of the death in the U.S., after heart disease and cancer. |
One of the key problems of the U.S. health system is that as many as 40 million people in the U.S. do not have access to healthcare. The social and economic inequalities that are an integral part of American society are mirrored in the inequality of access to the health care system. Essentially, families of low socioeconomic status are cut off from receiving a decent level of health care. By citing these statistics, Starfield (2000) highlights the need to examine the type of health care provided to the U.S. population. The traditional medical paradigm that emphasizes the use of prescription medicine and medical treatment has not only failed to improve the health of Americans, but also led to the decline in the overall well-being of Americans. Starfield’s (2000) comparison of the medical systems of Japan and the U.S. captures the fundamental differences in the treatment approach. Unlike the U.S., Japan has the healthiest population among the industrialized nations. Instead of relying on sophisticated technology and professional personnel for medical treatment as in the U.S., Japan uses its technology solely for diagnostic purposes. Furthermore, in Japan, family members, rather than hospital staff, are involved in caring for the patients. The success of the Japanese medical system testifies to the dire need for Americans to alter their philosophical approach towards health and treatment. In the blind reliance on drugs, surgery, technology and medical establishments, the American medical system has inflicted more harm than good on the U.S. population. Starfield’s (2000) article is invaluable in unveiling the catastrophic effects of the medical treatments provided to the American people. In order to improve the medical system, American policymakers and the medical establishment need to adopt a comprehensive approach and critically examine the failure of the richest country in the world to provide decent health care for its people. The reason that they have difficulty doing that is explained on the following page. Starfield, B. (2000, July 26). Is US health really the best in the world? Journal of the American Medical Association, 284(4), 483-485 | | |
