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Interesting Article in the Journal of the American Medical Association

Reading an article like this makes me very happy I’m a chiropractor.  Conservative care certainly does not have the risks / side effects of medical care.   Enjoy!

Exploring the Harmful Effects of Health Care

Journal of the American Medical Association July 1, 2009, Vol. 302, No. 1

Charles M. Kilo MD, MPH; Eric B. Larson, MD, MPH KEY POINTS FROM THESE AUTHORS:

1) “While various forms of harm resulting from health care are well known, the full nature of such harm and the magnitude of health care’s aggregate adverse health effects deserve more exploration.”

2) “The benefits that US health care currently deliver may not outweigh the aggregate health harm it imparts.”

3) Although there is no doubt that “many health services are effective,” it is possible that the net health harm caused by health care may be greater than the benefits.

4) There is evidence that about one-third of medical spending is for services that don’t appear to improve health or the quality-of-care, and may make things worse.

5) Health care delivery can cause direct adverse physical and emotional effects.

6) Health care delivery can cause indirect harm through excess health care costs, which may compete with other health-producing services.

Examples of direct harm include: A)) Adverse drug effects. B)) Medical errors. C)) Overuse of powerful medications and radiation from computed tomography. D)) Use of treatments that lack sufficient evidence of effectiveness. E)) Use of a treatment before the magnitude of its risks are understood.

(“Encainide and Flecainide [drugs to treat cardiac arrhythmia] were widely used before their harmful effects were elucidated and more than 50,000 individuals were estimated to have died from their cardiovascular effects.”)

(Vioxx [a prescription COX-2 inhibiting pain drug] also killed about 50,000 before its harmful effects were understood by physicians). F)) Medication harm may become apparent only long after widespread use. G)) Data on the safety and efficacy of procedures or devices may be delayed.

7) “End-of-life care provides another example of medical excess. One study found that only 30% of hospitalized patients older than 80 years wanted care to prolong life, but 63% received life-prolonging care such as intensive care unit admissions, intubation, surgery, and dialysis.”

18) “Higher-intensity care generally does not improve survival, and complications of medical care accounted for 1.1 million hospitalizations in 2006, costing nearly $42 billion.”

9) Paradoxically, Medicare patients in higher-cost cities are more likely to die of colon cancer, myocardial infarction, and hip fracture than those in low-cost cities.

10) Unnecessary care can also cause emotional harm, including anxiety from testing or treatment and from creating inappropriate expectations.

11) Unproven screenings, such as the prostate-specific antigen test, remain commonly used, are unlikely to help and may induce harm, including anxiety associated with false-positive results.

12) “Exaggerated fears and ‘medicalizing’ normal phenomena are as harmful as unrealistic expectations and are fostered frequently by marketing hype and sometimes inadvertently by health care clinicians.”

13) Indirect harm occurs when health care expenditures are excessive or of low clinical value.

14) “Health care may cause indirect harm by diverting resources from other determinants of health, such as education, environmental quality, jobs, and income.”

15) “Health care and education increasingly compete in national and state budgets. By diverting money from education, excess health care spending may risk worsening population health.”

16) Health care costs adversely affect household finances. The average family now spends more of its disposable income on health care than on housing, food, or clothing. Because personal finances strongly affect the health of individuals and families, health care’s untoward effect on personal finances may degrade health.

17) US health care spending totaled approximately $2.5 trillion in 2008, accounting for nearly 17% of the gross domestic product.

18) “Government spending on health care diverts funds from other health- producing services.”

19) “In 2007, the federal government spent approximately 28% of its total revenue on health care.” [WOW!]

20) “Medicaid spending accounts on average for approximately 22% of state expenditures, compared with 21% for K-12 education, 10% for higher education, and 8% for transportation.”

21) “Aggregate state spending on Medicaid increased from $89 billion in 2000 to $151 billion in 2007, leaving less money for education and infrastructure needs.”

22) “Although health care’s objective should be to improve health, its primary emphasis has been on producing services.”

23) “The possibility that health care might cause net harm is increasingly important given the sheer magnitude of the modern health care enterprise.”

Thanks to Dr. Murphy for sending this article to me.

Gregg F. Moses, D.C.

chiropractic physician

1800 Forest Hill Blvd.  A8-10

West Palm Beach, FL 33406

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