There are people who honestly think that medicine makes the world a worse place to live in. That if somehow we replace it with the holy grail of alternative medicine then all our ills will be cured and we will live long healthy lives bereft of any problems and die happy.
But the fact of the matter is that many people simply don’t get how medicine works.
According to a review of medical care provided in hospitals around the world, 43 million patients are harmed by medical care each year, with two-thirds of those cases occurring in mid to low income countries. To put that in perspective, there are 38 million people who live in the state of California.
There are 7 billion people on the planet. This is 0.6%. At least at some point in the next year you will fall sick and you will take real medicine. 0.6% isn’t that bad as failure rates go.
This argument works by trying to make it seem like the entire state of California regularly falls sick thanks to real medicine! Rather than a very very small number of people.
7 types of harm studiedData came from 4,000 articles published in the years since 1976 that have studied the quality of care provided in hospitals worldwide. The review authors focused on 7 types of poor care: harm from prescribed drugs, catheter-associated urinary tract infections, catheter-associated bloodstream infections, hospital-acquired pneumonia, blood clots, falls, and bedsores.
Yes these can happen as a product of medical treatment.
The issue however is that these are part and parcel of medical care. Some people are allergic to medications. Some people don’t take medications properly. Some people don’t mention the medications they take. Some people have side effects and indeed some people just don’t understand why they should tell us some things before we administer a drug.
UTIs from catheterisation assumes that catheters are inserted for “fun” rather than for clinical purposes (Such as keeping a bladder empty during a surgery). IV lines are vital for many drugs. Hospital acquired pneumonia is due to mechanical ventilation, blood clots due to prolonged immobility, falls due to patients slipping on stuff and bedsores are again due to immobility.
These are not products of medicine but a fact that sometimes a procedure doesn’t go precisely according to plan. None of these things are done pointlessly and in fact in a system aimed at the patient most patients are informed about these problems.
Rich countries’ harm comes from medicines
Yes, because everything else that causes harm has been eliminated.
The statistics show that 14 percent of hospital patients in high income countries receive substandard care, causing 17 million cases of harm. Meanwhile, 26 million cases of harm were caused by mid and low income countries. Most often in more affluent countries, harm comes from medicines. This happens in 5 percent of hospital visits. Blood clots were the most common issues in poorer countries, accounting for 3 percent of harm incurred by hospital stays.
Patient satisfaction is a terrible beast.
Blood Clots? Yes it’s a problem. The problem being that invalid patients think being invalid means lying in bed all day. That’s just a great way to get DVT.
Patients don’t have the same idea of ideal outcome as doctors. Many are satisfied by painless procedures. Many have weird notions on what is important.
Let’s take an example in Ziztur. For those who are unaware, Ziztur who blogs at WWJTD is an amputee. She broke her foot. A car fell on it. Now to you an amputation is a bad thing. To her?
Well her foot was pretty broken and honestly to fix it would have taken longer than to simply cut it off and teach her to walk on a prosthesis and indeed the chance of repair was low so she wouldn’t have had a functioning foot. Her “real” foot would probably have not been as good as the prosthetic.
To her the ideal outcome was her choice. To you? Well that’s just some bloodthirsty ortho wanting to dismember someone and flog a prosthesis!
In poorer nations a couple more problems come into play. Hygiene is harder to maintain and patients often don’t understand or combine their traditional medicine resulting in complications. In addition? Patients tend to come in later requiring more drastic action and so more side effects.
Millions of years in lost life recorded
If we didn’t do these things the OP thinks that somehow we would not lose millions of years.
The study, published on Sept. 18 online in the journal, BMJ Quality & Safety, quantified the deaths in the following way: “Substandard hospital care resulted in 22.6 million years of life lost thato death or disability. Low and middle income countries had twice as many years lost to death or disability as high income families.” Most of these years come from premature loss of life, compared with how many years the person might have lived if medical harm had not occurred.
Yes and the notion is to improve and reduce the mistakes being made. For instance? Paperless drug prescribing. Prescriptions, safety testing, universal records…
Things that would help reduce these tragic cases where we don’t coordinate.
Nigeria has very little healthcare in the rural parts. Doctors live far away and are few and far between. Life expectancy? Around 45. The problem with the OP’s argument is that he forgets what hospitals exist for and all the things hospitals stop from killing us.
Dr. Ashish Jha, one of the study’s lead authors and faculty member at the Harvard School of Public Health said, “When patients are sick, they should not be further harmed by unsafe care. This should be a major policy emphasis for all nations.”
Yes, and that is what a lot of policy is aimed at. Trying to unify treatment plans, reduce red tape and increase communication systems.
Patients should be active in own health care
I agree and disagree.
You are not an expert. You are no more an expert of medicine than I am an expert in electronics. I cannot fix my laptop should it break and you are far more complex. We think patients should have a lot of say in their healthcare but are frustrated when what they choose is some quack flogging bullshit that doesn’t work. Herbal medicine? Morphine is pretty herbal you know. It’s just that we scientifically process it to get the active ingredient rather than making you smoke an opium pipe. Homeopathy? Magic Water. Magnets? How does it work?
The people who tend to argue for patient choice are a frightful group of people who flog alternative medicine because the choice they want is their pet quack being treated like a real doctor.
We can help you understand but that means realising that choice means choice within science rather than quackery.
In America, these results are significant because of the high number of problems related with adverse drug events. These events are, for the most part, preventable. However, they are even more unlikely when a patient takes an active role is his or her own care, according to Robin Diamond, chief patient safety officer at The Doctors Company. “Unless patients are engaged in their own health care, the likelihood of medical error . . . is much more significant,” Diamond explained.
Yes, and we accept that. We routinely tell patients to be more pro-active with their healthcare and indeed preventative. The errors that occur in this case are down to patient compliance. If a patient is more interested and understanding of his healthcare then he is more likely to stick to a treatment plan.
In India we have a problem called MDR TB. Multi Drug Resistant TB. This thing’s scary. It’s immune to many of the frontline TB Drugs. Why? Because TB has a long treatment time and people were prone to not taking their pills daily.
So the rules changed. We started DOTS. Directly Observed Therapy. You eat the pills in front of a person who comes and bugs you to take them. Compliance shoots up!
The harm being caused was by poor compliance. Trying to reduce that requires a lot of things. Doctors need to inform patients better but patients also have to listen to doctors more. You cannot simply change your own medications without intimating a doctor then get mad when the doctor’s treatments cause harm.
I had a case of a patient who replaced his normal anti-Rheumatic Arthritis medication with NSAIDs. He contracted an ulcer that got exacerbated by pre-surgical fasting and caused gastritits on the table. Why?
Because he changed his regimen and never thought about telling me when I asked.
Doctors and patients are human, they both make mistakes. But the mistakes they make are so varied.
If the USA wants to cut down on mistakes? Unified health standards, reduced working hours for junior doctors and more logical shift systems along with electronic prescribing and a unified patient record. That reduces more deaths than simply demonising medicine.