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Under Construction
You're in Charge of Your Own Health
Samuel Garten, Ph.D., M.S., M.S., CPT, ACPT, NREMT-B and
R. Victor Falkner, M.A., M.S., M.A.L.S.
Preventive Medicine instead of Inadequate
Curative Medicine
Health care consumers cannot assume that they can get sick and then simply go
to their favorite doc and s/he will
find a way to get them back to normal.
The current health care system seems to be inadequate and unreliable. The first national report on the quality of
health care in America (conducted by the Rand Corporation) found that overall participants with various sicknesses
received only 55% of the recommended care.
How is it going to the doctor these days?? You used to think your doc was sensitive to your needs but now it seems
s/he has less and less time for you. It is true that most physicians have been forced by the economics of managed health
care to see more patients in less time than ever before. Maybe you find it takes longer to get an appointment, that your
doc seems rushed, and s/he acts like s/he doesn't even know you or your condition anymore. According to the
National Center for Health Statistics the majority of doctor office visits last fewer then 15 minutes down from
a standard of 20 to 30-minutes. What has been observed - actual doctor - patient face time averages around eight minutes
per visit. During those precious few minutes you attempt to describe how you feel - the doc seems to simply prescribe
another drug for each symptom. S/He may have you taking so many drugs - that when you feel bad - you're not sure
if it's caused by a drug side effect or drug-drug interaction or a symptom of some underlying condition. Now we find -
that doctors get money and other perks (meals, entertainment) from drug companies for prescribing the drug company's drugs
that may be unnecessary, harmful and expensive.
You know - maybe I should try taking better care of myself - I just don't have time and I just know I can count on my doc
being there when I really get sick, even if I have to go to the hospital, to get me cured and back on my feet. It has
been found in a lot of cases that your primary doctor, the person that knows your health history the best, may not even
be the doctor that cares for you in the hospital. In fact, more than half of Americans are concerned that if they become
sick, their health plan (if fortunate enough to have health insurance) will be more focused on saving money than
providing the best treatment (according to the Kaiser Family Foundation/Harvard School of Public Health).
I just know it won't happen to me - I'll get the best care if I go to the hospital; they'll successfully treat my
condition - RIGHT - Well - what are my chances of surviving during a hospital stay???
Here are some of the facts about hospitals: 7,000 deaths per year from
medication errors, 20,000 deaths per year from
other hospital errors, 80,000 deaths per year from infection during your
hospital stay, 106,000 deaths/year from
non-error-prescribing adverse effects of medication. That makes about
225,000 deaths per year as a direct result of
treatment by physicians, whether it is from misdiagnosis of the ailment
or from adverse drug reactions used to treat
the illness. These deaths rank as the #3 killer of people in the USA.
(Dr. Barbara Starfield, JAMA 284(4): 7/26/2000).
One major study found medical errors kill some 44,000 people in US
hospitals each year. Another study puts the number
much higher, at 98,000. Even using the lower estimate, more people die
from medical mistakes each year than from highway
accidents, breast cancer or AIDS. Regarding life-threatening
infections - each year, studies
show, about two million patients or one in 20 - contract an infection
after they are admitted to a hospital. This accounts for half of all major
complications and 90,000 deaths annually (The Wall Street Journal, Personal
Journal, 3/8/2006). More on Adverse Drug Reactions - bad reactions to
prescription drugs cause 1.5 million hospital visits each year and 100,000
deaths, says Dr. Sidney Wolfe of Public Citizen. He adds that many doctors
don't know the side effects (adverse reactions) and the data sheets from
pharmacies are unregulated. His advice: (1)Assume any new symptom is related
to
a drug, even if it bears no relation to why you're taking it. "Most drugs affect
multiple parts of the body," says Wolfe. Some drugs mimic diseases like
Parkinson's, causing tremors. Often. changing drugs or lowering the dose
can prevent lasting damage. (2)Be careful you're not being prescribed medicine
for a condition caused by another drug. Insomnia and depression are common
side effects. Changing the dose and time of day when a drug is taken may solve
the problem.
Public Citizen offers a Web site
, and a comprehensive guide, Worst Pills, Best Pills at bookstores
(Intelligence Report, Is Medicine Making You Sick? by Lyric
Wallwork Winik, Parade 3/12/2006).
These days you're not even sure if
decision to approve a drug for human use is based
on solid evidence of safety and effectiveness - drug companies can hide
critical evidence that doesn't fit in to getting
approval to market another drug. Even with experts hired to advise the
FDA (USA Today Sept 25, 2000) - it has been found
that more than half of these experts hired to advise the FDA on the safety
and effectiveness of medicine have financial
relationships with the pharmaceutical companies that will be helped or hurt
by their decisions. These experts are
making decisions that affect the health of millions of Americans and billions
of dollars in drug sales. With few
exceptions the FDA follows the committees' advice, seldom checking for
possible errors because of their bias.
Even worse - now we find that dozens of
American hospitals offshore-outsource the interpretation of radiologic
tests
(e.g. brain scans) to foreign doctors in places like India.
("More hospitals outsource patient tests," Lindsey Tanner,
The Associated Press, The News & Observer, Raleigh, NC, December 6, 2004).
It has been found that every psychiatric expert involved with writing the
manual on the standard diagnostic criteria for disorders such as depression
and schizophrenia has had financial ties to drug companies that sell
medications for those illnesses. (Psychiatric experts, drug makers tied,
Analysis finds financial links, Shankar Vedantam, The Washington Post, April
20, 2006.)
Gee - I better not take it for granted that the health care system will work
for me. You know - I better find out
how to take better care of myself and convince the people that I love
to do the same. I want them around and would
hate for them to suffer from some long term chronic disease such as
cancer and possibly die a cruel,
premature death.
Although the risk of disease and disability does increase with advancing age but poor health is not an inevitable
consequence of aging. Much of the illnesses, disability and death associated with chronic disease is avoidable
through preventive measures. To a large degree - the major chronic disease killers heart disease, cancer, stroke and
diabetes are an extention of what people do, or not do, as they go about their daily lives. Key disease prevention
measures involve practicing a healthy lifestyle which includes: healthy eating, regular physical activity* and the
avoidance of tobacco use.
You do need a good doctor - well trained and competent. Communication is extremely important (communication is key to
good health care), you want the doctor who will listen carefully to your concerns, answer your questions and explain all
diagnoses and recommendations clearly and fully. You are in charge - you are the customer for whom the health care
people provide a service - understand your condition and the alterative forms of treatment. If you do not understand
something, bring a friend who understands your problem or do some research on your own with books or the Internet.
- branch to selecting a physician and patient responsibilities/clinician responsibilities.
You want a doctor that emphasizes both disease prevention in addition to disease management. Screening for early
detection of diseases should be part of the preventive medicine arsenal.
* - get your doctor's approval before starting a physical exercise program.
Hippocrates, the founder of modern medicine and the author of The Oath of
Medical Ethics wrote that a wise man should
consider that health is the greatest of human blessings.
Taking care of your body is part of most people's moral code regardless of
faith.
COPYRIGHT NOTICE: The content of this web module may not be copied
or used in any manner without permission of the authors.
Don Wright, Palm Beach Post