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Monday 13 February 2012

How Doctors Do Harm

Posted By Dr. Mercola | February 13 2012 | 10,103 views




Story at-a-glance

  • Americans spend more on health care than citizens of any other country, up to 1.5 times more per person -- but we rank 50th in life expectancy and 47th in infant mortality
  • A large number of Americans are dying avoidable deaths because of inappropriate medical care, including medical errors, unnecessary surgeries, adverse drug reactions, and more
  • Medical treatments are often ordered because of the providers’ financial interests -- even though evidence to support their effectiveness is lacking, and oftentimes they end up doing more harm than good, sometimes even causing the patient to die
  • The more you take responsibility for your own health -- in the form of nurturing your body to prevent disease -- the less you need to rely on the "disease care" that passes for health care in the United States
By Dr. Mercola
It’s a widely held tenet in our society that if you get sick, you should visit your doctor to “get well.”

But many physicians are relatively clueless about “wellness care,” they are in the business of disease treatment.

This is why the vast majority of physicians’ visits end up with a medication being prescribed, or if that is not appropriate, a surgery or invasive medical test is often recommended.

What is blatantly missing from many of these appointments is a discussion of what is causing your ailment ... which often means hope for a real “cure” is forsaken in favor of expensive and often dangerous symptom management.

Many Americans Dying Prematurely Because of the U.S. Medical System

Medical care is designed to help you when you are sick, but in the United States the term “health care” is an oxymoron. “Sick care” would be more fitting. Consider this: Americans spend more on health care than citizens of any other country, up to 1.5 times more per person -- but we rank 50th in life expectancy and 47th in infant mortality. These are dismal outcomes from the most expensive health care system in the world!

In a new book ("How We Do Harm: A Doctor Breaks Ranks About Being Sick in America”) by Dr. Otis Webb Brawley, chief medical officer of the American Cancer Society, explains CNN:
“ ... a large number of our fellow Americans are suffering and dying avoidable deaths, because of lack of quality health care. ... Doctors deserve some blame for this mess. Appreciation of the science of medicine and the scientific method is often lacking.

It is amazing the number of health care professionals who seemingly reject the scientific method. They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence. This form of ignorance is a root cause of much of the overuse of medical therapy.

Too often, doctors fail to distinguish what is scientifically known from what is unknown, from what is believed. This is beyond mere disagreement about interpretation of the science. There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.

Health care providers and the public often overlook the emotional and financial conflicts of interest of health care professionals. While I blame the medical profession, blame also rests on hospitals, drug and device manufacturers, insurance companies, lawyers, politicians, government and even with patients.”

When the Treatment is Worse Than the Disease...

Dr. Brawley, a practicing oncologist, gives CNN a telling example in the case of 50-year-old Helen, who was diagnosed with early stage breast cancer in 1990. After receiving surgery, she then was given high dose chemotherapy and a bone marrow transplant, a treatment that resulted in her being hospitalized for nearly a year and “almost killed her several times.” According to Dr. Brawley, this chemo/bone marrow transplant combo treatment was common at the time for women with breast cancer, even though no study had ever proven it beneficial.

In 1999, clinical trials were finally completed showing that not only was the treatment no better than standard therapy, it may have actually been more harmful.

And therein lies the crux of the problem -- medical treatments are often ordered even though evidence to support their effectiveness is lacking, and oftentimes they end up doing more harm than good, sometimes even causing the patient to die. Why? Sadly, it’s often based on financial gain. Dr. Brawley continued:
“Even without evidence, some patients and their doctors had faith that it worked. The procedure was common because some doctors taught that the transplant was beneficial to patients. Truth be told, it was very beneficial to the doctors and hospitals offering it … The American health care system is fundamentally flawed and encourages inappropriate behavior and a subtle form of corruption. There truly is a combination of greed, ignorance and apathy within health care that is a cancer on this country. There is nothing wrong with medicine as a business, and nothing wrong with making an honest profit. However, in some cases, greed needs to be replaced with public interest, a concern for the national good.”

"Pharmageddon" is Here

Pharmageddon is "the prospect of a world in which medicines and medicine produce more ill-health than health, and when medical progress does more harm than good" -- and it is no longer a prospect but is fully upon us.

Last year an analysis of data from the U.S. Centers for Disease Control and Prevention (CDC) revealed that deaths from properly prescribed drugs now outnumber traffic fatalities in the United States! And when you add in deaths attributable to other medical care modalities, like hospital admissions and surgery, the modern medical system becomes the leading cause of death and injury in the United States.
Authored in two parts by Gary Null, PhD, Carolyn Dean, MD ND, Martin Feldman, MD, Debora Rasio, MD, and Dorothy Smith, PhD, the comprehensive Death by Medicine article described in excruciating detail how everything from medical errors to adverse drug reactions to unnecessary procedures caused more harm than good. That was in 2003. 
In 2010, an analysis in the New England Journal of Medicine found that, despite efforts to improve patient safety in the past few years, the health care system hasn't changed much at all.i Researchers noted:
“In a study of 10 North Carolina hospitals, we found that harms remain common, with little evidence of widespread improvement.”
They revealed that 18 percent of patients were harmed by medical care (some repeatedly) and over 63 percent of the injuries could have been prevented. In nearly 2.5 percent of these cases, the problems caused or contributed to a person's death. In another 3 percent, patients suffered from permanent injury, while over 8 percent experienced life-threatening issues, such as severe bleeding during surgery. In all there were over 25 injuries per 100 admissions! In other words you have a one in four chance of getting injured if you are admitted to the hospital -- not very good odds by any stretch.

Medical Care Often Dictated by Your Providers' Financial Interests

In her book, "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer," Shannon Brownlee also talks about the number of people who die in hospitals due to incorrect care, drug dosage or hospital-acquired infections. Even with new safety regulations in place, 180,000 hospitalized Americans still die every year from largely preventable causes – and the worst part about it, Brownlee says, is that as much as a third of that care does nothing to improve your health!

What happens is that you often get certain medical tests because of what your physician's specialty is, not because that's necessarily the test you need. For example if you have low back pain and see different specialists you will get different tests: rheumatologists will order blood tests, neurologists will order nerve impulse tests, and surgeons will order MRIs and CT scans.

But no matter what tests you get, you'll probably end up with a spinal fusion because it's one of the "more lucrative procedures in medicine," Brownlee says – even though the best success rate for spinal fusions is only 25 percent!

Angioplasties and certain types of chemotherapy with similar low success rates are just as prone to be ordered, Brownlee says, because that's where hospitals' investments lie. You see, they have all this equipment and they need to use it to get a return on it – but they also need to get you out of there as quickly as possible, so they can get the next patient in.  
What ensues is a type of aggressive patient therapy that can end in disaster: according to the Office of Inspector General for the Department of Health and Human Services, 1 in 7 Medicare recipients will be harmed every year as a result of the medical care they received in the hospital.

Some Physicians are Recognizing the Power of "Alternative" Care

It seems that even while physicians continue to promote the drugs and surgeries upon which this flawed system is based, some health care workers are also poignantly aware of many of the pitfalls of modern medicine … and as such are embracing more holistic modalities when it comes to their own care.

In fact, 76 percent of health care workers use complementary and alternative medicine (CAM), compared to 63 percent of the general population, according to research in the journal Health Services Research.ii Even more revealing, health care providers, including doctors and nurses, were more than twice as likely to have used practitioner-based CAM, and nearly three times as likely to use self-treatment with CAM, during the prior year than support workers.

Alternative medicine, or as I prefer to call it, “traditional” medicine (because many of these therapies have been used for many centuries), typically offers a more positive treatment experience and often produces better results with less risk. And Americans are also increasingly distrustful of prescription medicines -- rightfully so! If more physicians would begin to embrace traditional medicine practices like nutritional-based therapies, as well as advocate for preventive health care strategies like healthy diet, exercise and stress relief, we would likely begin to see a real turnaround in rates of chronic disease, not to mention deaths due to medical care.

As Dr. Brawley wrote on CNN:
“The triad of obesity, lack of physical activity and high caloric intake (bad diet) is creating a tsunami of chronic disease. If the system persists as is, medical costs will grow dramatically over the next several decades as the number of patients with diabetes, cardiovascular diseases, cancer and orthopedic injury dramatically grows.

The current course is not sustainable. Medical costs will rise until the economy collapses. We all need to realize that some Americans are harmed by lack of treatment and others by overtreatment. The cold hard reality is America does not need to reform health care, we need to transform health care.”

You Can Make Your Own Health Care Decisions, and Even Influence Your Doctor

What is the proof that the health care system is in need of urgent transformation? Hundreds of thousands are killed by medical care itself, while others are walking around with far less than stellar health due to these treatments. Rates of chronic diseases are through the roof, and we're facing epidemics of obesity, heart disease, diabetes, depression and too many others to list. As a whole, Americans are not healthy – they're tired, depressed, stressed out and often in pain.

As patients, many people have taken their health into their own hands by abandoning this fatally flawed medical model and embracing holistic modalities that can help heal on a body-wide level.

It’s important to remember that the more you take responsibility for your own health -- in the form of nurturing your body to prevent disease -- the less you need to rely on the "disease care" that passes for health care in the United States. If you carefully follow some basic health principles -- simple things like exercising, eating whole foods, sleeping enough, getting sun exposure, reducing stress in your life, and nurturing personal relationships -- you will drastically reduce your need for conventional medical care, which in and of itself will reduce your chances of suffering ill side effects.

But in the event you do need medical care, seek a health care practitioner who will help you move toward complete wellness by helping you discover and understand the hidden causes of your health challenges ... and create a customized and comprehensive -- i.e. holistic -- treatment plan for you.

What's more, you can have an impact on your doctor's tendency to recommend natural alternatives, as when you inquire about them, some health care providers do in fact listen. Dr. Aditi Nerurkar, an internist and integrative medicine fellow at Harvard Medical School and Beth Israel Deaconess Medical Center, did just that, because of her patients’ requests.
As reported by CommonHealth:iii
"Nerurkar, 35, says she was "inspired by her patients," to pursue the research because so many of them kept telling her how much better they felt — that their insomnia or anxiety had ceased — after taking a meditation or yoga class."
So many people are now asking their health care providers about alternative options that even medical schools have had no choice but to listen -- many are now offering courses in alternative medicine, such as the use of herbs, acupuncture and mind-body medicine! 
Remember, when you do go to the doctor, know that it's OK to ask questions and opt for less medical intervention while choosing a more natural way of healing your body.
If your physician is not open to such options, it may be time to find one who is, who can help coach you and your family to Take Control of Your Health.
REFERENCES:


Source: CNN January 20, 2012

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http://articles.mercola.com/sites/articles/archive/2012/02/13/how-doctors-do-harm.aspx