Bad Medicine
Dr Vernon Coleman
If you think that iatrogenic disease (doctor induced disease) is something new then you’re wrong. The following essay is taken from Vernon Coleman’s book `Betrayal of Trust’ which was published in 1994. If you have any interest in health matters, the contents of the book will astonish and horrify you.
Bad medicine
Drug-related tragedies are often the ultimate responsibility of the drug industry rather than the medical profession but there is ample evidence to show that incompetent or careless doctors do cause a horrifying amount of death or injury.
When doctors from the Harvard School of Public Health studied what happened to more than 30,000 patents admitted to acute care hospitals in New York they found that nearly 4% of them suffered unintended injuries in the course of their treatment and that 14% of the patients died of their injuries. This survey concluded that nearly 200,000 people die each year in America as a result of medical accidents. This means that more than four times as many people die from injuries caused by doctors as die in road accidents.
Carotid endarterectomies – in which deposits are removed from the arteries in the neck – are currently fashionable in America where doctors earn $1.5 billion a year performing them. But when a study of carotid endarterectomies was recently completed it was found that 64% of these operations were either unjustified or of debatable value because the symptoms were not severe enough to justify the risks of the operation. For pacemaker implants the equivalent figure is 56%. Coronary bypass operations are immensely popular among heart surgeons (and extremely profitable) but a major study conducted in Europe showed that many patients who don’t have surgery live longer than those who do. In 1990 American surgeons performed 350,000 coronary bypass operations and charged $14 billion for them. When one researcher studied 300 patients who had had bypass operations at several hospitals in California he discovered that 14% of the patients would have thrived as well without surgery as with it while another 30% were borderline. Around 50% of lower back disc operations and up to 70% of hysterectomies are probably unnecessary. In America death toll from unnecessary surgery alone has been estimated to be as high as 80,000 patients per year.
Two Irish doctors recently reported in the British Medical Journal that 20% of British patients who have slightly raised blood pressure are treated unnecessarily with drugs. Two pathologists who carried out 400 post mortem examinations found that in more than 50% of the patients the wrong diagnosis had been made. A British Royal College of Radiologists Working Party reported that at least a fifth of radiological examinations carried out in National Health Service hospitals were clinically unhelpful. In Britain the Institute of Economic Affairs claimed that inexperienced doctors in casualty units kill at least one thousand patients a year.
Today’s doctors may laugh at the surgeons who chopped out lengths of bowel to treat constipation or who cut out pieces of brain to treat hysteria, but modern practices may to future generations seem no easier to understand. Around the world there are still hundreds of doctors chopping out lengths of bowel, putting staples in stomachs or wiring up jaws to treat patients who eat too much. There are still hundreds of doctors giving patients electric shocks because they are depressed or chopping out bits and pieces of brain to treat problems as varied as schizophrenia, anxiety and drug addiction. Most alarming of all, perhaps, is the fact that as hospitals are filled with increasingly sophisticated equipment (which doctors and technicians often do not entirely understand) so the opportunities for error are constantly being upgraded. For example, there have been several reports showing that patients receiving radiation treatment have been given the wrong dosage.
It was recently estimated in one medical publication that three quarters of Britain’s surgeons were still using hernia repair techniques which were regarded internationally as obsolete. Surveys of junior hospital doctors regularly show an alarming ignorance about drugs, prescription writing and the performance of simple, practical procedures.
The overuse of medical facilities – particularly surgery – is a common cause of unnecessary injury and death. When a patient is likely to die if an operation is not performed, the risks associated with the operation may be acceptable. But when procedures are performed unnecessarily the risks become unacceptable.
According to Fortune magazine American hospitals now try to attract doctors who will bring in patients likely to run up substantial bills. Centres offering investigative facilities often offer lucrative partnerships to doctors who are prepared to promise to make lots of referrals. Research in British hospitals has shown that pregnant women who are in private beds in NHS hospitals are twice as likely to have their babies by Caesarian section as women in NHS beds. Could this be due to the fact that surgeons looking after private patients can charge a hefty extra fee for delivering a baby by Caesarian section?
The above extract is from `Betrayal of Trust’ by Vernon Coleman. A new paperback version is available via the bookshop on www.vernoncoleman.com
Copyright Vernon Coleman 1994 and 2024
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