Iatrogenic (doctor-related) causes and
Prescription Drugs Are The Leading Cause of Hospitalization and Death in the US
, Causing over 250,000 Hospital Related Deaths Every
Year;
Prescription Drugs are Responsible for over 100,000 Deaths Every
Year
(documentation provided)
While doctors provide
needed treatment successfully for many patients and conditions, it is also well
documented that doctor errors and adverse effects of doctor-prescribed drugs or
treatments is one of the leading causes of hospitalizations, deaths, and other
adverse health
events(
1-28). 14 % of
the U.S. Gross National Product is related to medical and health
care, but
in spite of
the much higher levels of
spending on health care the U.S. ranks very poorly compared to other developed
countries regarding health statistics and effectiveness of health care(
18,etc.
). Experts analyzing the basis for this
have suggested that a profit driven medical system dominated by pharmaceutical
companies and advertising result in
over use
of
technology and pharmaceutical drugs and expensive procedures that have
significant risk of adverse health
effects(
11,1,28).
The following
hospitalization, death, and adverse
annual
effects statistics
come from the medical literature, as referenced:
Hospital
Events
Annual
Incidence Related
Deaths
In-hospital
adverse drug
reactions(
ADR)
:
2.2 million
(
3,4,10,11) over
100,000
Unnecessary
surgery or medical procedures 7.5 million
(8,5,11,23
) over
30,000
Medical
mistakes-surgery and other
- over
400,000
(
7,10,11,23
) over
100, 000
Hospital
medication errors (5% of
patients) over
300,000 harmed, over 7,000(9,13
) Infections
and antibiotic-resistant
infections
?
over
80,000 (10,20)
Unnecessary
hospitalizations 8.9
million
(
6)
?
Total
hospital related adverse
effects 300,000
to 700,000
Malnutrition/dehydration
in nursing homes over 100,000 premature
deaths (24)
Outpatient
adverse drug
effects(ADR)
over 190,000
(
25)
Unnecessary
prescriptions of antibiotics Over 20 million
(16) thousands
Significant
levels of antibiotics and prescription drugs in water bodies and the food chain
Unnecessary
X-rays or radiation procedures
70
% of all
cancers;
250,000
(19)
Commentary
by Dr. Mercola with snips from Gary Null
:
These total to over
300,000 hospital 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.
The only more common
causes are cancer and heart disease which result in 700,000 and 553,000 deaths
annually(
17). If the higher estimates are used,
hospital related deaths due to iatrogenic causes would range from 230,000 to
400,000 per year and constitutes the third leading cause of death in the United
States. With non-hospital related iatrogenic deaths added the total may be the
largest factor in U.S. deaths.
The
article that led to this compilation, Dr. Barbara
Starfield’s
study 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
1,2
. This information is a
followup
of the Institute of Medicine report which hit the
papers in December of last
year(
7). Now
such information is published in JAMA which is the most widely circulated
medical periodical in the world. It should be noted that most of the estimates
in the previous table are likely greatly understated, as it is well documented
that medical mistakes are greatly under reported- with studies indicating that
only 5 to 20 percent of medical mistakes are
reported(
28,4,11). Studies
indicate that medical mistakes are not consistently or accurately reported by
any of the health professional groups, for a number of
well known
reasons.
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
_
The drugs with the worst
record of adverse effects were NSAIDS,
SSRIs, calcium
-channel
blockers, antibiotics, cardiovascular drugs, and chemotherapy.
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
(15)
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.(
15)
However, evidence from a
few studies indicates that as many as 20% to 30% of patients receive
inappropriate care. The treatment of the elderly appears to be
even more problematic. Studies find that the elderly see
multiple doctors and receive multiple drugs, greatly increasing the likelihood
of adverse drug interactions and
effects(
11). The
average senior receives 25 prescriptions per
year
and
studies have determined there are millions of inappropriate and contraindicated
prescriptions per year and millions of cases of dose errors. Many of
the drug prescriptions were given without a documented diagnosis justifying
there use and without consideration of interactions with other
drugs. Studies also find seniors in pain seldom receive appropriate
treatment.
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 (18), 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.
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.
Antibiotic use has increased dramatically over
the last 2 decades, with a likewise
serious dramatic
increase in antibiotic resistance among harmful
bacteria
types.
Over 30 million pounds
of antibiotics are used each year in the U.S., with over 25
million pounds of this
in animal husbandry to promote growth and prevent bacterial
outbreaks in animals
kept in close
quarters(
21). The high use of
agricultural
antibiotics is resulting
in significant amounts of antibiotics in water bodies and the
food chain, resulting in
significant increases in antibiotic resistance. Salmonella is
found in 20% of ground
meat, with 84% of salmonella resistance to some antibiotics.
Approx. 20% of chickens
and eggs are contaminated with salmonella or
campylobacter, with over
50% of campylobacter resistant to some antibiotics. Meat
borne bacteria
is
responsible for millions of human cases per
year.
The approx. 3 million pounds of antibiotics used
on humans in the U.S. amounts
to about 10 teaspoons
per person. Although according to the CDC over 90% of
upper respiratory
infections are
viral
and sinus infections are fungal,
with antibiotics
contraindicated, approx.
50% of treated patients receive
antibiotics(
22). Likewise
Group A beta-hemolytic
streptococci is the only common cause of sore throat that
responds to antibiotics,
with over 90% of sore throats being viral or other. But it is
estimated that 73% of
doctor visits for sore throat result in antibiotic prescriptions
(22,16). A
National Cancer Institute found a strong relation between level of
antibiotic use and
breast
cancer(
12).
Some doctor’s state that women are treated more
aggressively and differently than men, resulting in more iatrogenic effects
affecting
women(
26,11). One doctor
notes
that:
thousands of
prophylactic mastectomies are performed
annually;
one-third of U.S. women
have had a hysterectomy before
menopause;
women are prescribed
drugs more frequently than are
men;
more
women are given
potent drugs for disease
prevention, which results in disease substitution due to side
effects;
fetal monitoring is unsupported by studies and not recommended by
the CDC
since it confines women
to a hospital bed and may result in higher incidence of
Caesarean
section;
normal processes such as menopause and childbirth
have been
highly
medicinized
; synthetic hormone replacement therapy has been
actively
promoted though it does
not prevent the conditions it was promoted for and does
increase the risk of
breast cancer, heart disease, stroke, and gall bladder attack.
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.
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 and drugs are the third leading cause of death in this country
killing over a quarter million people a year. The only more common causes are
cancer and heart disease which result in 700,000 and 553,000 deaths
annually(
17).
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
benefitted 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.
1. Dr. Barbara Starfield, Johns Hopkins School of Hygiene and
Public Health,
Journal American Medical
Association
(
JAMA)
;
July 26, 2000;284(4):483-5
www.mercola.com/2000/jul/30/doctors_death.htm
2.
Schuster MA, McGlynn EA, Brook RH.
How good is the quality of health care in the United States?
Milbank Q.
1998;76(4):517-63,
509;
3.
Drug-Induced
Disorders,
E. G.
Holland, PHARM.D., and F. V.
Degruy
,
M.D. University of South Alabama College of Medicine, Mobile,
Alabama
American Family
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Leape
LL.
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or Instant Tables: 2001
prerun
tables: most common
procedures, http://hcup.ahrq.gov/HCUPnet.asp and U.S.
Congressional House Subcommittee Oversight Investigation, Cost and Quality of
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Christenfeld
N, Glynn LM.
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Lancet. 1998 Feb
28;351(9103):643-4;
&(b) Bond CA
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a
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11.
M.Feldman
(MD
),
C
.
Dean
(
MD
),
D
.
Rasio
(
MD
),G.
Null(
PhD
),D
Smith(
Phd
), Death
by Medicine,
Dec
2003,
www.garynull.com/documents/iatrogenic/deathbymedicine/DeathByMedicine.pdf
12.
study at Henry Ford Health System,
Epidemiol Rev 2002, 24(2):154-75; &
European Respiratory Society's annual conference in Vienna; &
(b)J. H. J. Droste and colleagues
in
Clinical
& Experimental
Allergy
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Nov
2000; &
(c)
American Academy of Allergy, Asthma, and
Immunology(
AAAAI), 2002, Selected
Articles from
the Recent Literature,
Summary www.aaaai.org/aadmc/currentliterature/selectedarticles/2002archive/adverse_effects.html
& (d) S. Taplin et al, National Cancer
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NEJM
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(
b) Dr. William Tierney, Medication side
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The
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B,
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DL, Martin JA, Ventura SJ,
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World
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; &
(
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from Medical
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21. Egger WA,
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Antibiotic
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****************
National
Istitute
of
Health(
NIH),
special interest ties of
officials ,
several
received over $500,000 in fees from pharmaceuticals they have regulatory
control over, several instances of health harm and death in trials have been
overlooked in products of
compancies
they received
fees
from. Smart
Publications: Health and Wellness Update, Vol 141, p16,17.