Doctors are the Third Leading Cause of Death Part IV
By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD
Medical and Surgical Procedures
It is instructive to know the mortality rate associated with different medical and surgical procedures. Even though we must sign release forms when we undergo any procedure, many of us are in denial about the true risks involved. We seem to hold a collective impression that since medical and surgical procedures are so commonplace, they are both necessary and safe. Unfortunately, partaking in allopathic medicine itself is one of the highest causes of death as well as the most expensive way to die.
Shouldn't the daily death rate of iatrogenesis in hospitals, out of hospitals, in nursing homes, and psychiatric residences be reported like the pollen count or the smog index? Let's stop hiding the truth from ourselves. It's only when we focus on the problem and ask the right questions that we can hope to find solutions.
Perhaps the words "health care" give us the illusion that medicine is about health. Allopathic medicine is not a purveyor of health care but of disease-care. Studying the mortality figures in the Healthcare Cost and Utilization Project (HCUP) within the U.S. government's Agency for Healthcare Research and Quality, we found many points of interest.13 The HCUP computer program that calculates the annual mortality statistics for all U.S. hospital discharges is only as good as the codes that are put into the system.
In an e-mail correspondence with HCUP, we were told that the mortality rates that were indicated in tables and charts for each procedure were not necessarily due to the procedure but only indicated that someone who received that procedure died either from their original disease or from the procedure.
Therefore there is no way of knowing exactly how many people died from a particular procedure. There are also no codes for adverse drug side effects, none for surgical mishap, and none for medical error. Until there are codes for medical error, statistics of those people who are dying from various types of medical error will be buried in the general statistics. There is a code for "poisoning & toxic effects of drugs" and a code for "complications of treatment."
However, the mortality figures registered in these categories are very low and don't compare with what we know from studies such as the JAMA 1998 study 1 that said there were an average of 106,000 prescription medication deaths per year.
Why aren't Medical and Surgical Procedures Studied?
In 1978, the U.S. Office of Technology Assessment (OTA) reported that, "Only 10 percent to 20 percent of all procedures currently used in medical practice have been shown to be efficacious by controlled trial."83
In 1995, the OTA compared medical technology in eight countries:
? Germany ? Netherlands
? United Kingdom
? United States
... and again noted that few medical procedures in the United States had been subjected to clinical trial. It also reported that infant mortality was high and life expectancy was low compared to other developed countries.84
Although almost 10 years old, much of what was said in this report holds true today. The report lays the blame for the high cost of medicine squarely at the feet of the medical free-enterprise system and the fact that there is no national health care policy. It describes the failure of government attempts to control health care costs due to market incentive and profit motive in the financing and organization of health care including private insurance, hospital system, physician services, and drug and medical device industries.
Whereas we may want to expand health care, expansion of disease care is the goal of free enterprise. "Health Care Technology and Its Assessment in Eight Countries" is also the last report prepared by the OTA, which was shut down in 1995. It's also, perhaps, the last honest, in-depth look at modern medicine. Because of the importance of this 60-page report, we enclose a summary in the Appendix.
Surgical Errors Finally Reported
Just hours before completion of this paper, statistics on surgical-related deaths became available. An October 8, 2003 JAMA study from the U.S. government's Agency for Healthcare Research and Quality (AHRQ) documented 32,000 mostly surgery-related deaths costing $9 billion and accounting for 2.4 million extra days in the hospital in 2000.85 In a press release accompanying the JAMA study, the AHRQ director, Carolyn M. Clancy, M.D., admitted:
"This study gives us the first direct evidence that medical injuries pose a real threat to the American public and increase the costs of health care." 86
Hospital administrative data from 20 percent of the nation's hospitals were analyzed for 18 different surgical complications including:
? Postoperative infections
? Foreign objects left in wounds
? Surgical wounds reopening
? Post-operative bleeding
In the same press release the study's authors said that:
"The findings greatly underestimate the problem, since many other complications happen that are not listed in hospital administrative data." They also felt that, "The message here is that medical injuries can have a devastating impact on the health care system. We need more research to identify why these injuries occur and find ways to prevent them from happening."
One of the authors, Dr. Zhan, said that improved medical practices, including an emphasis on better hand washing, might help reduce the morbidity and mortality rates. An accompanying JAMA editorial by health-risk researcher Dr. Saul Weingart of Harvard's Beth Israel Deaconess Medical Center said, "Given their staggering magnitude, these estimates are clearly sobering."87
When X-rays were discovered, no one knew the long-term effects of ionizing radiation. In the 1950s monthly fluoroscopic exams at the doctor's office were routine. You could even walk into most shoe stores and see your foot bones; looking at bones was an amusing novelty. We still don't know the ultimate outcome of our initial escapade with X-rays.
It was common practice to use X-rays in pregnant women to measure the size of the pelvis, and make a diagnosis of twins. Finally, a study of 700,000 children born between 1947 and 1964 was conducted in 37 major maternity hospitals. The children of mothers who had received pelvic X-rays during pregnancy were compared with the children of mothers who had not been X-rayed. Cancer mortality was 40 percent higher among the children with X-rayed mothers.88
In present-day medicine, coronary angiography combines an invasive surgical procedure of snaking a tube through a blood vessel in the groin up to the heart. To get any useful information during the angiography procedure X-rays are taken almost continuously with minimum dosage ranges between 460 and 1,580 mrem. The minimum radiation from a routine chest X-ray is 2 mrem. X-ray radiation accumulates in the body and it is well-known that ionizing radiation used in X-ray procedures causes gene mutation. We can only obtain guesstimates as to its impact on health from this high level of radiation. Experts manage to obscure the real effects in statistical jargon such as, "The risk for lifetime fatal cancer due to radiation exposure is estimated to be four in 1 million per 1,000 mrem."89
However, Dr. John Gofman, who has been studying the effects of radiation on human health for 45 years, is prepared to tell us exactly what diagnostic X-rays are doing to our health. Dr. Gofman has a PhD in nuclear and physical chemistry and is a medical doctor. He worked on the Manhattan nuclear project, discovered uranium-2323, was the first person to isolate plutonium, and since 1960, he's been studying the effects of radiation on human health.
With five scientifically documented books totaling over 2,800 pages, Dr. Gofman provides strong evidence that medical technology, specifically:
? CT scans
... are a contributing factor to 75 percent of new cancers.
His 699-page report, updated in 2000, "Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population to here"90 shows that as the number of physicians increases in a geographical area with an increase in the number of X-ray diagnostic tests, there is an associated increase in the rate of cancer and ischemic heart disease. Dr. Gofman elaborates that it's not X-rays alone that cause the damage but a combination of health risk factors including: poor diet, smoking, abortions, and the use of birth control pills. Dr. Gofman predicts that 100 million premature deaths over the next decade will be the result of ionizing radiation.
In his book, "Preventing Breast Cancer," Dr. Gofman says that breast cancer is the leading cause of death among American women between the ages of 44 and 55. Because breast tissue is highly radiation-sensitive, mammograms can cause cancer. The danger can be heightened by a woman's:
? Genetic makeup
? Preexisting benign breast disease
? Artificial menopause
? Hormonal imbalance 91
Even X-rays for back pain can lead someone into crippling surgery. Dr. Sarno, a well-known New York orthopedic surgeon, found that X-rays don't always tell the truth. In his books he cites studies on normal people without a trace of back pain who have spinal abnormalities on X-ray.
Other studies have shown that some people with back pain have normal spines on X-ray. So, Dr. Sarno says there is not necessarily any association between back pain and spinal X-ray abnormality.92 However, if a person happens to have back pain and an incidental abnormality on X-ray, they may be treated surgically, sometimes with no change in back pain, or worsening of back pain, or even permanent disability.
In addition, doctors often order X-rays as protection against malpractice claims to give the impression that they are leaving no stone unturned. It appears that doctors are putting their own fears before the interests of their patients.
? 8.9 million (8,925,033) people were hospitalized unnecessarily in 2001.4
In a study of inappropriate hospitalization 1,132 medical records were reviewed by two doctors. Twenty-three percent of all admissions were inappropriate and an additional 17 percent could have been handled in ambulatory out-patient clinics. Thirty-four percent of all hospital days were also inappropriate and could have been avoided.93 The rate of inappropriate admissions in 1990 was 23.5 percent.94 In 1999, another study confirmed the figure of 24 percent inappropriate admissions indicating a consistent pattern from 1986 to 1999,95 showing steady reporting of approximately 24 percent inappropriate admissions each year.
Putting these figures into present-day terms using the HCUP database, the total number of patient discharges from hospitals in the United States in 2001 was 37,187,641.13 The above data indicate that 24 percent of those hospitalizations need never have occurred. It further means that 8,925,033 people were exposed to unnecessary medical intervention in hospitals and therefore represent almost 9 million potential iatrogenic episodes.4
Women's Experience in Medicine
Briefly, we will look at the medical iatrogenesis of women in particular. Dr. Martin Charcot (1825-1893) was world-renowned--the most celebrated doctor of his time. He practiced in the Paris hospital La Salpetriere. He became an expert in hysteria diagnosing an average of 10 hysterical women each day, transforming them into ... "iatrogenic monsters," turning simple 'neurosis' into hysteria.96 The number of women diagnosed with hysteria and hospitalized rose from 1 percent in 1841 to 17 percent in 1883.
Hysteria is derived from the Latin "hystera," meaning uterus. Dr. Adriane Fugh-Berman stated very clearly in her paper that there is a tradition in U.S. medicine of excessive medical and surgical interventions on women. Only 100 years ago male doctors decided that female psychological imbalance originated in the uterus. When surgery to remove the uterus was perfected it became the "cure" for mental instability, effecting a physical and psychological castration. Dr. Fugh-Berman noted that U.S. doctors eventually disabused themselves of that notion but have continued to treat women very differently than they treat men.97
She cites the following:
? 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.
? 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.98 It confines women to a hospital bed and may result in higher incidence of cesarean section.99
? Normal processes such as menopause and childbirth have been heavily medicalized.
? Synthetic hormone replacement therapy (HRT) does not prevent heart disease or dementia. It does increase the risk of breast cancer, heart disease, stroke, and gall bladder attack.100
? We would add that as many as one-third of postmenopausal women use HRT.101,102 These numbers are important in light of the much-publicized
? Women's Health Initiative Study, which was forced to stop before its completion because of a higher death rate in the synthetic estrogen-progestin (HRT) group.103