Before reading these articles, let it be clear that I did not write them. Let it also be clear that there would be very few families in Australia that has not needed some sort of medical intervention to save the life/lives of our loved ones. On a personal note, I have had four surgeries, and certainly two of them have been of benefit.
Nonetheless, the following articles suggest that the advances in Pharmaceuticals and surgery are being overused; to our detriment. Therefore, it is imperative that we do not place undue pressure on doctors to prescribe long term use of pharmaceuticals, or to pressure the surgeon to perform an operation that may be no real benefit.
This is where skillful and applicable remedial therapy has a real chance of giving long term pain relief, by addressing the cause of the pain or dysfunction, and correcting the imbalance of muscle length, muscle strength and inflammation; leading to improved neuromuscular function.
To gain an insight into cases where surgery is often unnecessary, read my joint publication with Professor Burkett of the University of the Sunshine Coast - Click Here.
The heading below, 'Death by Medicine' is the work of Dean et al 2003, and suggests that acquiring the services of a Medical professional is not without dangers. However, as stated above, such a statement must be tempered by the fact that many of us would not be here today without medical intervention. What message can be learned from these two seemingly opposed views? Reading further offers insight into the quandary that is faced by patients today........[Only the comments in green are by Maleny Remedial Therapies]
SEPTEMBER 20, 2013 4:52 PM ET MARSHALL ALLEN, PROPUBLICA It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient's death, the numbers come out worse. In 1999, the Institute of Medicine published the famous "To Err Is Human" report, reported that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials. [Reading further will inform why these figures, once disputed, are now so popular]
In 2010, the Office of Inspector General for the Department of Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year – [estimates virtually doubled in an 11 year period]
Null and Dean et al 2003, states that natural medicine is under siege, as pharmaceutical company lobbyists urge lawmakers to deprive Americans of the benefits of dietary supplements. Drug-company front groups have launched slanderous media campaigns to discredit the value of healthy lifestyles. The FDA continues to interfere with those who offer natural products that compete with prescription drugs.
These attacks against natural medicine obscure a lethal problem that until now was buried in thousands of pages of scientific text. In response to these baseless challenges to natural medicine, the Nutrition Institute of America commissioned an independent review of the quality of "government-approved" medicine. The startling findings from this meticulous study indicate that conventional medicine is "the leading cause of death" in the United States.
The Nutrition Institute of America is a nonprofit organization that has sponsored independent research for the past 30 years. To support its bold claim that conventional medicine is America's number-one killer, the Nutritional Institute of America mandated that every "count" in this "indictment" of US medicine be validated by published, peer-reviewed scientific studies. It is not commonly known that more than 700,000 Americans die each year at the hands of government-sanctioned medicine, while the FDA and other government agencies pretend to protect the public by harassing those who offer safe alternatives.
A definitive review of medical peer-reviewed journals and government health statistics shows that American medicine frequently causes more harm than good, with approximately 2.2 million US hospital patients experiencing adverse drug reactions (ADRs) to prescribed medications in a one year period.(1) In 1995, Dr. Richard Besser of the federal Centers for Disease Control and Prevention (CDC) estimated the number of unnecessary antibiotics prescribed annually for viral infections to be 20 million; in 2003, Dr. Besser spoke in terms of tens of millions of unnecessary antibiotics prescribed annually.(2, 2a) Approximately 7.5 million unnecessary medical and surgical procedures are performed annually in the US,(3) while approximately 8.9 million Americans are hospitalized unnecessarily.(4)
The estimated total number of iatrogenic deaths--that is, deaths induced inadvertently by a physician or surgeon, or by medical treatment or diagnostic procedures-- in the US annually is 783,936. It is evident that the American medical system is itself the leading cause of death and injury in the US. By comparison, approximately 699,697 Americans died of heart in 2001, while 553,251 died of cancer.(5)
REFERENCES 1. Lazarou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998;279:1200-1205. 2. http://www.cdc.gov/drugresistance/community/ 3. Calculations detailed in Unnecessary Surgical Procedures section, from two sources: (13) http://hcup.ahrq.gov/HCUPnet.asp (see Instant Tables: 2001 prerun tables: most common procedures) and (71) US Congressional House Subcommittee Oversight Investigation. Cost and Quality of Health Care: Unnecessary Surgery. Washington, DC: Government Printing Office, 1976. 4. Calculations from four sources, see Unnecessary Hospitalization section: (13) http://hcup.ahrq.gov/HCUPnet.asp (see Instant Tables: 2001 prerun tables: most common diagnoses) and (93) Siu AL, Sonnenberg FA, Manning WG, Goldberg GA, Bloomfield ES, Newhouse JP, Brook RH. Inappropriate use of hospitals in a randomized trial of health insurance plans. NEJM. 1986 Nov 13;315(20):1259-66. and (94) Siu AL, Manning WG, Benjamin B. Patient, provider and hospital characteristics associated with inappropriate hospitalization. Am J Public Health. 1990 Oct;80(10):1253-6. and (95) Eriksen BO, Kristiansen IS, Nord E, Pape JF, Almdahl SM, Hensrud A, Jaeger S. The cost of inappropriate admissions: a study of health benefits and resource utilization in a department of internal medicine. J Intern Med. 1999 Oct;246(4):379-87. 5. National Vital Statistics Reports. Vol. 51, No. 5, March 14, 2003
Professor Ian Harris told a meeting of 1900 surgeons this week: "Too many surgeons are performing operations that are likely to do more harm than good. - About half of orthopaedic surgical procedures have no scientific evidence from randomised trials proving they work better than non-operative treatment."
Research showed another 25 per cent are no better than non-surgical alternatives, he said. Yet many of these are still being performed. Professor Harris, of the University of NSW, said ineffective and potentially harmful operations included knee arthroscopy for arthritis, some forms of spinal surgery for low back pain, Achilles tendon repairs, some shoulder arthroscopic procedures, and wrist and ankle fracture fixations.
Despite many studies showing knee arthroscopy was not beneficial for almost all patients with arthritis, many medical guidelines continue to support the procedure for such people. Professor Harris said some surgeons also continued to perform spinal fusion surgery to treat low back pain despite studies showing no benefit over non-surgical alternatives.
A 2012 study of people who had the procedure for low back pain through workers' compensation schemes in NSW found only 3 per cent had returned to pre-injury work duties two years after the surgery. About 70 per cent were still taking strong opioids such as OxyContin in an attempt to manage their pain.
While some surgeons might be unaware of the evidence, Professor Harris said, others were not aware of the strengths and weaknesses of scientific studies and often worked on the basis of "assumed effectiveness". They think "that's what my boss did, so that's what I do, and that's what everybody else seems to be doing", he told the Royal Australasian College of Surgeons annual scientific congress in Adelaide. He said research had also shown clinicians often overestimated the benefits of their work and underestimated the harm of it. One Australian study of more than 300 patients and their surgeons following joint replacements found the doctors were more satisfied with the results than their patients.
"Surgeons think the operation is great," he said. "The actual satisfaction rate for total knee replacement across the board is about 80 per cent, so there is a 20 per cent dissatisfaction rate."
Professor Harris told his peers to be more sceptical of new technology and devices, saying a 2011 study of new hip and knee replacements introduced over five years found none of them were superior to the old ones, and 30 per cent were worse.
"We can do better," Professor Harris said to hundreds of surgeons, urging them to conduct rigorous studies of old and new procedures to protect patients and improve their practice. His warning comes amid mounting evidence of ineffective, wasteful and harmful medical treatments worldwide, and not just in surgery. In January, an international group of leading doctors and academics said up to one-third of medical interventions were now being done unnecessarily, causing physical, psychological and financial harm that could threaten the viability of healthcare systems.
The Australian government is reviewing the Medicare Benefits Schedule to eliminate ineffective medical services taxpayers should not be paying for, so it can fund more effective care. Bruce Robinson, an endocrinologist who is leading the review, said he was preparing to release new recommendations about changes for spinal surgery and orthopaedics in coming weeks. He estimated the government would start acting on these recommendations at the end of 2018.
Professor Robinson said that although many surgical procedures and other health interventions did not have evidence to back them, it was sometimes too costly and impractical to conduct rigorous trials. "We have to accept that some things just feel like they are the right thing to do," he said. "Like taking out an appendix … Do we really need to do a trial that shows that removing a ruptured appendix is better than leaving it there? Of course not. It would probably be unethical to do it."
Philip Truskett, the immediate past president of the Royal Australasian College of Surgeons, said the college was focusing on reviewing surgical procedures and examining data that might point to inappropriate care. He said he could not speak for orthopaedic surgeons, but believed knee arthroscopy rates were falling.
"The message is being pushed. Hopefully things will change," he said. Editor note [A lot of money is involved here, and not all surgeons seem to be as concerned with patient welfare as Professor Harris.]
PLEASE - no surgery on Friday or on the Weekend. "Compared with Monday, the adjusted odds of death [taking into account case mix] for all elective surgical procedures was 44% higher, and 82% higher, if the procedures were carried out on Friday or at the weekend respectively," according to the team, which was led by Paul Aylin, a clinical reader in epidemiology and public health at Imperial College London.
Dangerous: Surgery risks can outweigh benefits. More than one in 10 deaths during or after surgery involved flawed care or serious injury caused by the treatment, a national audit has found. The Australian and New Zealand Audits of Surgical Mortality shows delays in treatment or decisions by surgeons to perform futile surgeries are still the most common problems linked to surgical deaths.
[Repeating what was said at the start of this page - Certainly, it is clear from the amount of research being presented over the last 15 years that patients are advised to take more responsibility for their health. If patients pressure doctors into presenting a quick fix to their health complaints, then there is a greater scope for error, culminating in unnecessary medications and surgeries.
May I suggest we take a leading from the American Academy of Neurology, which is to pursue all conservative therapies before resorting to surgery. It is almost certain, and in fact understated that the amount of injury and death reported on this page by various Government agencies, and Peer Reviewed Medical Journals is correct. If it was not correct, we can be assured there would be a plethora of lawsuits being brought against these researchers, medical journals and doctors. Nonetheless, it must also be remembered that many of these people that died of mistakes, would have died without treatment.
The take home message here would be to approach habitual drug use and surgery as a last resort only. As a therapist that concentrates on alleviating neuromuscular pain, it is my aim to limit unnecessary risk.]