Are hospitals always the safest place to be?

Recently, Professor Sir Liam Donaldson, an international patient safety expert has suggested that medical errors account for 1 in 10 hospital admissions. A 2016 study published in the British Medical Journal also suggested that 250,000 deaths per year in the United States were also related to medical error, making it the third leading cause of death, not to mention disability, after cardiovascular disease and cancer.

This was recently reported in an article in the Sydney Morning Herald which also quoted Prof Jeffrey Braithwaite from Macquarie University’s Australian Institute of Health Innovation, who had an interesting spin on the data when he suggested, “it was astonishing that 90% of people receive good care, given the complexities of the health system”.

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The article quoted Prof Sir Liam Donaldson who defined medical errors as avoidable infections, errors involving prescribed medicine such as wrong dosing, not using the treatment for the suggested indications, giving the wrong medicine to the wrong patient, accidents in hospitals; such as elderly people falling over, patients falling out of bed etc, etc and even the much quoted — performing the wrong operation on the wrong patient — often the origin of the good news/bad news jokes, which would be funny if this wasn’t so serious.

Medical therapy causing harm, whether it be medical or surgical therapy even has a medical term: iatrogenesis, defined as “inadvertent and preventable induction of disease or complications by the medical treatment or procedures of a physician or surgeon.

Despite the enormous cost of health care, in many instances, there does not appear to be a profound benefit. The United States, which is renowned as the most expensive medical system in the world, has life expectancy amongst the lowest in developed countries, poor infant mortality rates, and expensive and unrestrained technology.

Across the developed world, we’re now seeing a major move towards super specialisation, where the patient as a whole person is not considered, with spiralling costs for new drugs that often have not shown any clinical benefit over existing and proven treatments. A good case in point here is the very expensive PCSK9 inhibitors which pulverise LDL cholesterol to extremely low levels. Recent three-year data has shown a reasonable reduction in cardiovascular mortality and mortality but not particularly profound when compared with current proven therapy with much more long-term data. The PCSK9 inhibitors cost around $8,000 per year and require either a fortnightly or monthly injection and have only been trialled in very high risk patients.

Modern medicine is now very big business. It is making doctors, pharmaceutical companies, device companies and healthcare providers billions of dollars. But are we really benefiting the consumer?

Whilst ever we continue the “ambulance at the bottom of the cliff” approach to health care and continue to only give lip service to “fixing the fence at the top of the cliff”, nothing is going to change. There is no incentive for doctors to practice preventative, wholistic care to the whole patient and thus prevent this enormous carnage from Western healthcare.

The longest living people on our planet live in communities typically isolated from the modern world with very common similar life habits. They eat a significant amount of fruit and vegetables, they don’t smoke, have a strong sense of family and community, exercise regularly and have a life purpose. Their longevity has nothing to do with Western Healthcare.

But, don’t blame it all on doctors and the associated people working in the medical industry. Modern lifestyles have seen rampaging “Diabesity”, cardiovascular disease and cancer. Most people are stressed out of their brains, often depressed, anxious and sleep poorly. The medical industry is purely trying to combat these problems with the only tools they have been trained to use — the prescription pad and the scalpel. With the evidence I have presented, I certainly believe we need a total re-think about the services provided, possibly starting with the old Chinese approach of only paying doctors if their patients are healthy. Wouldn’t that be a strange thing to do!