Introduction

"Doctors Are the Third Leading Cause of Death In the US"

Seems hard to believe, but the most widely circulated medical periodical in the world, the Journal of the American Medical Association (JAMA), published this information July 26, 2000. The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health. According to Dr. Starfield, 225,000 deaths per year are due to causes induced by a physician's activity, manner, or therapy. These deaths include 12,000 from unnecessary surgery; 7,000 from hospital medication errors; 80,000 from hospital infections; 20,000 from hospital errors, and 106,000 from non-error but negative effects of drugs.

These estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.

225,000 deaths per year constitute the third leading cause of death in the United States, after deaths from heart disease and cancer.


Are You Getting the Best Healthcare Possible?

Evidence from a few studies indicates that as many as 20% to 30% of patients in America are receiving inappropriate care.

Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators. More specifically, the ranking of the US on several indicators was:

• 13th for years of potential life lost (excluding external causes) 
  
• 10th for life expectancy at 40 years for females, 9th for males 
  
• 7th for life expectancy at 65 years for females, 7th for males 
  
• 10th for age-adjusted mortality
  

The poor performance of the U.S. health was recently confirmed by a World Health Organization study, which used different data and ranked the United States as 15th among 25 industrialized countries.

Could this poor standing be explained by the lack of medical technology, the lack of able doctors, or the lack of financial resources? 

Lack of technology is certainly not a contributing factor to the U.S.'s low ranking. Among 29 countries, the United States is second only to Japan in the availability of magnetic resonance imaging units and computer tomography scanners per million population. Japan, however, ranks highest on health, whereas the US ranks among the lowest.

Lack of medical education is not a contributing factor. The average American doctor spends 8-10 years in medical training prior to practice in their field of specialty. This is longer than most countries in the world. The quality and intensity of residency training programs cannot be questioned as well.

Lack of financial budget is not a contributing factor. As a percentage of gross national product, the amount of money spend on health care in the US ranks among the top in the world.

There is an obvious problem. What are the missing pieces that contribute to this low standing?