sick of meds

In the year 2000, a study from Johns Hopkins estimated 225,000 people (minimum), died of iatrogenic causes in US hospitals. That is, the deaths were caused by the healer. The third leading cause of death nationwide. The deaths broke down as follows:

• 7,000 - medication errors in hospitals
• 12,000 - unnecessary surgery
• 20,000 - other errors in hospitals
• 80,000 - infections in hospitals
• 106,000 - non-error, negative effects of drugs

(Source: Dr. Barbara Starfield of Johns Hopkins School of Hygiene and Public Health, Journal of the American Medical Association, July 2000)

I have a lot of contact with doctors and nurses (I work with them daily on their English to prepare them to work and study abroad.), so I know that they are human, and under stress, and that the system is never perfect, and so accidents will happen. So at first blush I see nothing insidious with the medication errors, other errors, and infections. Unfortunate though they are, and worthy of every effort to be reduced, well, we all make mistakes.

Unnecessary surgery however, strikes me as different. Surgery is invasiveness in the extreme and should be a last resort. That 12,000 people died as a result of surgeries which were unnecessary in the first place is shocking to me. How many were merely maimed, disabled, traumatized, or caused to suffer - along with family and loved ones? Why push for surgery? My guess: money. Here in Thailand, companies providing prosthetic joints and implants have teams of talented people competing to win over surgeons to their product lines. Inducements include significant pocket money on every unit used, pampered treatment and perks, getting docs laid, holiday seminars at desirable locations, visibility and status.

This leads to the biggest number on the list: 106,000 - non-error, negative effects of drugs. These are non-error deaths caused by medication. The doctor prescribed the proper medication according to present accepted guidelines. The nurses administered the medications according to present accepted guidelines. The patients complied. Non-error. No mistake. 106,000 (minimum) dead per year. Look like something is wrong with our present accepted guidelines? It does to me. My guess: pharmaceutical money.

Here in Thailand big pharmaceutical companies regularly treat doctors and their families to vacation/seminars in Europe, America, or 5-star Thai beach resorts. The more the pharmCo likes you, the better the perk. But all doctors get the perks. All doctors. It's standard operating procedure. Entire hospitals can even be 'branded' to a 'family' of meds, receiving in return both individual and hospital-level kickbacks. Shifting to a cheaper, better, safer brand - or even using less can become socially impossible. These are the same pharm companies at work drumming up business in the US.

Oh, and here's a link to a Mind Hacks article about hot chicks selling pharmaceuticals.

But don't worry. America has the FDA to protect them with safe meds and guidelines, right? Sorry my son but you're too late in asking, Mr GalaxoSmithKline's pharm train done hauled it away.