Braininvat » Wed Dec 02, 2015 1:29 pm wrote:http://www.nytimes.com/2015/11/22/opinion/sunday/are-good-doctors-bad-for-your-health.html
The analysis seems to bear out the conclusion that less intervention can be good for you.
That’s an interesting article
Braininvat. I know that if I continued to take most of the anti-hypertensive drugs that my own GP prescribes that I would be a wheelchair-bound zombie by now. The central alpha blockers and the beta blockers all mess with my brain (interest and motivation), and the calcium blockers reduce me to a slow walk. The angiotensin 2 antagonists and ACE inhibitors don’t affect my motivation, but they have no detectable effect on my hypertension.
Along the lines of your OP, I found another disturbing ‘Commentary’ in the JAMA by a Dr Barbara Stanfield titled
“Is US Health Really the Best in the World?” (See
http://jama.jamanetwork.com/article.asp ... eid=192908 ) One sentence in her Introduction states
“In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors.”Unfortunately the full text is pay only, but the same work has been cited in the following article by Ronald Grisanti on a site called ‘Your Medical Directive’ on
http://www.yourmedicaldetective.com/public/335.cfm The article is titled
“Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”. The Report states that there were
105,000 deaths per year from ‘non-error negative effects of drugs’
80,000 from ‘infections in hospitals’
45,000 from ‘other errors in hospitals’
12,000 from ‘unnecessary surgery’
7,000 from ‘medication errors in hospitals’
The author adds “Dr. Starfield offers several caveats in the interpretations of 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 the many 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. If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.” It’s a worry that these figures represent ‘deaths’ only – without reference to those lingering non-death disabilities and discomforts that result from errors or bad judgments.
This places more emphasis
Biv on the recommendations of the author (Ezekiel J. Emanuel) in your OP. I believe his advice is worth repeating openly here, because in the end, each of us is responsible for speaking up for ourselves in exchanges with our own medical advisers.
“One thing patients can do is ask four simple questions when doctors are proposing an intervention, whether an X-ray, genetic test or surgery. First, what difference will it make? Will the test results change our approach to treatment? Second, how much improvement in terms of prolongation of life, reduction in risk of a heart attack or other problem is the treatment actually going to make? Third, how likely and severe are the side effects? And fourth, is the hospital a teaching hospital? The JAMA Internal Medicine study found that mortality was higher overall at nonteaching hospitals.”I’m embarrassed by the fact that most of what I’ve written here is negative. I dislike being the bearer of negative tidings. So I would like to balance this ‘bad’ news by stating that I am of the opinion that far more good than harm comes from medical intervention these days. I find many of the interventions rather amazing, particularly in the surgical fields.
The point I would like to emphasise in this post is that all professionals in every field are human, and by definition, prone to errors. It is up to each of us to realise this, no matter which professional or expert we are dealing with in any field and to learn to keep asking questions if we have any doubts. In the medical field, the suggestions made by Ezekiel Emanuel above, make sense.