Showing posts with label Patient safety. Show all posts
Showing posts with label Patient safety. Show all posts

Wednesday, October 9, 2013

Preventable Medical Mistakes Account for One-Sixth of All Annual Deaths

University of Massachusetts Medical School and...
University of Massachusetts Medical School and hospital, Worcester, MA; South side. (Photo credit: Wikipedia)
I’ve long stated that the conventional health care system is in desperate need of radical change, and the findings published in a new report clearly backs up this assertion.
You’re probably already aware that the US has the most expensive health care in the world. In fact, the US spends more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia.
If the US health care system was a country, it would be the 6th largest economy on the entire planet. Despite that, the US ranks last in health and mortality when compared with 17 other developed nations.
Sure, we may have one of the best systems for treating acute surgical emergencies, but the American medical system is an unmitigated failure at treating chronic illness.

I've previously posted my opinion of the so-called "Affordable Care Act".  There is always free cheese in a mouse trap, and if you've paid any attention to how our federal government names their legislation - the name is typically the opposite of the results. Just look to the "Patriot Act" or "Free Trade" agreements for confirmation, the bigger the lie the more easily it is believed.
Conventional medicine, which is focused on diagnostic tests, drugs, and surgical interventions for most ills, clearly kills more people than it saves. The lethality of the system is in part due to side effects, whether “expected” or not. But preventableerrors also account for an absolutely staggering number of deaths.
According to the most recent research1 into the cost of medical mistakes in terms of lives lost, 210,000 Americans are killed by preventable hospital errors each year.
When deaths related to diagnostic errors, errors of omission, and failure to follow guidelines are included, the number skyrockets to an estimated 440,000 preventable hospital deaths each year!
This is more than 4.5 times higher than 1999 estimates published by the Institute of Medicine (IOM),2 and makes medical errors the third-leading cause of death in the US, right after heart disease and cancer. As reported by the featured article inScientific American:3
“The new estimates were developed by John T. James, a toxicologist at NASA's space center in Houston who runs an advocacy organization called Patient Safety America...
[A] spokesman for the American Hospital Association said the group has more confidence in the IOM's estimate of 98,000 deaths. ProPublica asked three prominent patient safety researchers to review James' study, however, and all said his methods and findings were credible.”

Avoiding Hospitals Can Be 'Good Medicine'

In all, preventable medical mistakes may account for one-sixth of all deaths that occur in the US annually. To put these numbers into even further perspective, medical mistakes in American hospitals kill four jumbo jets’ worth of people each week.4
One of the reasons why I am so passionate about sharing preventive health strategies with you -- tips like eating right, exercising and reducing stress -- is because they can help you to stay out of the hospital. As a general rule, the hospital is a place you want to avoid at all costs, except in cases of accidental trauma or surgical emergencies.
According to statistics published in a 2011 Health Grades report,5 the incidence rate of medical harm occurring in the United States is estimated to be over 40,000 harmful and/or lethal errors DAILY! As John T. James writes in the featured report:
..."Perhaps it is time for a national patient bill of rights for hospitalized patients. All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes."

Overtesting and Overtreatment Are Part of the Problem

Scientific American also quotes Dr. Marty Makary, a surgeon at The Johns Hopkins Hospital and author of the book, Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare. I interviewed Dr. Makary on the topic of medical errors earlier this year.

According to Dr. Makary, James’ estimate “shows that eliminating medical errors must become a national priority.” He also calls for increasing public awareness of “unintended consequences” associated with medical tests and procedures, and urges doctors to discuss such risks with their patients.
Part of the problem is linked to overtesting and overtreatment. And instead of dissuading patients from unnecessary interventions, the system rewards waste and incentivizes disease over health.

According to a report by the Institute of Medicine, an estimated 30 percent of all medical procedures, tests and medications may in fact be unnecessary6 – at a cost of at least $750 billion a year (plus the cost of emotional suffering and related complications and even death, which are impossible to put numbers on).
For the past two years, the American Board of Internal Medicine Foundation, one of the largest physician organizations in the US, has released reports on the most overused tests and treatments that provide limited or no benefit to the patient, or worse, causes more harm than good. Last year’s report warned doctors against using 45 tests, procedures and treatments. This year, another 90 tests and treatments were added to the list.
To learn more, I encourage you to browse through the Choosing Wisely web site,7as they provide informative reports on a wide variety of medical specialties, tests, and procedures that may not be in your best interest.
It’s also important to be aware that many novel medical treatments gain popularity over older standards of care due to clever marketing, more so than solid science... Recent findings by the Mayo Clinic prove this point. To determine the overall effectiveness of our medical care, researchers tracked the frequency of medical reversals over the past decade. The results were published in Mayo Clinic Proceedings in August.8
The researchers found that reversals are common across all classes of medical practice, and a significant proportion of medical treatments offer no benefit at all. In fact, they found 146 reversals of previously established practices, treatments and procedures over the past 10 years.
The most telling data in the Mayo Clinic’s report show just how many common medical treatments are not helping patients at all—or are actually harming them. Of the studies that tested an existing standard of care, 40 percent reversed the practice, compared to only 38 percent reaffirming it. The remaining 22 percent were inconclusive. This means that anywhere between 40 and 78 percent of the medical testing, treatments, and procedures you receive are of NO benefit to you—or are actually harmful—as determined by clinical studies.

Safeguarding Your Care While Hospitalized

Once you’re hospitalized, you’re immediately at risk for medical errors, so one of the best safeguards is to have someone there with you. Dr. Andrew Saul has written an entire book on the issue of safeguarding your health while hospitalized. Frequently, you’re going to be relatively debilitated, especially post-op when you’re under the influence of anesthesia, and you won’t have the opportunity to see the types of processes that are going on. This is particularly important for pediatric patients, and the elderly.
It’s important to have a personal advocate present to ask questions and take notes. For every medication given in the hospital, ask questions such as: “What is this medication? What is it for? What’s the dose?” Most people, doctors and nurses included, are more apt to go through that extra step of due diligence to make sure they’re getting it right if they know they’ll be questioned about it.
If someone you know is scheduled for surgery, you can print out the WHO surgical safety checklist and implementation manual,9which is part of the campaign “Safe Surgery Saves Lives.” The checklist can be downloaded free of charge here. If a loved one is in the hospital, print it out and bring it with you, as this can help you protect your family member or friend from preventable errors in care.

Help for Victims of Preventable Medical Errors

If you or a loved one find yourself a victim of a preventable medical mistake, Dr. Makary suggests connecting with patient communities such as:
  • Citizens for Patient Safety10
  • ProPublica Patient Harm11
Besides that, he suggests:
“Ask to talk to the doctor about that mistake. If you’re not satisfied, write a letter or call the patient relations department. Every hospital is mandated to have this service. They are set up to answer your concerns. If you’re not satisfied with that, write a letter to the hospital’s lawyer, the general council. And you will see attention to the issue, because you’ve gone through the right channels. We don’t want to encourage millions of lawsuits out there. But when people voice what happened, what went wrong, and the nature of the preventable mistake, hospitals can learn from their mistakes.”

An Unacceptable Reality—a Healthcare System That Is a Leading Cause of Death

Medical errors are a large reason why the current, fatally flawed medical paradigm is in such desperate need of transformation. A majority of healthcare workers observe mistakes made by their peers yet rarely do anything to challenge them. A substantial portion of American doctors also suffer from burnout on the job, according to a 2012 study published in the Archives of Internal Medicine.12
Of the nearly 7,300 doctors surveyed, nearly half had at least one symptom of burnout; 38 percent had high emotional exhaustion scores; and 30 percent had high depersonalization scores (viewing patients more like objects than human beings) – twice the rate of the general population of working adults. Clearly, this is yet another piece of the puzzle as to why US medical care is so dangerous.
So what is the solution?
From my perspective there isn't any easy one, other than to simply minimize your interactions with the conventional system, as it has very little to offer anyway when it comes to prevention or treatment of chronic disease. More often than not, conventional strategies in no way shape or form address the underlying cause of your disease.
One of the reasons I am so passionate about sharing the information on this site about healthy eating, exercise, and stress management is because it can help keep you OUT of the hospital. You can use this site to find well-proven strategies that will address most chronic health problems. Please remember you can always use the search engine at the top of every page on the site to review previous articles we have written.
If you have an acute injury, of course you need to seek immediate competent care. However, the very first step for any chronic health challenge would be to follow my Nutrition Plan as that will likely improve, if not completely eliminate, more than 80 percent of your health challenges.
In the unusual case where you are not getting better, it will be wise to seek a health coach or medical professional that can guide you through complicating factors that may be impairing your progress. Typically, the time honored local social networking strategy works well. Ask people in your local community who the best practitioners are for your problem. You can typically find many good referrals from people in independently-owned health food stores. But be sure to get a clear consensus and ask as many people as you can, as choosing a doctor is a very important step, and you want to make sure you get it right.

Basic Tenets of Optimal Health

All in all, leading a common-sense, healthy lifestyle is your best bet to achieve a healthy body and mind. And while conventional medical science may flip-flop back and forth in its recommendations, there are certain basic tenets of optimal health (and healthy weight) that do not change. Following these healthy lifestyle guidelines can go a very long way toward keeping you well and prevent chronic disease of all kinds:
  1. Proper Food Choices: For a comprehensive guide on which foods to eat and which to avoid, see my nutrition plan. Generally speaking, you should be looking to focus your diet on whole, ideally organic, unprocessed foods. For the best nutrition and health benefits, you will want to eat a good portion of your food raw.
  2. Avoid sugar, and fructose in particular. All forms of sugar have toxic effects when consumed in excess, and drive multiple disease processes in your body, not the least of which is insulin resistance, a major cause of chronic disease and accelerated aging.
    I believe the two primary keys for successful weight management are severely restricting carbohydrates (sugars, fructose, and grains) in your diet, and increasing healthy fat consumption. This will optimize insulin and leptin levels, which is key for maintaining a healthy weight and optimal health.
  3. Regular exercise: Even if you're eating the healthiest diet in the world, you still need to exercise to reach the highest levels of health, and you need to be exercising effectively, which means including high-intensity activities into your rotation. High-intensity interval-type training boosts human growth hormone (HGH) production, which is essential for optimal health, strength and vigor. HGH also helps boost weight loss.
  4. So along with core-strengthening exercises, strength training, and stretching, I highly recommend that twice a week you do Peak Fitness exercises, which raise your heart rate up to your anaerobic threshold for 20 to 30 seconds, followed by a 90-second recovery period.
  5. Stress Reduction: You cannot be optimally healthy if you avoid addressing the emotional component of your health and longevity, as your emotional state plays a role in nearly every physical disease -- from heart disease and depression, to arthritis and cancer.
  6. Meditation, prayer, social support and exercise are all viable options that can help you maintain emotional and mental equilibrium. I also strongly believe in using simple tools such as the Emotional Freedom Technique (EFT) to address deeper, oftentimes hidden, emotional problems.
  7. Drink plenty of clean water.
  8. Maintain a healthy gut: About 80 percent of your immune system resides in your gut, and research is stacking up showing that probiotics—beneficial bacteria—affect your health in a myriad of ways; it can even influence your ability to lose weight. A healthy diet is the ideal way to maintain a healthy gut, and regularly consuming traditionally fermented foods is the easiest, most cost effective way to ensure optimal gut flora.
  9. Optimize your vitamin D levels: Research has shown that increasing your vitamin D levels can reduce your risk of death from ALL causes. For practical guidelines on how to use natural sun exposure to optimize your vitamin D benefits, please see my previous article on how to determine if enough UVB is able to penetrate the atmosphere to allow for vitamin D production in your skin.
  10. Avoid as many chemicals, toxins, and pollutants as possible: This includes tossing out your toxic household cleaners, soaps, personal hygiene products, air fresheners, bug sprays, lawn pesticides, and insecticides, just to name a few, and replacing them with non-toxic alternatives.
  11. Get plenty of high-quality sleep: Regularly catching only a few hours of sleep can hinder metabolism and hormone production in a way that is similar to the effects of aging and the early stages of diabetes. Chronic sleep loss may speed the onset or increase the severity of age-related conditions such as type 2 diabetes, high blood pressure, obesity, and memory loss.
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