Before I get into this story can I start by saying, as a doctor myself (albeit a very naturally leaning one), that I’m a huge fan of certain aspects of modern medicine. For instance, if someone who has their hip ravaged by osteoarthritis (and for whom medication or natural supplements just aren’t working) can have the quality of their lives seriously improved by the installation of new hip through surgical intervention. And let’s be frank, the appropriate treatment for a child with bacterial meningitis is probably antibiotics (not Echinacea). And no amount of spinach and broccoli is likely to make much a difference to someone with well-developed cataracts. Here, surgery again is the best option for individual wishing to regain their sight. Even with my generally sceptical attitude to conventional medicine, I am still not blind to the potential good it can do.
However, the ‘miracles’ of modern medicine should not cloud us to the fact that there are many issues with it too. First of all, conventional medicine simply not that effective. Lots of treatment exist which may help, say, reduce cholesterol levels or blood pressure, but have little or no effect on what really matters (such as death rates). Another example of the ineffectiveness of medicine concerns cancer: official statistics show that cancer affects one in three of us and kills one in four despite treatment. These statistics are not exactly a ringing endorsement of the ‘wonders’ of medicine.
The other thing that needs to be borne in mind is that conventional medical treatment is not without risk. Drugs, surgery and plain old human error can all harm individuals and even cost them their lives.
So, today I was naturally interested in the report just released by the Healthcare Commission in the UK which tells us that the NHS is not doing enough to protect patient safety. Although it’s not known for sure the rate at which Britons lose their lives due to medical safety issues, previous estimates have suggested it is up to 34,000 people each year.
Shocking those these statistics may be, they can divert our attention from the fact that medicine can have other hazards for us that don’t necessarily culminate in death. Taken as a whole, ‘adverse events’ may be very common indeed. One way to find out would be to review medical records. The thing is, is this litigious age, there can be a tendency for adverse events not to be adequately recording in the medical notes. Wise to this, one group of researchers decided to get their information from another source ” by attending the meetings, ward-round and case conferences where medical staff tend to have frank discussions about the medical issues at hand.
The results of this research was published in the Lancet medical journal in 1997 . These revealed that almost half (45.6 per cent) of surgical hospital patients had suffered from at least one adverse event. And, perhaps more worryingly, 17.5 per cent suffered ‘serious’ injury (which ranged from temporary physical disability to death).
The hazards of medicine come into sharp relief when one becomes aware of the phenomenon that when doctors go out on strike, deaths rates seem to go down (not up, as you might expect). This seemingly paradoxical effect was most recently reported in the British Medical Journal in the 2000 in relation to a doctor’s strike in Israel . As uncomfortable as these facts are, I think as a profession we doctors need to take them on the chin, and therefore I welcome the Healthcare Commission’s efforts to highlight the issue and help improve patient safety.
However, I want to come back to the fact that medicine is not nearly as effective as its image suggests. And bearing in mind its inherently hazardous nature, I generally urge individuals who are seeking to have long, healthy lives to not put too much of their faith in the hands of the medical profession. It is my belief that learning about and acting on information about healthy lifestyle habits is, generally, the best way to attain and maintain long term well-being. Which, by the way, is why this site exists at all.
1. Andrews LB, et al. An alternative strategy for studying adverse effects in medical care. Lancet 1997 1;349:309-313
2. Siegel-Itzkovich J. Doctors’ strike in Israel may be good for health. BMJ 2000;320:1561