Weight Loss Using Protein Supplements
This article published in the
prestigious Journal of the American Medical Association (JAMA) is the best
article we have ever seen written in the published literature documenting
the tragedy of the traditional medical paradigm.
This information is a follow up of the Institute of Medicine report which
hit the papers in December of 1999, but the data was hard to reference as it
was not in peer-reviewed journal. Now it is published in JAMA which is the
most widely circulated medical periodical in the world.
The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene
and Public Health and she describes how the US health care system may
contribute to poor health.
THESE ARE NUMBERS OF USA DEATHS PER YEAR BY CAUSE:
12,000 -- unnecessary surgery
7,000 -- medication errors in hospitals
20,000 -- other errors in hospitals
80,000 -- infections in hospitals
106,000 -- non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!
Iatrogenic is defined as induced in a patient by a physician's activity,
manner, or therapy. Used especially of a complication of treatment.
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
If the higher estimates are used, the deaths due to iatrogenic causes
would range from 230,000 to 284,000. In any case, 225,000 deaths per year
constitutes the third leading cause of death in the United States, after
deaths from heart disease and cancer. Even if these figures are
overestimated, there is a wide margin between these numbers of deaths and
the next leading cause of death (cerebrovascular disease).
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
The high cost of the health care system is considered to be a deficit, but
seems to be tolerated under the erroneous assumption that better health
results from more expensive care.
However, evidence from a few studies indicates that as many as 20% to 30% of
patients receive inappropriate care.
Shockingly, an estimated 44,000 to 98,000 among them die each year as a
result of medical errors.
These type of statistics might be tolerated if it resulted in better health,
but does it? Out of thirteen countries in a recent comparison, the
United States ranks an average of twelfth (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
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 scientific data absolutely
does not support this claim.
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
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
These estimates of death due to error are lower than those in a recent
Institutes of Medicine report, and if the higher estimates are used, the
deaths due to iatrogenic causes would range from 230,000 to 284,000.
Even at the lower estimate of 225,000 deaths per year, this constitutes the
third leading cause of death in the US, following heart disease and cancer.
Lack of technology is certainly not a contributing factor to the US's low
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.
Journal American Medical Association July 26, 2000;284(4):483-5
Author Affiliation: Department of Health Policy and Management, Johns
Hopkins School of Hygiene and Public Health, Baltimore, Md. Corresponding
Author and Reprints: Barbara Starfield, MD, MPH, Department of Health Policy
and Management, Johns Hopkins School of Hygiene and Public Health, 624 N
Broadway, Room 452, Baltimore, MD 21205-1996 (e-mail: firstname.lastname@example.org).
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