Doctors are the Third Leading Cause of Death in the US


Doctors Are The Third Leading Cause of Death in the US


Killing 225,000 People Every Year

The author is Dr. Barbara Starfield of the Johns Hopkins

School of Hygiene and Public Health and she desribes how the UShealth care system may contribute to poor health.


•           12,000 —

unnecessary surgery

•           7,000 —

medication errors in hospitals

•           20,000 —

other errors in hospitals

•           80,000 —

infections in hospitals

•           106,000 —

non-error, negative effects of drugs

These total to 225,000 deaths per year from iatrogenic


What does the word iatrogenic mean? This term is defined as

induced in a patient by a physician’s activity, manner, or therapy. Used

especially of a complication of treatment.

Dr. Starfield offers several warnings in interpreting these


•           First, most

of the data are derived from studies in hospitalized patients.

•           Second,

these estimates are for deaths only and do not include negative effects that

are associated with disability or discomfort.

•           Third, the

estimates of death due to error are lower than those in the IOM report.

If the higher estimates are used, the deaths due to

iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000

deaths per year constitutes the third leading cause of death in the



, after deaths from heart disease and

cancer. Even if these figures are overestimated, there is a wide margin between

these numbers of deaths and the next leading cause of death (cerebrovascular


Another analysis concluded that between 4% and 18% of

consecutive patients experience negative effects in outpatient settings,with:

•           116 million

extra physician visits

•           77 million

extra prescriptions

•           17 million

emergency department visits

•           8 million


•           3 million

long-term admissions

•           199,000

additional deaths

•           $77 billion

in extra costs

The high cost of the health care system is considered to be

a deficit, but seems to be tolerated under the assumption that better health

results from more expensive care.

However, evidence from a few studies indicates that as many

as 20% to 30% of patients receive inappropriate care.

An estimated 44,000 to 98,000 among them die each year as a

result of medical errors.

This might be tolerated if it resulted in better health, but

does it? Of 13 countries in a recent comparison, the



ranks an average of 12th (second from

the bottom) for 16 available health indicators. More specifically, the ranking

of the US


several indicators was:

•           13th (last)

for low-birth-weight percentages

•           13th for

neonatal mortality and infant mortality overall

•           11th for

postneonatal mortality

•           13th for

years of potential life lost (excluding external causes)

•           11th for

life expectancy at 1 year for females, 12th for males

•           10th for

life expectancy at 15 years for females, 12th for males

•           10th for

life expectancy at 40 years for females, 9th for males

•           7th for

life expectancy at 65 years for females, 7th for males

•           3rd for

life expectancy at 80 years for females, 3rd for males

•           10th for

age-adjusted mortality

The poor performance of the US

was recently confirmed by a World Health Organization study, which used

different data and ranked the United Statesas 15th among 25 industrialized countries.

There is a perception that the American public “behaves

badly” by smoking, drinking, and perpetrating violence.” However the

data does not support this assertion.

•           The

proportion of females who smoke ranges from 14% in Japanto 41% in Denmark


in the United States


it is 24% (fifth best). For males, the range is from 26% in Swedento 61% in Japan


it is 28% in the United States(third best).

•           The USranks fifth best for alcoholic beverage consumption.

•           The US has

relatively low consumption of animal fats (fifth lowest in men aged 55-64 years

in 20 industrialized countries) and the third lowest mean cholesterol

concentrations among men aged 50 to 70 years among 13 industrialized countries.

These estimates of death due to error are lower than those

in a recent Institutes of Medicine report, and if the higher estimates are

used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

Even at the lower estimate of 225,000 deaths per year, this

constitutes the third leading cause of death in the US


following heart disease and cancer.

Lack of technology is certainly not a contributing factor to

the US

‘s low


•           Among 29

countries, the United Statesis second only to Japan

in the availability of magnetic resonance imaging units and computed tomography

scanners per million population. 17

•           Japan


however, ranks highest on health, whereas the USranks among the lowest.

•           It is

possible that the high use of technology in Japan

is limited to diagnostic technology not matched by high rates of treatment,

whereas in the US


high use of diagnostic technology may be linked to more treatment.

•           Supporting

this possibility are data showing that the number of employees per bed

(full-time equivalents) in the United Statesis highest among the countries ranked, whereas they are very low in Japan


far lower than can be accounted for by the common practice of having family

members rather than hospital staff provide the amenities of hospital care.

Journal American Medical Association July 26, 2000;284(4):483-5

****  Choose a Doctor

over the age of 50.  That was the last

time medical school taught how to cure and prevent diseases.  After that medical schools went to Managed

Care, meaning they treat a symptom, not a disease.

Health and Wellness Associates

ARchived Articles



Grilled Shrimp and Homemade Cocktail Sauce


Grilled Shrimp and Homemade Cocktail Sauce


  • 2/3 to 3/4 cup chili sauce
  • 2 tablespoons prepared horseradish
  • 2 tablespoons lemon juice, about 1/2 lemon
  • 1 tablespoon hot sauce, eyeball it
  • 2 teaspoons Worcestershire sauce
  • 1 teaspoon celery seed, 1/3 palmful
  • 1 rib celery from heart with leafy tops, finely chopped
  • Coarsely ground black pepper
  • 16 jumbo shrimp, peeled and deveined
  • 2 tablespoons extra-virgin olive oil


Combine the first 7 ingredients in a bowl, and season with pepper, to taste. Refrigerate until ready to use.

Heat a grill pan or grill to medium-high.

Dress the shrimp with extra-virgin olive oil, salt and pepper, to taste, and smoked paprika. Skewer the shrimp onto metal skewers, to ease in turning them, and grill until the shrimp are opaque and firm, about 7 to 8 minutes. Pile the shrimp on a serving platter, and drizzle with the sauce or pass the sauce at the table
Health and Wellness Associates

Archived Recipe


Foods, Health and Disease

Vegetable Oils


  1. Vegetable Oils – Vegetable oils (and margarine, made from these oils) are oils extracted from seeds like the rapeseed (canola oil) soybean (soybean oil), corn, sunflower, and safflower. They were practically non-existent in our diets until the early 1900s when new chemical processes allowed them to be extracted. Vegetable oils are manufactured in a factory, usually from genetically modified crops that have been heavily treated with pesticides. Unlike butter or coconut oil, these vegetable oils can’t be extracted just by pressing or separating naturally. They must be chemically removed, deodorized, and altered. These are some of the most chemically altered foods in our diets. Vegetable oils are found in practically every processed food, from salad dressing to potato chips to mayo to conventional nuts and seeds. Today, people consume, on average, about 70 pounds of vegetable oils throughout the year! Anytime you cook a food, you run the risk of creating heat-induced damage. The oils you choose to cook with must be stable enough to resist chemical changes when heated to high temperatures, or you run the risk of damaging your health. One of the ways vegetable oils can inflict damage is by converting your good cholesterol into bad cholesterol–by oxidizing it. When you cook with polyunsaturated vegetable oils (such as canola, corn, and soy oils), oxidized cholesterol is introduced into your system. As the oil is heated and mixed with oxygen, it goes rancid. Rancid oil is oxidized oil and should NOT be consumed–it leads directly to vascular disease. Trans-fats are introduced when these oils are hydrogenated, which increases your risk of chronic diseases like breast cancer and heart disease. Instead, whenever I cook, I use either butter or coconut oil. Coconut oil is practically 100% saturated, which means it is stable at high temperatures. It also is very beneficial to the health of your body.