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Let's stop hiding the truth from ourselves. It's only when we _ Surgical Errors Finally Reported focus on the problems and ask the right questions that can we Just hours before completion of this paper, statistics on surgery- hope to find solutions. related deaths became available. A study in JAMA [October 8, Perhaps the term "health care" gives us the illusion that 2003], from the Agency for Healthcare Research and Quality, medicine is about health. Allopathic medicine is not a purveyor documented 32,000 mostly surgery-related deaths costing $9 bil- of health care but of disease care. Studying the mortality figures lion and accounting for 2.4 million extra days in the hospital in in the Healthcare Cost and Utilization Project (HCUP) within the 2000.* In a press release accompanying the JAMA study, the US government's Agency for Healthcare Research and Quality AHRQ director, Carolyn M. Clancy, MD, admitted: "This study (AHRQ), we found many points of interest. '* The HCUP gives us the first direct evidence that medical injuries pose a real computer program that calculates the annual mortality statistics threat to the American public and increase the costs of health for all US hospital discharges is only as good as the codes that are —_care."*° ut into the system. Hospital administrative data from 20% of the nation's hospitals In an email correspondence with HCUP, we were told that the were analysed for 18 different surgical complications including mortality rates that were indicated in tables and charts for each post-operative infections, foreign objects left in wounds, surgical procedure were not necessarily due to the procedure but only wounds reopening and post-operative bleeding. In the same press indicated that someone who received that procedure died either release, the study's authors said: "The findings greatly from their original disease or from the procedure. Therefore, underestimate the problem, since many other complications there is no way of knowing exactly how many people died from a _ happen that are not listed in hospital administrative data." They particular procedure. also stated: "The message here is that medical injuries can have a There are also no codes for adverse drug side-effects, none for devastating impact on the health care system. We need more surgical mishap and none for medical error. Until there are codes research to identify why these injuries occur and find ways to for medical error, statistics on those prevent them from happening." One of eople who are dying from various the authors, Dr Zhan, said that types of medical error will be buried improved medical practices, including in the general statistics. There is a an emphasis on better hand-washing, code for "poisoning & toxic effects of . might help reduce the morbidity and drugs" and a code for "complications Unfortunately, partaking mortality rates. a treatment”. However, ¢ © mortality in allopathic medicine itself An accompanying JAMA editorial, igures registered in these categories . . by health-risk researcher Dr Saul are very low and don't compare with Is one of the highest causes Weingart of Harvard's Beth Israel what we know from studies such as Deaconess Medical Center, said: the JAMA 1998 study' that said there of death as well as the most "Given their staggering magnitude, were an average of 106,000 expensive way to die. these estimates are clearly sobering."*” prescription medication deaths per year. UNNECESSARY X-RAYS When X-rays were discovered, no Why Aren't Medical and one knew the long-term effects of ion- Surgical Procedures Studied? ising radiation. In the 1950s, monthly In 1978, the US Office of Technology Assessment (OTA) fluoroscopic exams at the doctor's office were routine. You could reported that "Only 10%-20% of all procedures currently used in even walk into most shoe stores and see your foot bones—looking medical practice have been shown to be efficacious by controlled at bones was an amusing novelty. We still don't know the ulti- trial". In 1995, the OTA compared medical technology in eight mate outcome of our initial escapade with X-rays. countries (Australia, Canada, France, Germany, Netherlands, It was common practice to use X-rays in pregnant women to Sweden, United Kingdom and the United States) and again noted — measure the size of the pelvis and make a diagnosis of twins. that few medical procedures in the US had been subjected to clini- Finally, a study of 700,000 children born between 1947 and 1964 cal trial. It also reported that infant mortality was high and life was conducted in 37 major maternity hospitals. The children of expectancy was low compared to other developed countries.“ mothers who had received pelvic X-rays during pregnancy were Although this report is almost 10 years old, much of it holds true | compared with the children of mothers who had not been X- today. The report laid the blame for the high cost of medicine —rayed. Cancer mortality was 40% higher among the children with squarely at the feet of the medical free-enterprise system and the | X-rayed mothers. fact that there is no national health care policy. It described the In present-day medicine, coronary angiography combines an failure of government attempts to control health care costs due to _— invasive surgical procedure of snaking a tube through a blood ves- market incentive and profit motive in the financing and sel in the groin up to the heart. To get any useful information dur- organisation of health care including private insurance, the hospital ing the angiography procedure, X-rays are taken almost continu- system, physician services, and drug and medical device ously, with minimum dosage ranges between 460 and 1,580 industries. Whereas we may want to expand health care, mrem. The minimum radiation from a routine chest X-ray is 2 expansion of disease care is the goal of free enterprise. mrem. X-ray radiation accumulates in the body, and it is well- "Health Care Technology and Its Assessment in Eight known that ionising radiation used in X-ray procedures causes Countries" is the last report prepared by the OTA, which was shut gene mutation. We can only obtain guesstimates as to the impact down in 1995. It's also perhaps the last honest, in-depth look at on health from this high level of radiation. Experts manage to modern medicine. Because of the importance of this 60-page obscure the real effects in statistical jargon, such as "The risk for report, we enclose a summary in the Appendix [see the NIA's lifetime fatal cancer due to radiation exposure is estimated to be 4 website, http://www.nutritioninstituteofamerica.org]. in one million per 1,000 mrem".” Unfortunately, partaking in allopathic medicine itself is one of the highest causes of death as well as the most NEXUS * 35 expensive way to die. OCTOBER — NOVEMBER 2004 www.nexusmagazine.com