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Third leading Cause of Death in America is the American Medical System

By Michael Greger M.D.
September 24, 2017
File under: Health Concerns, Medical Care, Practical Solutions

In my video Why Prevention Is Worth a Ton of Cure, I profiled a paper that added up all the deaths caused by medical care in this country, including the hundred thousand deaths from medication side effects, all deaths caused by errors, etc. The paper’s author concluded that the third leading cause of death in America is the American medical system.

What was the medical community’s reaction to this revelation? After all, the paper was published in one of the most prestigious medical journals, the Journal of the American Medical Association, and authored by one of our most prestigious physicians, Barbara Starfield, who literally wrote the book on primary care.

When asked about the response, Starfield replied that her primary care work had been widely embraced, but her findings regarding harmful and ineffective healthcare received almost no attention.

This inspires the recollection of “the dark dystopia of George Orwell’s 1984, where awkward facts are swallowed up by the ‘memory hole’ as if they had never existed at all.” Report after report has come out, and the response has been a deafening silence, failing to even discuss the problem.

In my video How Doctors Responded to Being Named a Leading Killer, the first report was published in 1978, suggesting about 120,000 preventable hospital deaths a year. The response? Silence for another 16 years until another scathing reminder was published. If we multiply 120,000 by those 16 years, we get 1.9 million preventable deaths, with no substantial effort to reduce the number of deaths.

The Institute of Medicine (IOM) released its landmark study in 1999, asserting that yet another 600,000 patients died during that time when providers could have acted.

Some things have finally changed. Work hour limits were instituted for medical trainees. Interns and residents could no longer work over 80 hours a week, with shifts not be more than 30 hours. That may not sound like a big step, but when I started out my internship, I worked 36 hour shifts every three days, 117-hour work weeks.

When interns and residents are forced to pull all-nighters, they make 36 percent more serious medical errors, five times more diagnostic errors, and have twice as many “attentional failures.” That doesn’t sound so bad, until you realize that means things like nodding off during surgery.

The patient is supposed to be asleep during surgery, not the surgeon.

Performance is impaired as much as a blood alcohol level that would make it illegal to drive a car—but these overworked interns and residents can still do surgery. No surprise there were 300 percent more patient deaths. Residents consider themselves lucky if they get through training without killing anyone. Not that the family would ever find out.

With rare exceptions, doctors are unaccountable for their actions.

The IOM report did break the silence and prompted widespread promises of change, but what they did not do is act as if they really believed their own findings. If we truly believed that a minimum of 120 people every day were dying preventable deaths in hospitals, we would draw a line in the sand.

The IOM could demand doctors and hospitals immediately adopt a minimum set of preventive practices such as, bar-coding drugs to avoid mix-ups. Rather than going on to write yet another report, they could bluntly warn colleagues of public censure for those resisting implementation of minimum practices, attaching stringent sanctions.

For those curious about my time in medical training, you can read my memoir of sorts, Heart Failure: Diary of a Third Year Medical Student.


Michael Greger, M.D., New York Times bestselling author and internationally recognized speaker on healthy eating, has produced hundreds of nutrition videos available at Follow Dr. Greger on Twitter


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