A curious title for a serious article on why health
care is considered by some to be the leading cause of death in America?
Sure. But this is a curious subject.
Let me make this a bit more curious. I say
“considered by some” only to keep us honest, to ensure that what follows
sounds more informed than inflamed. But, truth be told – and that is our
goal here – I know, and soon so will you, that health care is the
leading cause of death in America.
Let’s go back in time a bit to, say, 400 B.C., when
Hippocrates (aka, “the father of medicine”), the ancient Greek credited
with making medicine a profession distinct from philosophy or theurgy
(i.e., ritual and magic), may have first uttered the phrase primum non
nocere – first do no harm.” W
e
have all heard of the Hippocratic Oath taken by physicians promising
their strict adherence to the ethical practice of medicine (you might
want to Google the full text), which includes the following assurance:
"I will prescribe regimens for the good of my patients according to my
ability and my judgment and never do harm to anyone."
(In 1964, Dr. Louis Lasagna, then Academic Dean of
the School of Medicine at Tufts University, wrote a Modem Version of the
oath, which is used in many schools today. See,
http://en.wikipedia.org/wiki/Louis_Lasagna#Revision_of_Hippocratic_oath)
OK. So far, so good. Now to the term Iatrogenesis,
which derives from the Greek iadtros, meaning "healer." Iatrogenesis
literally means "brought forth by a healer." In practical use, the term
refers to any adverse effects or complications caused by or resulting
from medical treatment or advice. It applies to actions taken not only
by physicians, but by all healthcare professionals, including but not
limited to, psychologists, pharmacists, therapists, nurses, dentists, et
al. Iatrogenesis is equally applicable to conventional as well as
complementary and alternative medicine.
The causes of Iatrogenesis include (but, again, are
not limited to) error, negligence, the adverse effects or interactions
of prescription drugs, overuse of drugs leading to antibiotic
resistance, blood transfusions, poor prescription handwriting, and
emotional distress from attributing transient personal problems to
mental pathology.
The estimated number of annual deaths caused by
Iatrogenesis in the U.S. varies from a low of about 240,000 to a high of
nearly 784,000, making it either the # 3 or # 1 cause of death and
injury in the U.S., behind or ahead of Heart Disease (about 700,000) and
Cancer (about 554,000). Based on published research, most notably in the
report "Death By Medicine'. (Life Extension Magazine, March 2004, Dr.
Gary Null, PhD; Dr. Carolyn Dean, MD, ND; Dr. Martin Feldman, MD; Dr.
Debora Rasio, MD ; and Dr. Dorothy Smith, MD) and Dr. Lucian L. Leape's
1994 paper, "Error in Medicine," published in the Journal of the
American Medical Association (JAMA), we firmly believe Iatrogenesis is
the #1 killer, propagated by Big Pharma, the FDA, hospital boards, and
the traditional medical establishment to promote and protect their
obscene profit margins at the expense of your health, and all too often,
your life.
Now to Andy Warhol.
For the few people who don't know the name, Andy
Warhol (aka, "the father of Pop Art") was one of the most influential
artists of the 20th Century. At the tine of his death at age 58 in 1987,
his estimated personal wealth was $150 million (or $350-400 million in
2009 dollars) –certainly enough to assure the best medical care
possible. On February 20, 1981, Warhol entered the prestigious New York
Hospital-Come11 Medical Center in New York City for a fairly routine
removal of an inflamed gall bladder. On February 22, 1981, Warhol died
of what Dr. Elliot M. Gross, the Chief Medical Examiner for New York
City, termed "an unexplained death of a relatively young person in
apparently good health." (quoted in The New York Times, Feb. 23, 1981).
The August 1, 1981 New York Times further reported
that The New York State Health Department, in a report in April, was
sharply critical of care Mr. Warhol was given from the time he was
admitted to New York Hospital on Feb.20 until his death two days later.
The department called Mr. Warhol's treatment "inadequate" and said it
had found scores of "deficiencies," including failure to do proper tests
before surgery and the failure to keep his medical chart accurately
...According to ...[a] letter to Dr. Gross from the Manhattan District
Attorney, Robert M. Morgenthau, the inability to determine the
underlying cause of Mr. Warhol's death was a result of several layers of
uncertainty and ambiguity in the medical treatment that Mr. Warhol was
given."
A January 24, 1981 New York Times article by its
Medical Correspondent, Lawrence K. Altman, M.D., "A Great Hospital in
Crisis," describes in depth a slew of other such cases as this
"five-star" hospital, including the {ironic) 1986 death of Michael
Gannon, a 39-year-old vice president of Empire Blue Cross and Blue
Shield, who after being examined in the emergency room by a resident who
took no blood tests and diagnosed Mr. Gannon's chest and left arm pains
as muscular and bone problems, discharged him without consulting an
attending physician. Gannon died of a heart attack that night at home.
Iatrgenesis strikes again... and again... and
again...and again... and again
The above stories are by no means to suggest that
the pandemic of "Death By Medicine" is limited to, or more important
for, the rich and famous. They stress that in America, even money cannot
buy adequate or life-preserving medical care. On the contrary, we quite
possibly don't have sufficient bandwidth to point out how this
completely unnecessary plague, fueled by unmitigated greed and disregard
for basic human life, touches the lives and financial well-being of
every man, woman, and child in America -and increasingly worldwide.
Here are but a few of the myriad of horrifying
annual statistics and estimates:
In 1994, Dr. Lucian L. Leape published what has
become the seminal Iatrogenic study,
"Error in Medicine," in the Journal of the American
Medical Association (JAMA). With its publication, he opened medicine's
Pandora's box and ensured that the problem could no longer be ignored.
In it, he cited autopsy studies that showed 35-40% rates of misdiagnoses
leading to death. He also calculated a 1% failure rate in intensive care
units. To put that seemingly small number in perspective, a 0.1% failure
rate in aviation would translate to 2 unsafe landings a day at Chicago's
O'Hare Airport; in the U.S. Postal Service, it would equal 16,000 pieces
of lost mail every hour; and in the banking industry, would mean 32,000
bank checks deducted from the wrong bank accounts.
At a 1997 press conference. Leape released a
nationwide survey on Iatrogenesis conducted by the National Patient
Safety Foundation (NPSF}, which is sponsored by the American Medical
Association (AMA). The survey concluded that more than 100 million
Americans have been affected directly and 84% knew of someone who had
experienced medical mistake. At the same press conference, Dr. Leape
updated his 1994 statistics, noting that as of 1997, inpatient medical
errors nationwide could be as high as 3 million at a cost of $200
billion annually.
Let's step back for a moment and digest these
anecdotes and numbers.
It's insane, isn't it?
It's completely insane that according to the
"National Scorecard on U.S. Health System performance, 2008" prepared by
the respected Commonwealth Fund Commission, “Performance on measures of
health system efficiency remains especially low, with the U.S. scoring
53 out of 100 on measures gauging inappropriate, wasteful, or fragmented
care; avoidable hospitalizations; variation in quality and costs;
administrative costs; and use of information technology." In addition,
the report concludes that "The U.S. fell to last place among 19
industrialized nations on mortalityamenable to health care -deaths that
might have been prevented with timely and effective care." (For the full
report, horrifying as it is, go to
www.commonwealthfund.org )
Why?
Perhaps in a future article we will delve into the
many, many causes behind the terrible reality of U.S. health care, but
for right now, the causes can be summed up as follows:
