Not long ago I read a report that made the astonishing claim that the leading cause of death in the US is the American medical system. Medicare's recent announcement that it will no longer reimburse hospitals for the cost of treating certain "serious preventable events," such as an object left in a patient's body after an operation or giving a patient the wrong kind of blood, and particular infections amounts to a frightening acknowledgement of how bad things have gotten in mainstream health care.
Authors of the report on causes of death, published in Life Extension magazine, attributed nearly 800,000 deaths each year to medical interventions, in contrast to approximately 650,000 deaths from heart disease and 550,000 from cancer. The methodology they used to calculate that number didn't stand up to our analysis, so I don't think the numbers are quite so high. However, it did get my attention since the figures came from credible sources including peer-reviewed medical journals, citing for instance, 106,000 deaths annually from adverse drug reactions, 98,000 from medical errors and 88,000 from infections. This compares with 160,000 deaths from lung cancer anticipated for 2007, for instance. Death can't be held off forever, of course -- but preventable deaths from hospital-acquired infections, especially if due to poor hygiene such as those transmitted by not washing hands, are particularly egregious.
For greater insight into the risks we face, I spoke with David J. Sherer, MD, a board-certified anesthesiologist in Falls Church, Virginia, and the coauthor of Dr. David Sherer's Hospital Survival Guide: 100+ Ways to Make Your Hospital Stay Safe and Comfortable (Claren). He said that although this report is controversial and somewhat alarmist, it has elements of truth. Numbers can always be crunched and interpreted in different ways, but the indisputable point here is that medical errors and complications or adverse effects from medical interventions have reached a crisis point in this country -- one that needs to be addressed. That's beginning to happen.
Dr. Sherer and I discussed what's behind this alarming trend and how we can protect ourselves.
BEHIND THE RISE IN MEDICAL-RELATED DEATHS
First of all, the problem is not that medical practitioners have suddenly and inexplicably become sloppy and careless. That's far too simplistic an explanation. Instead, Dr. Sherer chalks up the alarming statistics to a number of different factors:
The American public is getting older and sicker. Growing numbers of graying baby boomers are developing the diseases of aging -- heart disease, diabetes, orthopedic problems, etc. In the meantime, in people of all ages, ballooning rates of obesity contribute to these same health challenges. More sick people mean more medical interventions... and in hard numbers, that adds up to more mistakes or complications.
In a kind of medical "perfect storm," just as more Americans are developing serious health problems, we're struggling with a shortage of medical support personnel including nurses, which decreases the attention paid to patient needs and details of treatment. Also, managed care has meant doctors have less time to devote to patients during office visits and, as a result, are less likely to know the particulars of their history. Dr. Sherer warns that this sets up a system ripe for errors.
Americans today take more medications than anyone else in the world -- and drug companies are working hard to get us to take even more. Spending on direct-to-consumer drug advertising has increased over 300% in nearly a decade, to $4.2 billion in 2005 from $1.1 billion in 1997. With that much money aimed at advertising drugs not just to save lives, but to enhance mood or correct erectile dysfunction or alleviate restless legs syndrome, Dr. Sherer points out that drugs are often being taken by people who don't need them. More drugs mean more drug reactions and interactions to juggle than ever before... again, many more opportunities for errors.
We're paying closer attention to medical errors and preventable complications and -- paradoxically, the harder we look for them, the more we find. This makes the numbers look terrible in the short run, but in the long run this increased vigilance and accountability should result in improved care.
HOW TO PROTECT YOURSELF
Forewarned is forearmed: There are many proactive steps you can take to shield yourself and your loved ones from this epidemic of deaths related to medical interventions. At the doctor's office or in the hospital, Dr. Sherer recommends...
Bring an up-to-date list of all medications you take. Make sure that you list not only prescription drugs, but also over-the-counter medications, herbal remedies, vitamins and other dietary supplements. These can all react with one another. Also list the condition for which you take each drug.
Include correct name, spelling, usage and dosage. Dr. Sherer cautions that many drugs -- for example, Xanax (for anxiety) and Zantac (to treat ulcers) -- sound similar. A comprehensive and accurate list that includes the condition for which a drug or supplement has been prescribed will help ward off confusion and errors. This is especially important when dealing with health-care professionals who don't speak English as their first language.
Tell practitioners about any drug allergies or sensitivities and all pre-existing conditions. For example, perhaps you are allergic to penicillin. While this information should appear on your chart, don't take for granted that it does. Reminding health-care providers of your medical history, including drug allergies, is a simple and effective way to avoid potentially life-threatening medical errors.
Do your homework. If you are scheduled to take a new drug or undergo a test or procedure, first research it at reliable government, hospital or university-based Web sites such as www.medlineplus.gov or www.mayoclinic.com or www.jhu.edu (Johns Hopkins). Peer-reviewed journals such as the Journal of the American Medical Association (jama.ama-assn.org) and the New England Journal of Medicine (content.nejm.org) can also be excellent sources of information. An objective non-biased drug assessment database is available through both print and on-line subscription (www.factsandcomparisons.com/) -- ask your health-care provider and/or pharmacist whether they use it.
Speak up. Ask your doctor the right questions. Why do I need this drug/test/procedure? What are the risks versus benefits? Is this the best drug/test/procedure for my condition? What about side effects? In the case of tests, are the results typically straightforward or subject to interpretation? How often is this test/procedure performed at your facility? How often does the surgeon or other medical practitioner perform it? In both cases, the more often, the better. Will there be pain or discomfort? If your physician can't or won't take the time to answer your questions, it's time to get a new physician.
Designate a friend or family member to be your advocate. When you're ill, it's all too easy to become nervous and forget the questions you want to ask, or fail to recall your physician's advice. It's not only comforting to have a trusted advocate by your side at such moments, it also contributes to a better understanding of the situation on your part, and more accountability on the part of your caregivers. If you're in the hospital, try to have someone with you or visiting frequently so that they can get help/nurse's attention if need be.
Take personal responsibility. In the long run, you remain in charge of your own health. Responsibility includes not just your interactions with medical practitioners, but also making lifestyle changes that reduce your risk of illness.
No doubt we will continue to hear more about this vitally important health topic -- and I'll continue to cover it in upcoming issues of Daily Health News. Given that hospitals will now have to absorb the costs of their mistakes due to Medicare's refusal to provide coverage for "serious preventable events," with a stipulation that prevents billing patients for them, too, it's clear that they will focus intently on reducing these events, which can only be good news. And meanwhile, Medicare's new hospital inpatient provisions will result not only in an estimated savings for the government of more than $20 million annually -- but, we can only hope, the saving of many lives as well.
Source(s):
David J. Sherer, MD, a board-certified anesthesiologist in clinical practice at Falls Church Ambulatory Surgery Center in Falls Church, Virginia, affiliated with Mid-Atlantic Permanente Group. He is coauthor of Dr. David Sherer's Hospital Survival Guide: 100+ Ways to Make Your Hospital Stay Safe and Comfortable (Claren).
Braggi
11-06-2007, 09:26 AM
Authors of the report on causes of death, published in Life Extension magazine, attributed nearly 800,000 deaths each year to medical interventions, in contrast to approximately 650,000 deaths from heart disease and 550,000 from cancer. The methodology they used to calculate that number didn't stand up to our analysis, so I don't think the numbers are quite so high.
Bull. The little bit of truth in this is the last sentence.
Consider the source. (Life Extension magazine? Sheesh.)
I'm sure it's possible to come up with a number that high, but it's not hard to imagine most of those people would have died within days anyway.
People in hospitals are sick or injured. Sick and injured people die. Get a drug interaction and you might even die more quickly.
If you have a poor reaction to a drug and you die one did not necessarily cause the other, though it could be recorded that way or misinterpreted that way by a researcher.
With all the problems with our medical system, with all the "toxins" in our environment, with all the foods grown on depleted soils, and on and on, we still live longer, healthier, happier lives than any humans that ever lived before us.
Sure, we can make improvements in many areas, but let's stick with the truth when we can.
-Jeff
Zeno Swijtink
11-06-2007, 10:37 AM
Bull. The little bit of truth in this is the last sentence.
Consider the source. (Life Extension magazine? Sheesh.)
/snip/
-Jeff
Jeff,
Your "Shit Happens" attitude leads here to overreaction. There are genuine problems. Medical care gets more and more complicated and medical personnel is often overworked. Errors are increasing.
The patients need to be more skillful in getting the doctor's attention.
In my own cancer treatment it has helped enormously always to have my girlfriend go with me to office visits. I could dig up some studies showing that this gets the doctor's attention!
Learn how doctors think! Read:
How Doctors Think By Jerome Groopman, MD
"On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country's best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together."
See https://books.google.com/books?id=mHnLAAAACAAJ&dq=how+doctors+think&num=100&as_brr=0 for reviews and further discussion.
Dynamique
11-06-2007, 11:35 PM
It has long seemed to me that the leading cause of death, disease, reduced health, addiction and general malaise in the United States is allopathic medical practice. If you want to live long and prosper, then avoid allopaths! Allopathy excels at fixing lacerations, broken bones and other effects of trauma. Other than that, it is causes more problems than it fixes. Nutrition (food as medicine) and inflammation-related disease seem to be particularly problematic for allopathic practice.
Jeff: you might be interested in a recent Science Friday podcast regarding nutrition and health. It includes a discussion of the erroneous assumption that the human body is a "metabolic black box" that operates on the basis of caloric arithmetic and nothing more. The audio recording is available at
https://www.sciencefriday.com/program/archives/200711024
Bull. The little bit of truth in this is the last sentence.
Sara S
11-07-2007, 07:07 AM
Oh, Jeff, your sensibleness and intelligence amaze me more and more. And your croutons!!!
Bull. The little bit of truth in this is the last sentence.
Consider the source. (Life Extension magazine? Sheesh.)
I'm sure it's possible to come up with a number that high, but it's not hard to imagine most of those people would have died within days anyway.
People in hospitals are sick or injured. Sick and injured people die. Get a drug interaction and you might even die more quickly.
If you have a poor reaction to a drug and you die one did not necessarily cause the other, though it could be recorded that way or misinterpreted that way by a researcher.
With all the problems with our medical system, with all the "toxins" in our environment, with all the foods grown on depleted soils, and on and on, we still live longer, healthier, happier lives than any humans that ever lived before us.
Sure, we can make improvements in many areas, but let's stick with the truth when we can.
-Jeff
Braggi
11-07-2007, 07:17 AM
Jeff,
Your "Shit Happens" attitude leads here to overreaction. There are genuine problems. Medical care gets more and more complicated and medical personnel is often overworked. Errors are increasing.
You've misread my "attitude." Sure there are problems, lots of them. Please understand I've had family members in the health care business all my life. I'm fully aware of the zillions of errors and problems that occur, many of them at the hands of HMOs.
However, the medical establishment is the leading cause of death in the US? Sorry, that's bull.
We are living longer than we ever have. Life expectancy continues to rise every year. How can that be? Because we eat better, exercise more, stay more slim and active? Please answer that one.
Your "How Doctors Think" quote flies in the face of my personal experience. I've never worked with a doctor who thinks like that. More bull, based on my limited experience.
I fully agree our current medical system is rife with problems and there is a great deal of room for improvement. The biggest single problem is the invention of the HMO and "Managed Care."
-Jeff
phooph
11-07-2007, 08:50 AM
That you defend your position based on all your family members in the medical profession is an indicator of your bias. Then you admit there are "zillions of errors." Do you think that those errors are harmless?
The President of Kaiser gave a speech to the Commonwealth Club in March in which he addressed the alarming rise in deaths and injury due to medical treatment, why they were happening, and what needed to be changed to reversed the situation.
The National Academies of Science press has published a book based on research from their Institute of Medicine on the subject. This is a body of scientists and medical people.
https://www.nap.edu/openbook.php?isbn=0309068371
Excerpts are on the right side of the page. Note that one of them is entitled "Errors in Health Care: A Leading Cause of Death and Injury"
Here's an article from their press on the subject from 2000, and the subsequent reports in the intervening years have moved the figures up from eighth to first:
Medical Mistakes Kill 100,000 Americans A Year
The promise every doctor makes is, “Do no harm.” But doctors and hospitals do make mistakes. And the November 30 shocking report from the Institute of Medicine showed medical mistakes are a common and potentially life-threatening risk. If medical mistakes counted among the leading causes of death in America, they would be eighth.
Surgical gaffes like amputating the wrong foot or a deadly chemotherapy overdose make headlines. But patients may never hear of the more subtle errors, like a delay in diagnosis or testing that costs precious time to fight off disease. Medical mistakes costing lives. Medical mistakes are a stunningly huge problem, says a new report by the Institute of Medicine. It quoted studies estimating that at least 44,000 and perhaps as many as 98,000 hospitalized Americans die every year from errors. To put that into sharper and more alarming perspective, even the lower figure of 44,000 deaths exceeds the number of people who die each year either on the highways, of breast cancer or of AIDS.
It is an intolerable situation, especially when it's taking place in the United States, which leads the world in medical advances. The cause, according to the Institute of Medicine, is not as much recklessness on the part of doctors, nurses and other health providers as it is basic flaws in the way hospitals, clinics and pharmacies operate. That kind of problem is fixable.
As a matter of fact, safeguards have already been implemented to reduce the likelihood of such lethal medical errors. Some hospitals are now using computerized prescriptions to ensure that pharmacists don't misread doctors' scrawled prescriptions. At the urging of anesthesiologists, anesthesia equipment is being standardized. And the Food and Drug Administration is trying to reduce confusion by ensuring that the names of new drugs don't sound too similar to drugs already on the market.
Doctors' notoriously poor handwriting too often leaves pharmacists squinting to decipher a dose was it 10 milligrams or 10 micrograms, or even the name of the prescribed drug. Too many drug names sound confusingly alike. Consider the painkiller Celebrex and the anti-seizure drug Cerebyx; or Narcan, which treats morphine overdoses, and Norcuron, which can paralyze breathing muscles.
But far more is needed: a concerted and comprehensive effort to raise the bar on consumer safety in the health care industry, not unlike what has already taken place in other industries. Since many doctors already feel beleaguered by financial constraints imposed on their care, insurers and health maintenance organizations must also bear the burden of improving safety.
At a minimum, the Institute of Medicine wants to reduce medical errors by half within five years. Considering the number of people who die each year in hospitals - where they presumably go to get better - even that goal may be too conservative.
Keeping Up with Changes
Health care is a decade behind other high-risk industries in improving safety, the report said. It pointed to the transportation industry as a model: Just as engineers design cars so they cannot start in reverse, and airlines limit pilots’ flying time to keep them rested, so can health care be improved. Some fixes already are under way: Some hospitals have computerized prescriptions. The Food and Drug Administration is hunting ways to catch sound-a-like drugs.
Anesthesiologists persuaded many manufacturers to standardize equipment and thus decreased technology-caused errors. Many doctors now literally mark the spot of surgical incisions before patients are put to sleep, so everyone agrees on what will be cut.
Changes Coming from Congress
The Institute of Medicine is part of the National Academy of Sciences, a private organization chartered by Congress to advise the government on scientific matters. Congress just passed legislation ordering the Agency for Health Care Policy and Research to hunt strategies to reduce medical mistakes. The bill will even change the name to the Agency for Healthcare Research and Quality to reflect the emphasis. President Clinton is expected to sign the bill soon. But the Institute of Medicine said reducing medical mistakes requires a bigger commitment.
It recommended that Congress should establish a federal Center for Patient Safety. It would require $35 million to start and should eventually spend $100 million a year in safety research.
The report said the total cost of medical mistakes, lost income and production, cost of disability and health care, totals $17 to 29 billion a year.
And that’s not mentioning the human toll. The government should require that hospitals, and eventually other health organizations, report all serious mistakes to state agencies so experts can detect patterns of problems and take action. About 20 states now require error reporting.
But how much and what penalties they impose varies widely. State licensing boards and medical accreditors should periodically re-examine health practitioners for competence, stressing safety practices. Standardized medical equipment and treatment guidelines can help doctors keep up. Change the “culture of secrecy” that surrounds medical mistakes, encouraging doctors to discuss errors as well as near misses so problems are fixed.
But is there something you can do, even from your sickbed, to protect yourself?
Become an Expert
First, know what ails you. Ask your doctor all about it. Research it on the Internet, for instance. Patients should feel entitled to inquire about their care no matter how sick they are. Second, know about your drugs. The study shows more than 7,000 die each year because of medication errors.
Kohn L, ed, Corrigan J, ed, Donaldson M, ed. To Err Is Human: Building a Safer Health System.
Washington, DC: National Academy Press; 1999
You've misread my "attitude." Sure there are problems, lots of them. Please understand I've had family members in the health care business all my life. I'm fully aware of the zillions of errors and problems that occur, many of them at the hands of HMOs.
However, the medical establishment is the leading cause of death in the US? Sorry, that's bull.
We are living longer than we ever have. Life expectancy continues to rise every year. How can that be? Because we eat better, exercise more, stay more slim and active? Please answer that one.
Your "How Doctors Think" quote flies in the face of my personal experience. I've never worked with a doctor who thinks like that. More bull, based on my limited experience.
I fully agree our current medical system is rife with problems and there is a great deal of room for improvement. The biggest single problem is the invention of the HMO and "Managed Care."
-Jeff
Zeno Swijtink
11-07-2007, 01:27 PM
You've misread my "attitude." Sure there are problems, lots of them. Please understand I've had family members in the health care business all my life. I'm fully aware of the zillions of errors and problems that occur, many of them at the hands of HMOs.
However, the medical establishment is the leading cause of death in the US? Sorry, that's bull.
We are living longer than we ever have. Life expectancy continues to rise every year. How can that be? Because we eat better, exercise more, stay more slim and active? Please answer that one.
Your "How Doctors Think" quote flies in the face of my personal experience. I've never worked with a doctor who thinks like that. More bull, based on my limited experience.
I fully agree our current medical system is rife with problems and there is a great deal of room for improvement. The biggest single problem is the invention of the HMO and "Managed Care."
-Jeff
"How Doctors Think" is written by Dr. Jerome Groopman, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston who teaches at Harvard Medical School. You are rather quick to dismiss this as "bull."
An interesting excerpt talking about what made him write the book is on the NPR website at
Life Extension Magazine does not seem to be a reliable source for medical information, and the organization that publishes it (The Nutrition Institute of America) will have its own agenda, but the article "Death by Medicine"
is actually detailed and well referenced to the peer reviewed literature. Worth a read if you are interested in this issue!
scorpiomoon
11-07-2007, 01:49 PM
"How Doctors Think" is written by Dr. Jerome Groopman, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston who teaches at Harvard Medical School. You are rather quick to dismiss this as "bull."
An interesting excerpt talking about what made him write the book is on the NPR website at
Life Extension Magazine does not seem to be a reliable source for medical information, and the organization that publishes it (The Nutrition Institute of America) will have its own agenda, but the article "Death by Medicine"
is actually detailed and well referenced to the peer reviewed literature. Worth a read if you are interested in this issue!
My experience has been that if the doctor had listened he would not have killed me!!! I was almost thirty and had medical professionals in my family. I came into the ER and showed the doc an ultra sound that I had done with a cousin. I said, "I have a stomach blockage." Now after 10 days and mis and re-miss diagnosis oh you must have a cyst on your ovary or endometriosis I drank and ate a meal and was almost released. An amazing thing happened. It was like a scene out of the exorcist. About four gallons of fluid in under a minute all fluids I had taken introvenously and my first meal in ten days. So, I changed hospitals and doctors, and what on earth was it??
A stomach blockage after all. Almost biffed!! Moral of the story is listen to your intuition concerning your health, know your body, and if the doctor doesn't listen kick him in the head!!
Braggi
11-07-2007, 07:53 PM
"How Doctors Think" is written by Dr. Jerome Groopman... You are rather quick to dismiss this as "bull."
Go read what I actually wrote before debunking my statements.
Pooph's post, which contains information from credible sources, supports my positions and my statements.
-Jeff
Braggi
11-07-2007, 08:10 PM
That you defend your position based on all your family members in the medical profession is an indicator of your bias. Then you admit there are "zillions of errors." Do you think that those errors are harmless?
The fact that I have family members in the health care business means I have been exposed to various facets of the medical industry all my life so I may just know a few things others who haven't had this exposure don't. It means I have an interest in it that is greater than most folks'. I'm curious about health care in a way that is greater than caring about my own and my family's. I like to listen to health and medicine shows on the radio and read a great many articles relating to medicine and health care. It's just an interest of mine and that interest relates to my exposure over the years.
I'm a pragmatist and a realist when it comes to medical care. I scrutinize my own doctors' opinions more than most folks do, I imagine. I'm actively involved in my own health care and I like being an informed consumer. I also don't mind sharing my experiences with others (obviously), and frankly, I get defensive when I hear statements that are exceedingly negative about the medical industry and I know them to be wrong.
Please reread my posts to see if I ever stated medical errors are harmless. Quite the contrary.
-Jeff
scorpiomoon
11-07-2007, 08:10 PM
Go read what I actually wrote before debunking my statements.
Pooph's post, which contains information from credible sources, supports my positions and my statements.
-Jeff
Jeff-- No one is bebunking anyone. I was only relating my experience, and I WILL go back, and read what you actually wrote, again, and that will be tomorrow. I do not really need any supported statements to speak from personal experience regarding health care. It's totally subjective in that regard. This is supposed to be informative at least. I am not a demographic or anything, or a statistic, just yet anyway. Good evening to you there,
Braggi
11-07-2007, 08:16 PM
Jeff-- No one is bebunking anyone.
Scorpiomoon, I wasn't replying to your post, but to Zeno's.
I appreciate your post and I could relate a few stories from my own life.
I know there are many misdiagnoses and mistreatments in medicine today. I think your bottom line was well made and rings true.
In a world where the consumers (that is, insurance companies and big corporations) demand ever more and more performance from medical staff, there are bound to be errors and compound errors. It is incumbent upon you and me to keep an eye on our own medical care.
-Jeff
phooph
11-08-2007, 03:49 PM
And I have worked in the health care industry and have seen behavior among medical personnel that lead to problems. I have observed deliberate non-compliance with medical protocol that is designed to protect the interests of the patient.
That said, I am also involved in this discussion on another list and am posting below one of the responses to a retired physician who also listed all the benefits of medical science, as if that dismisses the problems.
phooph
It is no more fair to bundle all of "modern medicine" into one amorphous entity and then judge it in a binary way (net "good" or net "bad") than it is to do the same for religion. A case can be made that both cause more harm than good (and I have done that myself), but that is too lazy-minded and rhetorical. It would be more useful to distinguish what good and harm results from "modern" (i.e., established allopathic) medicine as practiced (and in what ways it accomplishes that good and harm), and place all that in the larger context of alternatives to the medico-pharmaceutical industry, alternatives such as lifestyle choices and other paradigms of health.
This is a much larger conversation than the limited bandwidth of e-mail allows, especially since that limited bandwidth tends to compress complexity and subtlety into over-simplified and over-positional fractiousness.
It is important to remember that "modern medicine" is practiced in the context of a civilization that generates the challenges which that medical approach has evolved to resolve. Those problems are not necessarily "relentless," or even necessary, as trans-cultural epidemiological investigations show.
"Iatrogenesis" is a larger problem than at first it seems, for conflicts of interest in a market-values-driven society drive out many human values. Doctors are simultaneously co-victims, agents of the system, propagators of economic interests, and occasional rescuers of all of us in this regard. The mean life expectancy of physicians (and others in the medical system) does not reassure us that exclusive reliance on this paradigm is necessarily advantageous.
Until "modern medicine" can reliably prevent, instead of merely compensate for, the maladies of modern life, it cannot claim to cause less harm than propagated by the larger cultural, economic, and industrial system of which it is an integral part. I must ask Dr. W if he can explain how the "medical" situations in those legitimate examples he gives us arose such that the persons afflicted required medical assistance. They did not occur in a vacuum.
The tragedy is that there are so many conflicts of interest in the industry (an indicative word) that physicians who seek to prevent and cure (instead of fix and maintain) are subverted and marginalized (if not outright ostracized). They simply aren't "profitable" enough for the system. For us to make valuable distinctions in this conversation the system we examine must be expanded to include essentially all the drivers of health in our contemporary world.
It might be useful to recognize that accomplishing health has other components than the knife and the chemical. That isn't an "attack" that requires defending. M.D.s do have a place in this world, it's just not the place they and their industry seek to claim (and even monopolize).
Alexander
The fact that I have family members in the health care business means I have been exposed to various facets of the medical industry all my life so I may just know a few things others who haven't had this exposure don't. It means I have an interest in it that is greater than most folks'. I'm curious about health care in a way that is greater than caring about my own and my family's. I like to listen to health and medicine shows on the radio and read a great many articles relating to medicine and health care. It's just an interest of mine and that interest relates to my exposure over the years.
I'm a pragmatist and a realist when it comes to medical care. I scrutinize my own doctors' opinions more than most folks do, I imagine. I'm actively involved in my own health care and I like being an informed consumer. I also don't mind sharing my experiences with others (obviously), and frankly, I get defensive when I hear statements that are exceedingly negative about the medical industry and I know them to be wrong.
Please reread my posts to see if I ever stated medical errors are harmless. Quite the contrary.
-Jeff
Braggi
11-08-2007, 08:44 PM
The tragedy is that there are so many conflicts of interest in the industry (an indicative word) that physicians who seek to prevent and cure (instead of fix and maintain) are subverted and marginalized (if not outright ostracized). They simply aren't "profitable" enough for the system. For us to make valuable distinctions in this conversation the system we examine must be expanded to include essentially all the drivers of health in our contemporary world...
Alexander
Sad Alexander isn't here to defend that statement. I'll call it what it is: bull.
In case this fellow hasn't noticed, doctors are overworked. Hospitals are screaming for good help and help is hard to find. I know of no doctor that isn't booked up weeks or months in advance. Tried to get an appointment lately? Most docs would love to just take a damn vacation.
There are no doctors I've ever hear of out there trying to make people ill so they can have more work. That's just insane.
When a doctor can stamp a case: cured! they're really happy about that.
I know a lot of doctors and I think every one would agree with that statement.
-Jeff
phooph
11-08-2007, 11:52 PM
I think you need to re-read that quote and understand what it really says. I am beginning to suspect that you are seriously paranoid when it comes to any criticism of a medical system that is called broken by those who are in it.
Sad Alexander isn't here to defend that statement. I'll call it what it is: bull.
In case this fellow hasn't noticed, doctors are overworked. Hospitals are screaming for good help and help is hard to find. I know of no doctor that isn't booked up weeks or months in advance. Tried to get an appointment lately? Most docs would love to just take a damn vacation.
There are no doctors I've ever hear of out there trying to make people ill so they can have more work. That's just insane.
When a doctor can stamp a case: cured! they're really happy about that.
I know a lot of doctors and I think every one would agree with that statement.
-Jeff
Braggi
11-09-2007, 07:22 AM
I think you need to re-read that quote and understand what it really says. I am beginning to suspect that you are seriously paranoid when it comes to any criticism of a medical system that is called broken by those who are in it.
It's hard for me to argue with someone who I generally agree with Pooph. I agree the medical system has many serious problems. OK?
That doesn't mean that every allegation made by well meaning but ignorant people is true. I wish I had more time to fully explain that but right now I don't.
I think the biggest problems with our system involve insurance companies that pay their CEOs hundreds of millions each year in salary while "cost cutting" by forcing medical staff to treat more and more people in less and less time and bumping patients down the ladder of expertise over time. In the "good old days" when you went to the doctor you saw a doctor and explained what's the matter. Now you see a nurse, or a physician's assistant, or a social worker or someone with very minimal training who jots down answers to inane questions on a clipboard. It won't be long before you'll log onto a computer from home and fill out a form online. Then the computer will decide whether you get to see a doctor! That's sick but it's coming soon.
The next biggest problems are caused by lawyers ready to sue for any and every reason. The "class actions" filed by Texas based lawyers are the biggest offenders. The breast implant fiasco is the big case that comes to mind. That brought a giant company to its knees, forced it to make a four billion dollar settlement when the charges against it were completely false! Again, that's pretty sick.
Now let's look at the bean counters. They have taken over medicine as far as HMOs and "managed care" are concerned. They look only at the bottom line. They treat medical staff and patients like cogs in a money making machine. The human element is lost and doctors are forced by the system to practice "cookbook" medicine which is kind of like cookbook tarot readings. They just don't work.
Doctors, generally speaking, are not fighters and have "gone along" with these gradual changes without putting up much of a fight. It's very sad. The AMA has been disgraceful in this regard since it's supposed to be a doctor's union. There has been little to no bargaining on behalf of doctors and other medical staff.
I gotta run, but I'm only dipping my pen in this ink. My complaints go on and on and I'm willing to discuss it further, but I propose we start a new thread that at least begins with some propositions that are true.
In good health,
-Jeff
Moon
11-11-2007, 10:42 PM
What i noticed in five years as a pre-veterinary student is that, on average:
1) My pre-med classmates were better at brute-force memorization.
2) My pre-vet classmates were better at reasoning.
In other words, never assume that an MD is using even common sense, and if something
s/he proposes doesn't sound reasonable to you, ask the doctor why that's recommended.
Don't be shy about making your own alternative proposal; womyn with the highest 5- and
10-year breast cancer survival rates are the ones their MD's most dislike--
because they argue.
Here's a stunner: A 14-year-old boy was given elective surgery for a depressed sternum.
The operation was successfully completed, but in the next hour or so his blood pressure
started dropping. It fell further and further, while the four experienced surgeons at
the hospital debated among themselves what could be causing such a thing. They
tried various medications, none of which worked, and before the sun rose the next morning,
a mid-teens patient who had entered the hospital healthy was dead.
Think about this information (all of us with a medical background disqualifying
ourselves, please) and post your hypothesis as to the cause of death. [Hint: It was
preventable.] I'll post the answer here on 11/18. Let's see how many people
with no medical education figure out by plain horse-sense what four practicing
surgeons had to wait for the autopsy to find out. I think it will give us the confidence
to question MDs' plans for our bodies and ourselves. You can reply privately
if you might feel embarrassed at a wrong guess; i'll say how many private replies were
correct and not mention names unless you want me to let people know you got it right.
Not long ago I read a report that made the astonishing claim that the leading cause of death in the US is the American medical system. Medicare's recent announcement that it will no longer reimburse hospitals for the cost of treating certain "serious preventable events," such as an object left in a patient's body after an operation or giving a patient the wrong kind of blood, and particular infections amounts to a frightening acknowledgment of how bad things have gotten in mainstream health care.
Authors of the report on causes of death, published in Life Extension magazine, attributed nearly 800,000 deaths each year to medical interventions, in contrast to approximately 650,000 deaths from heart disease and 550,000 from cancer. The methodology they used to calculate that number didn't stand up to our analysis, so I don't think the numbers are quite so high. However, it did get my attention since the figures came from credible sources including peer-reviewed medical journals, citing for instance, 106,000 deaths annually from adverse drug reactions, 98,000 from medical errors and 88,000 from infections.
For greater insight into the risks we face, I spoke with David J. Sherer, MD, a board-certified anesthesiologist in Falls Church, Virginia, and the coauthor of Dr. David Sherer's Hospital Survival Guide: 100+ Ways to Make Your Hospital Stay Safe and Comfortable (Claren). He said that although this report is controversial and somewhat alarmist, it has elements of truth. Numbers can always be crunched and interpreted in different ways, but the indisputable point here is that medical errors and complications or adverse effects from medical interventions have reached a crisis point in this country -- one that needs to be addressed. That's beginning to happen.
Dr. Sherer and I discussed what's behind this alarming trend and how we can protect ourselves.
First of all, the problem is not that medical practitioners have suddenly and inexplicably become sloppy and careless. That's far too simplistic an explanation. Instead, Dr. Sherer chalks up the alarming statistics to a number of different factors:
The American public is getting older and sicker. Growing numbers of graying baby boomers are developing the diseases of aging -- heart disease, diabetes, orthopedic problems, etc. In the meantime, in people of all ages, ballooning rates of obesity contribute to these same health challenges. More sick people mean more medical interventions... and in hard numbers, that adds up to more mistakes or complications.
In a kind of medical "perfect storm," just as more Americans are developing serious health problems, we're struggling with a shortage of medical support personnel including nurses, which decreases the attention paid to patient needs and details of treatment. Also, managed care has meant doctors have less time to devote to patients during office visits and, as a result, are less likely to know the particulars of their history. Dr. Sherer warns that this sets up a system ripe for errors.
We're paying closer attention to medical errors and preventable complications and -- paradoxically, the harder we look for them, the more we find. This makes the numbers look terrible in the short run, but in the long run this increased vigilance and accountability should result in improved care.
HOW TO PROTECT YOURSELF
Forewarned is forearmed: There are many proactive steps you can take to shield yourself and your loved ones from this epidemic of deaths related to medical interventions. At the doctor's office or in the hospital, Dr. Sherer recommends...
Bring an up-to-date list of all medications you take. Make sure that you list not only prescription drugs, but also over-the-counter medications, herbal remedies, vitamins and other dietary supplements.
Tell practitioners about any drug allergies or sensitivities and all pre-existing conditions. For example, perhaps you are allergic to penicillin. While this information should appear on your chart, don't take for granted that it does. Reminding health-care providers of your medical history, including drug allergies, is a simple and effective way to avoid potentially life-threatening medical errors.
Do your homework. If you are scheduled to take a new drug or undergo a test or procedure, first research it at reliable government, hospital or university-based Web sites such as www.medlineplus.gov (https://www.medlineplus.gov) or www.mayoclinic.com (https://www.mayoclinic.com) or www.jhu.edu (https://www.jhu.edu) (Johns Hopkins). Peer-reviewed journals such as the Journal of the American Medical Association (jama.ama-assn.org) and the New England Journal of Medicine (content.nejm.org) can also be excellent sources of information. An objective non-biased drug assessment database is available through both print and on-line subscription (www.factsandcomparisons.com/ (https://www.factsandcomparisons.com/)) -- ask your health-care provider and/or pharmacist whether they use it.
Designate a friend or family member to be your advocate. When you're ill, it's all too easy to become nervous and forget the questions you want to ask, or fail to recall your physician's advice. It's not only comforting to have a trusted advocate by your side at such moments, it also contributes to a better understanding of the situation on your part, and more accountability on the part of your caregivers. If you're in the hospital, try to have someone with you or visiting frequently so that they can get help/nurse's attention if need be.
Take personal responsibility. In the long run, you remain in charge of your own health. Responsibility includes not just your interactions with medical practitioners, but also making lifestyle changes that reduce your risk of illness.
No doubt we will continue to hear more about this vitally important health topic -- and I'll continue to cover it in upcoming issues of Daily Health News. Given that hospitals will now have to absorb the costs of their mistakes due to Medicare's refusal to provide coverage for "serious preventable events," with a stipulation that prevents billing patients for them, too, it's clear that they will focus intently on reducing these events, which can only be good news. And meanwhile, Medicare's new hospital inpatient provisions will result not only in an estimated savings for the government of more than $20 million annually -- but, we can only hope, the saving of many lives as well.
David J. Sherer, MD, a board-certified anesthesiologist in clinical practice at Falls Church Ambulatory Surgery Center in Falls Church, Virginia, affiliated with Mid-Atlantic Permanente Group. He is coauthor of Dr. David Sherer's Hospital Survival Guide: 100+ Ways to Make Your Hospital Stay Safe and Comfortable (Claren).
Braggi
11-12-2007, 09:00 AM
... Take personal responsibility. In the long run, you remain in charge of your own health. Responsibility includes not just your interactions with medical practitioners, but also making lifestyle changes that reduce your risk of illness. ...
I agree completely with this statement. Remaining healthy is the best way to prevent illness. Is that too obvious? I suppose not, since so many people are running headlong into chronic illness because of their lifestyle choices and the rest of us will be forced to care for them, one way or another.
The rest of the last post I'll not respond to except to say if you, dear readers, feel the medical establishment is too dangerous to risk contact with, by all means, when you are sick or injured, just stay home and "heal thyself." Or perhaps a visit to a vet makes more sense than to a doctor trained to heal humans.
I will do what I can to seek out the best medical professionals when I need them and do as much of the preventative and rehabilitative care as I can for myself. That will minimize my time in hospitals, which, I agree can be dangerous time.
I'll not make another post in this thread because I think the title is unnecessarily negative and one sided and the opening article, repeated in total above, is so flawed.
If someone wishes to continue the discussion, let's start another thread. Let's call it: Ways to Improve Medical Care, Spotlight on Medicine, or something that's more neutral so we can leave the defensive stuff behind and look at the real problems with our medical system with open minds.
I think all our hearts are in the right place. We all want to see a medical care system that treats all of us with respect and wisdom and heals rather than harms. Let's agree to seek out the positive while we illuminate the negative. Let's avoid demonizing the well meaning professionals we all depend on while we work to expose the problems that prevent them from doing the best jobs their training prepares them to do.