Many people who are interested in Health Care Reform and Integrative Medicine are familiar with Gary Null’s publication, Death By Medicine, a compilation of various studies on the state of healthcare statistics in the US. This publication, which cites references for estimated costs, death rates, and unnecessary medical events, concludes the alarming statement that American medicine causes more harm than good.
For example, the article listed the following conditions with their estimated rates of mortality:
Adverse Drug Reaction
Medical error
Bedsores
Nosocomial Infection
Malnutrition
Outpatients
Unnecessary Procedures
Surgery-related
Total 7,841,360
The conclusion was, “Our estimated 10-year total of 7.8 million iatrogenic deaths is more than all the casualties from all the wars fought by the US throughout its entire history.” Yikes.
A June 2010 report by the Commonwealth Fund echoed this disconcerting news on the state of US healthcare. The Commonwealth Fund is a private organization advocating for a “high performance health care system providing better access, improved quality, and greater efficiency.” The Fund supports independent research on health care issues and grants to improve health care quality, access, and an international program in health policy.
The 34 page report released in June 2010 read:
EXECUTIVE SUMMARY
The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from the most recent three Commonwealth Fund surveys of patients and primary care physicians about medical practices and views of their countries’ health systems (2007-2009), confirms findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the most recent (2008) U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.
Among the seven nations studied–Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States–the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by the U.K. and Australia. The 2010 edition includes data from the seven countries and incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care.
The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014.
Key Findings were listed for quality of care, access ( we ranked bottom three), efficiency (last place), equity (last place), and quality of life (last place).
Depressing news, isn’t it? Or is it? Despite some of the negative press around doctors and health care, I never cease to be amazed at the absolute dedication and brilliance across all forms of specialties in medicine and the doctor’s dedication to do what is best for the patient.
As a Naturopathic Doctor and Integrative Medical Specialist, I admit the obvious difference in my viewpoint on how to treat certain conditions and the importance of treating the cause, but I still hold the upmost respect for the diagnostics and skills of doctors as a whole. Most Physicians got into the profession of medicine to help people, not to hurt them. That we are not doing well with results, allows us room to make change and the answer is now here at the forefront-integration! This is where integrative medicine, functional medicine, and naturopathic medicine shine. Instead of using the acute care model to treat chronic disease, focus is on lifestyle and diet modifications, epigenetics, and nutrigenomics, supplementation, and mind-body techniques to prevent high cost pathology to begin with.
Here’s my thoughts: with these dreary statistics, maybe lack of access in the past was a self-protective mechanism? Why create more access to a broken down system that isn’t producing results?
With statistics and dis-satisfaction of the current state of healthcare, the day is coming when the focus on prevention, integration, and use of the most evidence based and clinically effective treatments (be them natural or synthetic) will be the norm.
In fact, the CDC even states the following about the leading cause of death, cardiovascular disease, “A healthy diet and lifestyle are the best weapons you have to fight heart disease. Many people make it harder than it is.”
Furthermore, various journals are reporting the same conclusion:
Ford ES, Bergmann MM, Kroger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-1362.
Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-952.
INTERPRETATION: Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.
And, natural products with lower toxicity are being studied more and more. For example, the following was reported on breast cancer and the use of fish oil in a recent article from vitalchoice.
So the results of a very large epidemiological study from Seattle’s Fred Hutchinson Cancer Research Center are making headlines worldwide.
In short, the study showed that women who took fish oil regularly were 32 percent less likely to develop breast cancer over a six-year period (Brasky TM et al. 2010).
The Seattle team surveyed 35,016 postmenopausal women between the ages of 50 and 76, who were taking part in the Hutchinson Center’s Vitamins and Lifestyle (VITAL) study.
The goal was to compare the women’s breast health over the six year study period to their intake of non-vitamin, non-mineral “specialty” supplements.
The nearly one-third reduction in breast cancer diagnoses among fish oil users came almost entirely from a reduction in common ductal tumors … there was no drop in the fish oil users’ risk of the far less frequent lobular tumors.
Invasive lobular carcinomas make up a small portion of all breast cancers. The most common type of breast cancer – ductal carcinoma – begins in the breast ducts.
Further references:
Environ Health Perspect. 2000 Sep;108(9):895-900.
Identification of phthalate esters in the serum of young Puerto Rican girls with premature breast development.
In summary, one must look at what is not working in order to take inventory and sort out what is. Rather than the “throw the baby out with the bath water approach,” how about let’s work with the best skilled team, using everything we have and empowering people to health rather than fighting disease! The new model will also embrace a new mindset!
I try to encompass this vision everyday by empowering my clients to be their own best doctor and giving them information from both sides of medicine; conventional and integrative. I don’t believe there has to be a choide. The answer isn’t ALL in integrative medicine or ALL in conventional medicine, but in what’s best for the patient. As one of my mentors always said, “I don’t fall in love with the theory of medicine, I fall in love with the patient.” Amen to that!
