The Surprising Tactic Doctors Use to Keep Their Families Healthy
“Money and Medicine” Medical Waste
and Overtreatment
May 02, 2015
Story at-a-glance
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The US health care system is loaded with medical
waste and overtreatment, which compounds your health
risks
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Tests such as mammograms, PSAs, and CT scans often
produce false positives that lead to risky drugs,
unnecessary surgeries, and expensive medical
interventions
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Cancer patients who receive fewer standard cancer
treatments but earlier palliative care live longer
and report superior quality of life, study shows
By Dr. Mercola
America spends more per capita on health care than any other
developed nation, yet health outcomes are among the worst.
Despite sizeable health care expenditures, Americans are
among the sickest citizens of the developed world, ranking only
50th worldwide for life expectancy. Americans also rank near the
bottom for everything from infant mortality to obesity, heart
disease, and disability.1
US health care costs are driven through the roof by
inefficient delivery of care, excessive administrative costs,
fraud, and a mountain of medical waste, as well as a fragmented
insurance system that lacks any standardized price setting
mechanism.
If something isn’t done about our out-of-control health care
costs, there’s a real danger they may bankrupt this country.
Filmmaker Roger Weisberg takes on these issues in the PBS
program “Money and Medicine.” In his feature, he interviews
several physicians and health care administrators who seek to
reform a very broken
health care system.
When It Comes to Medical Care, More Is Definitely NOT Better
Americans are receiving—and paying for—an enormous amount of
unnecessary medical treatment.
According to a report by the Institute of Medicine,
approximately 30 percent of all medical procedures, tests, and
medications may in fact be unnecessary, at a cost of more than
$750 billion a year.2
The worst part is that gross overtreatment is making Americans
sicker, rather than healthier.
When you consider drug reactions and unnecessary
interventions that typically come with multiple side effects, as
well as the financial and emotional stress involved with medical
treatment, there is more likely an inverse relationship
between money spent on health care and wellness.
An approach that tends to be underutilized today is “watchful
waiting.”
In many situations, your body is capable of healing itself
when treated with lifestyle modifications like diet,
exercise,
sleep and movement. Many patients will opt for a more
moderate approach if their physician presents the option.
Intermountain Health Care in Utah is an excellent example of
how the game can be changed. The hospital has reduced its
surgical rates by 40 to 60 percent by simply giving patients a
choice between having surgery and taking a more “watchful
waiting” approach—with no worsening of outcomes.
Interestingly, this rate is about the same as that shown by
physicians themselves when they make similar medical decisions
for their own families.
Medical Care Is the Third Leading Cause of Death in the US
When you add up medical errors, drug interactions, and
hospital-acquired infections, medical care is the third leading
cause of death in the US, right after heart disease and cancer.
Preventable medical mistakes account for one-sixth of all
American deaths.
According to the latest estimates, 210,000 to 440,000
Americans die from
egregious hospital errors each year, with hospitals that
cater primarily to Medicare patients tending to rank the worst.
Types of errors include the following:
Treating the wrong patient: Can
lead to wrong medications or even wrong surgeries—such
as amputation of the wrong limb |
Surgical souvenirs: Surgical tools
or objects left inside the patient’s body are more
common than you might think |
Operating on the wrong body part |
Fake doctors: One
estimate from 25 years ago is that there were more than
5,000 fake doctors in the US—and the numbers are much
higher today, thanks to phony degree mills3 |
Hospital-acquired infections: In 2011, an
estimated 722,000 patients contracted an infection
during a stay in an acute care hospital in the US, and
about 75,000 of them died as a result of it |
Wrong medical tubing: Many types of
medical tubing look alike—yet they can be deadly when
the wrong ones are used. |
Lost patients: Those with dementia
or mental disorders can wander off and fall victim to
many hazards |
Waking up during surgery |
Waiting too long in the ER:
Excessive waiting for medical care costs many their
lives each year4 |
Air bubbles in the blood: After
removal of a chest tube, if the hole isn’t sealed
correctly, air can enter and cut off blood to your
lungs, heart, or brain—a life-threatening event |
CT Scans Expose You to Massive Radiation
The performance of more diagnostic tests and screening
procedures leads to increased false positives, medical errors,
and complications. One type of diagnostic test that’s grossly
overused today is the CT scan. Physicians are ordering CTs for
even the mildest of head injuries that could be evaluated
effectively with a simple hands-on exam. Of course, no one wants
to miss a brain bleed, but the vast majority of scans add no
meaningful information to the physical exam.
Then why are so many being done? Many physicians are
practicing defense medicine. Today’s legal climate has them so
concerned about being sued over missing that “one in a thousand
brain bleed” that they’re ordering scans for nearly everyone who
bumps their head.
But CT scans introduce their own measure of risk—just one CT
exposes you to the radiation equivalent of 200 to 500 chest
x-rays. This is very concerning in light of the estimate that
tens of thousands of cancer deaths each year result from
excessive exposure to ionizing
medical radiation. The radiation from just two or three
scans triples your child’s risk for developing brain cancer
later in life. I’m not saying that CT scans should never be
done, but they should be used judiciously, when truly medically
indicated.
Mammogram Screenings Are Riddled with False Positives
Thirty-nine million American women get mammograms each year.
Over their lifetimes, one in eight women will receive a breast
cancer diagnosis, but FOUR of the eight will have at least one
false positive within a decade.
Unfortunately, working up false positives sometimes kills
people. Studies show that the incidence of
mammography actually saving women’s lives is extremely
low—and routine screenings may actually be harmful. When you get
a false positive, your physician will feel compelled to steer
you toward a series of unnecessary medical interventions that
may result in physical and psychological suffering, financial
strain, and even cancer. False positives can result in the loss
of a breast or even death, in rare cases. A cancer diagnosis may
also interfere with your eligibility for medical insurance.
Prostate Cancer Screenings Are Essentially Meaningless
The US spends $10 billion per year treating prostate cancer.
Last year, 218,000 men were diagnosed and 32,000 died of the
disease. However, the 30 million men who get screened annually
for prostate cancer are put at risk due to the ridiculously high
numbers of false positives. More than half of older men have
pathologic evidence of prostate cancer. Therefore, PSA screening
makes little sense, which explains why it’s shown to have barely
any impact on mortality rates.
According to Stanford University researchers, the PSA test
indicates nothing more than the size of your prostate gland.
According to Dr. Gilbert Welch, professor at Dartmouth Medical
School: “Prostate cancer screening is the poster child for
overdiagnosis.”
A great deal of harm results from unnecessary prostate
treatments after
false positive PSA tests. Estimates are that 15 prostates
must be removed in order to prevent just one prostate cancer
death, and these surgical procedures carry serious side effects
including impotence and incontinence. There are presently no
good comparative studies to indicate which treatments produce
the best outcomes, so a physician’s own personal preference and
habits are what typically dictate his recommendations, rather
than science.
Cesarean Sections: Low Risk for Docs, High Risk for Moms
Cesarean sections have become the most common surgery in the
US today, accounting for nearly one-third of all
births. In 1965, C-sections represented a mere 4.5 percent of
all births. Sadly, Cesareans have become almost “fashionable” to
some women, especially those of higher socioeconomic status who
are scheduling them for no reason other than
convenience—referred to by the media as the “too posh to push”
crowd.5
Surgical births are very physician-friendly, as they are more
easily scheduled during normal business hours. They are more
predictable and much faster than vaginal deliveries, plus less
likely to end in a lawsuit, minimizing the risk—the risk
to your doctor, that is.
A study in the British Medical Journal6
found that a woman's risk of death during delivery is three to
five times higher during Cesarean section than vaginal delivery
due to complications from blood clots, infection, and
anesthesia. There are wide variations in Cesarean rates across
the country, but the national rate is about 34 percent. The
World Health Organization (WHO) states that no country should
have a Cesarean rate greater than 10 to 15 percent.
Some hospitals are taking active measures to reduce their
Cesarean rates, such as Intermountain Healthcare in Utah, which
has reduced their rate to 20 percent by implementing a
team-based approach to patient care. Intermountain Chief Quality
Officer Dr. Brent James said that a massive decrease in elective
inductions has saved the residents of Utah $50 million per year
in medical costs. He estimates that if hospitals across the
country would do the same, it could save the US $3.5 billion
annually.
The Cost of Chasing Miracles
Another area of health care that deserves a good, long look
is end of life care. Medical breakthroughs have led to a near
doubling of the human lifespan over the last century, from 47
years in 1900 to nearly 80 years today.7
According to one study, 30 percent of all
Medicare expenditures are attributed to the five percent who
die that year, with one-third of that cost occurring in the
final month of life.8
But just because we can extend life, where is the line between
promoting life and prolonging death? Unfortunately, this is a
difficult question to answer.
Intensive care units (ICUs) were originally designed to help
critically ill people recover. However, increasing numbers of
beds are now occupied by patients on life support, with a
growing percentage for whom medical science offers no hope of
recovery. If a physician were to offer your loved one an
operation that had only a one in a million chance of success, if
you’re like most Americans, you’d probably consent to the
procedure... we’re all about hope.
However, the harsh reality is that chasing end of life
miracles can lead to dying patients being hooked up to feeding
tubes and ventilators indefinitely and put through agonizing
therapies long after all reasonable hope is gone. Most would
probably agree that this is no way to die. Yet, many family
members understandably cling to the tiniest measure of hope and
when faced with end of life decisions, feel like terminating
life support is the equivalent of performing a “medical
execution” or euthanasia.
In the featured program, one ER physician says, “Our current
system propagates the idea that we can stave off death
indefinitely.” Perhaps for many of these patients, we should
begin shifting our focus away from high-tech medical
interventions and more toward palliative care. Studies are
showing that palliative care, especially when begun early, is of
greater benefit to terminal patients—for longevity AND quality
of life. Besides, miracles are just as likely to happen without
as many drugs and pumps and tubes—and probably even more so.
A study in the New England Journal of Medicine9,10
found that cancer patients who received early palliative care
and fewer oncology treatments lived longer and showed
significant improvements in both quality of life and mood.
Another study11
found that the less money spent in the final month of life, the
better the patient’s death experience. Not only does palliative
care improve patients’ final days, but limiting medical
interventions to when they are actually appropriate promises to
lessen the financial burden on our already-stretched health care
system.
Avoiding Unnecessary Medical Care Can Save Your Life
One of the reasons I’m so passionate about sharing the
information on this site about healthy eating, exercise, and
stress management is because it can help you stay OUT of the
hospital. But if you do require a hospitalization, you can
minimize your risk by knowing how to play the game. My primary
recommendation is to avoid hospitals unless it's an absolute
emergency and you need life-saving medical attention. In such
cases, it's advisable to bring a personal advocate—a relative or
friend who can speak up for you and ensure you're given proper
care if you can't do so yourself. Dr Saul reviews this in far
greater detail in
my interview with him.
If you're undergoing an elective procedure, remember that
this gives you greater leverage and personal choice—be sure to
use it! Many believe training hospitals will provide them with
the latest and greatest care, but they may actually be more
dangerous. You may wish to avoid elective surgeries and
procedures during the month of July because this is when brand
new residents begin their training. According to a 2010 report
in the Journal of General Internal Medicine,12
lethal medication errors consistently spike by about 10 percent
each July, particularly in teaching hospitals, due to the
inexperience of new residents. Also be cautious of weekends.
Keeping yourself healthy by making wise lifestyle choices is
the best way to reduce your need for medical care in the first
place, and one of the best strategies is to optimize your diet.
You can get up to speed on this by reviewing my comprehensive
Nutrition Plan. Additionally, knowing what to do to make
your hospital stay as safe as possible is equally important, in
the event that you are hospitalized. Understand that you, the
patient, are the most powerful entity within the entire hospital
system. However, the system works on the assumption that the
patient will not claim that power. Knowing your rights and
responsibilities can help ensure your hospital stay is a safe
and healing one.
Copyright 1997- 2015 Dr. Joseph Mercola. All Rights Reserved.
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