Posted on 03/14/2005 3:25:09 AM PST by Humblebum
By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD
ABSTRACT
A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.1 Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.2, 2a
The number of unnecessary medical and surgical procedures performed annually is 7.5 million.3 The number of people exposed to unnecessary hospitalization annually is 8.9 million.4 The total number of iatrogenic deaths shown in the following table is 783,936. It is evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.5
long article, click the link to read
What? You've not read my blog?
Series, and briefly:
1. Get the malpractice trials out of the civil courts and move them into specialized courts like the patent courts or the tax courts. I'm not qualified to make a judgment if a minor alteration of a microchip is a patent violation or not. You're probably not qualified to make similar medical judgments.
2. Loser pays. Did you know that the USA is one of like 6 countries in the developed world that doesn't have loser pays?
3. Severe limits on non-economic damages.
4. Create a climate that encourages rather than punishes the reporting of medical errors. We make the same flipping mistakes day in and day out because we are collectively reinventing the wheel.
5. Force doctors, at figurative gunpoint if need be, to adopt high tech data sharing. I mean, come on, if UPS across town can keep track of 8 zillion packages to the point that I can know exactly where in the system my Ann Coulter doll is, surely we ought to be able to make sure that the right patient gets the right medication.
6. The least popular to all the civil libertarians (they should be forced to sign a waiver forbidding the to sue), a manditory medical records system in which a patient's entire medical record is keep on a credit card (we have the technology to do it now). I'm fed up with patients not bothering to tell me, in spite of specific questioning, what medications they have and what other conditions they're being treated for. They're the very ones that'll sue the nine iron off of you.
In third world countries they use yogurt douches to treat vaginal infections. Yoplait only costs 45 cents.
I've actually heard of females who do that in this non third world country. And then there was some sort of garlic concoction.
You can get cheaper yogurt if you buy the store brand.
My niece was two years old when she was diagnosed with a huge abdominal tumor. She is alive today (she turns 15 in May) thanks to chemotherapy and surgery, prescribed by some of the best oncologists in the US.
I myself nearly died in 1997 from pancreatitis, thanks to years of alcohol abuse. And while I am still alive and in relatively good health today because I quit drinking, I was only able to have the chance to quit drinking because of a hospital stay and medical treatment.
My mother is still alive today thanks to an aortic valve replacement and coronary bypass she had performed in 2000.
If we were to follow your reasoning, the three of us would be in the ground today. Millions more people can probably share similar stories.
Hey, Doc, please learn to post paragraphs. You are writing what could be an informative comment here, not a prescription. :)
"The average OBGYN probably SAVES about 500 lives..."
The average abortion is performed by an OBGYN. Perhaps we should talk about "net" lives saved or lost.
The problem with a written agreement to waive liability is that a slick lawyer can make mincemeat out of it in Court.
A lawyer can claim that a patient was "coerced" into signing a waiver of liability. The law recognizes a form of coercion when the waiver was presented to the patient too late for the patient to back out, effectively removing their right to decide if they should sign.
So, there you are in the courtroom, with the sobbing patient on the witness stand................
"I was in so much pain. I couldn't think straight. And then that < dripping sarcasm> man < /dripping sarcasm> (points at you with a quivering finger) put this form in front of me and demanded that I sign it or he would .....SOB!....Gasp!!....SOB!!....refuse to treat me. What could I do?!? I had to give in to his blackmail!!!"
The lawyer then gives his sobbing client his handkerchief to blow her nose with and the jury gives you the "You're going down you disgusting SOB" look.
So, the bottom line is that you can rely on those liability waiver forms as much as you can rely on the Easter Bunny.
As far as "Going Bare", re-read the article carefully and notice that the State does not limit the liability to $250,000. It only requires the doctor to prove that he can cough up $250,000 in cash at a moment's notice.
The actual liability is limitless.
When Dr. Ransomed is sued, he is sued as "Dr. Ransomed and Jana Doe Ransomed, husband and wife".
That means that the lawyer is going after your insurance coverage plus your community property plus your wife's community property plus your dog Toto too.
The $250,000 cash is only the amount you have to show the State of Florida you have in a bank account ready to fly out the door at a minutes notice before they will even let you practice medicine.
However, as the article documented, a pre-mature baby cost an OB doctor a judgment of $80 million.........Eighty Million Dollars!.
The reason those doctors put up $250,000 in cash is because a $250,000 limit malpractice policy for delivering babies in Miami would cost them $125,000.
As a radiologist in Washington State, I purchase a $3 million insurance policy every year.
If I were an OB doctor in Miami, that $3 million dollar insurance policy would cost me $1,500,000.00 (One Million Five Hundred Thousand Dollars) in premiums every year.
Even then, a slick talking lawyer has been known to get an $80 Million verdict out of a jury so you could still end up owing $77 Million after your insurance pays off.
In medical school, many, many moons ago, I delivered 5 or 6 babies in Miami.
Today, if I were an OB doctor instead of a radiologist, there would be no way in Hades you could ever convince me to move back to Miami to deliver babies no matter how much you paid me.
The devastating financial risk is simply not worth it.
JusPasenThru had some pretty good suggestions in the legal side to solve this issue and the bottom line is to get grotesquely huge verdicts and ignorant juries out of the system.
In the mean time, is is simply a matter of common sense that doctors will continue to abandon the high risk specialties such as OB in geographic areas where lawyers have made delivering a baby a potential $80 million risk.
"The Pharmaceutical companies are the gods of our medical gurus..."
Vioxx, Bextra, Cellebrex. These drugs kill people. The drug companies, doctors and the FDA know that is true. The FDA refuses to ban these drugs.
There are statistics that show the average life expectancy of a woman with breast cancer is 3 years if she chooses surgery, chemo, radiation. The statistics show that this jumps to 12 years if she does nothing. And there are alternative protocols that will result in the cancer being cured - but the patient has to go to Mexico, because a doctor doing it in the US will find himself in prison. There are even those who have been kidnapped in Mexico by bounty hunters, returned to the US, and are now in prison - for curing patients.
Cancer research is a 100 billion dollar a year industry. Curing cancer eliminates the need for this industry. Think these cancer researchers will find a cure?
DMSO is beneficial - but if you are not a DVM (Vet) and you are not treating horses, using it is generally illegal.
Carpal tunnel can be treated successfully with Vitamin B-6, making surgery unnecessary. Know any conventional medical practicioners prescribing it?
The list goes on and on.
There has been cultivated a disdain of physicians by patients. It has occurred by advertisement of barristers, as well as news organizations as well as a few bad doctors. Most doctors do their dead level best to do the right thing for their patients. To those freepers who disparage "defensive medical practices", you simply have not been there and do not know what you are saying.
There are other motivating parameters in organized medicine which are very unseemly, but have little or nothing to do with this topic.
The end point of it all seems to be a 2 tiered system....one for the very, very, rich and 1 for the rest of us. Yours and mine will be not unlike the VA system.
I am struck that every time a physician does an appendectomy, ectopic pregnancy,ruptured viscous, places a chest tube for pneumothorax, rapidly accesses the subclavian or internal jugular vein and rapidly expands volumn, removes a colonic polyp at a Dukes A stage, or any of hundreds of commonly done proceedures that physician is saving that persons life. These proceedures are so routine that we do not think of them as life-saving, but they are. If you rewind 75 years ago ,all of those patients which I just collated would die of their disease.
Nowadays physicians are literally being scared out of treating certain patients. I remember one case where a man with a very large pancreatic pseudocyst came to me and needed a "Peaustew" proceedure. I tried to refer him to a medical center (tertiary care center) because surgery on the pancreas can be very unforgiving. I was trained in it but did not like dealing with potential complications. My patient refused to go. So I told him I would do the proceedure, but, before I did, I needed to see him and his wife in my office the following week. In the intervening time I was served papers and was being sued for treating a patient whose life I and my team had saved. (She had developed pseudomembranous enterocolitis from being treated with antibiotics after a total knee replacement. She had, in fact, received 1 dose of Rocephin. When I was called in she had a markedly dilated cecum and ascending colon.) Anyway she had to have a colectomy. She was age 74, 200% ideal body weight, hypertensive, diabetic, and had COPD. Anyway, the man about 48 came in and I told him and his wife I could not do his operation. I shoved the papers across the desk and said, "I just go served papers for saving someones life". He and his wife said they would not sue me, no matter what. But as you know a promise under duress is not worth the paper it is written on. I insisted he be referred to a tertiary center.
My point of that story is that doctors are taking themselves out of the game. They are avoiding risky proceedures. If it was all about money, we would be cutting anything we could.
Unfortunantly for the public they do not understand or do not care that they are causing doctors, properly trained, the selectivley exclude proceedures for fear of lawsuit, paycheck or no paycheck. As you know, many places around the country are now lacking neurosurgeons where they once had neurosurgeons. The problem is when a closed head injury with a subdural hematoma has to be life-flighted and that transfer takes 3 or 4 hours, the damage done cannot be reversed. You know many places no longer treat any high rish obstetrical patient even though they are trained to do so.
You know, every one seems pissed off and everyone wants to delegate blame. Forget gravity, bacteria, old age. If there is an adverse outcome blame the doctor. Some day in the not too distant future, the public will come to understand that it was too high a price to pay.
Oh yea, that lady who sued me,.....the suit was dropped about 18 months later and my insurance premiums went up about 12,000 dollars per year after that. The last premium was 54,000 for 200,000/600,000 coverage.
Actually, yes. That is exactly what I meant.
I make and use colloidal silver. I also make and use colloidal gold which is more difficult
The web. Do your own google search.
Not all the facts are in from this case, methinks. I'll have to wait for the official autopsy report. Autopsy are usually required in cases of unexpected death. Especially in an otherwise healthy 30 years old individual. I wonder if in those 2 visits to 2 different doctors, did she have a chest xray done? Was she placed on antibiotics by any of these 2 docs? What were her vital signs like? Did she have a fever? Was she short of breath or in any respiratory distress? How was she oxygenating on room air? How far apart were these 2 visits? Did she follow discharge instructions to return for re-evaluation if she gets worse or not feeling better in so many days? There are too many unanswered questions and without all the facts, so let's not jump to conclusions.
Perhaps she did not die of pneumonia. Perhaps she died of a pulmonary embolus. Just because someone has a cough and a low grade fever does not always mean they have a pneumonia. Healthy individuals without any past medical problems or co-morbidities are discharged from ER's and clinics everyday to take oral antibiotics at home after they are diagnosed with pneumonias. One just don't simply flop over and croak/die immediately after a diagnosis of pneumonia. There are criterias for admission to hospitals and criterias for IV antibiotics (some antibiotic have the same bioavailability in oral form as in IV form). Age (very young and very old), co-morbidities (any thing or existing medical problems that can cause a patient to be immuno-compromised), decreased oxygenation/hypoxia, abnormal labs (very high white blood cell count, electrolyte abnormalities, etc...), dehydration, inability to take oral antibiotics such as persistent vomitting, etc...are all examples of positive criterias for inpatient admission to a hospital for agressive treatment of pneumonia. For an otherwise healthy individual such as Ms. DeHuff (and I'm assuming she has no serious past medical history since she's only 30 years old) sending her home on oral antibiotics for pneumonia isn't uncommon at all if she meets no criteria for inpatient admission. She may have died from a pulmonary embolus, often misread on chest xrays as pneumonia. If she indeed died that quickly only several days after contracting the disease, she must have died from some extremely agressive strain such as SARS. Who could have predicted that? The point is...let's wait for the autopsy report and all the facts to come in before we judge.
because they were not taught about it in med school or their residency training.
I wonder what would make a better douche, Yoplait or Kroger?
Probably the Sams Choice. :)
I noticed the only replies to your post were from a person suggesting you get an infection, and another with a surgery success anecdote. What I found most amazing about the recent Clinton resurgery is none of the MSM talked about everyone else who goes in for "bypass" and ends up with problems breathing. So Clinton has very good doctors and gets his extra surgery, but how many don't? Antibiotics are not a modern miracle but the last great medical advance (1928).
The simple fact is only lifestyle changes will cure chronic illness in the long run. The drugs and surgery are mostly a way for doctors and pill companies to make money.
Before I became a cardiologist, I was residency trained and had dual board certification in Emergency and Internal Medicine. After working 4 years in a very busy ED and 7 frivolous lawsuits later, I gave up emergency medicine.
My first lawsuit involved an 800 plus lbs. woman. Her family activated 911 after she had "passed out" at home. When the paramedics came out to her house, they had to call in an additional 7 firemen. They pushed her from her bed onto a tarp, dragged her to the door, broke down the door, jamb, and wall of her bedroom, dragged her out to the front door of the house, broke down the front door, dragged her across the yard, broke down the fence, and 9 big guys lugged her out to the street and carried her onto the bed of a pick up truck because she couldn't fit into the back of the ambulance. They ambu-bagged her all the way to the hospital. From the ramp of the ED, we tied 2 Big Boy bed together. It took 11 people to move her into the ED. She came in at around 3AM and it was too dark outside to do anything. Finally made it to ED. Placed her on the monitor. She was pulseless, apneic, unresponsive and in an idioventricular rhythm. Of course there was no IV access. At 800+ lbs, she was an airway nightmare as you can imagine. I couldn't intubate her at all. On top of that she was frothing from the mouth and was in pulmonary edema. Had I given up and pronounce her DOA, I wouldn't have been sued. But being fresh out of residency and gung ho, I cric'ed her. Did an open cric. There were no discernable anatomic landmark. She had a short bull neck. Just took a 15 blade and cut away at the inches and inches of redundant fatty tissue. Finally, got it in! Bagged her up, got her vitals back. Subclavian central line in. Gave Dobutamine, got her pressure up, diuresed her...saved her life. A remarkable save that I had bragged about for months, only to face a subpoena about a year later. Yes, I nicked her recurrent laryngeal nerve and left her hoarse. Yes, I fractured the thyroid cartilage, but it was repaired by an ENT surgeon. What left me even more flabbergasted, ticked off, and dumbfounded was that she also sued me for a "disfiguring scar" on her neck. It took an entire year out of my life, countless of sleepless hours, fighting with my malpractice insurance, convincing them not to settle, etc...the case finally made it to court. It was finally tossed out. Vindicated but still pissed.
I'll save the other frivolous cases for another time. I've been sued for a total of 9 times, haven't had to settle or lose a case yet. They were all just as frivolous as the one above.
Not true, many post-CABG patients develop the same complications as Clinton does and have successfuly undergone the same surgical procedure. It's quite routine. You just don't hear about them because of their non-celebrity status.
Antibiotics are truly a medical miracle, but certainly not the last medical advance. Somehow, though, I have a feeling that I won't be able to convince you otherwise.
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