Critics of “conventional” medicine delight in pointing out how much harm it causes. Carolyn Dean, Gary Null, and others have written extensively about “death by medicine.” A typical statement (from Mercola.com) says:
A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million. Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics. The number of unnecessary medical and surgical procedures performed annually is 7.5 million. The number of people exposed to unnecessary hospitalization annually is 8.9 million. The total number of iatrogenic deaths shown in the following table is 783,936. It’s evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.
To show what’s wrong with this reasoning, let’s substitute “food” for “medicine.”
Death by Food
A definitive review and close reading of medical peer-review journals and government health statistics shows that food frequently causes more harm than good. The number of unnecessary calories ingested is astronomical. The number of overweight Americans is 100 million and continues to rise. Overweight is known to cause hypertension, heart disease and early death, as well as a huge number of other health problems. It is a major factor contributing to diabetes. Attempting to control weight (treating the symptoms instead of the cause) has led to a proliferation of dangerous diets and drugs such as the recent Fen/Phen scandal and the ephedra catastrophe. Unnecessary surgical procedures (again, treating the symptoms instead of the cause) mutilate the gastrointestinal tract of these unfortunate victims of food. Concerns about food lead to anorexia nervosa and bulimia. More money is spent on food than on any other class of products; just think how much more good that money could have done if it were spent instead on valuable research into things like homeopathy, acupuncture, and therapeutic touch! Frequent automobile trips to grocery stores and restaurants cause accidents, depletion of fossil fuels, and contamination of the atmosphere. Thousands suffer from indigestion, constipation, and diarrhea. Certain foods are deadly for those with allergies. Wheat is poison for those with celiac disease. Phenylalanine in foods causes mental retardation in children with undiagnosed PKU. Food may not contain all the vitamins and minerals and trace nutrients required for good health; people who depend on diet and refuse to take supplements can be seriously harmed. If you add up all the years of life lost due to overeating, obesity, allergic reactions, contaminants and toxic chemicals in food, deficiency syndromes, botulism, food-transmitted diseases like hepatitis, salmonella and E. coli, etc. etc. you will quickly come to the conclusion that food is the leading cause of death and injury in the United States. In fact, it is the ONLY cause: no illness has ever developed without previous food ingestion.
Yes, I’m being ridiculous, but I think this points out why you can’t take the doctor-bashers seriously. We don’t give up food just because it can harm people; we don’t give up scientific medicine just because effective treatments can have side effects and because errors can occur.
In the first place, how can they claim medicine does more harm than good by just listing harms? That’s like saying people buy more kumquats than artichokes and just presenting numbers for kumquat sales. You can’t say that’s “more” unless you also know what the artichoke sales figures are.
Most of their numbers are wrong. They are based on extrapolations. Even when they are more or less accurate they are misleading.
Drug reactions? All effective drugs also have side effects. It’s meaningless to count the side effects without counting the benefits. An insulin reaction counts as an adverse drug reaction, but if the patient weren’t taking insulin he probably wouldn’t be alive to have a reaction. Some of the counted drug reactions are transient minor annoyances like a rash. People have iatrogenic infections in the hospital, for instance post-op infections; but without hospitalization and surgery they might have been dead instead of infected.
Iatrogenic deaths? How many of those were of people who would have died many years earlier without modern medical care? How many of those iatrogenic causes were high-risk treatments in high-risk patients who had no other option?
Unnecessary antibiotics, procedures, hospitalizations? Sure, they happen, but judgment about what is necessary is open to debate, and these numbers are ridiculously inflated. Anyway, they’re arguing about death by medicine and they don’t even try to estimate how many of those “unnecessary” treatments led to deaths.
They even list bedsores and malnutrition in nursing homes as harms of modern medicine. I wonder how the incidence of those things compares between home care by untrained family members and science-based care in a well-run institution.
Doctor-bashers use their numbers to argue that alternative medicine is safer. Maybe it is. I suppose not treating at all would be safer still. It depends on how you define “safe.” To my mind, a treatment is not very “safe” if it causes no side effects but lets you die. Most of us don’t just want “safe:” we want “effective.” What we really want to know is the risk/benefit ratio of any treatment.
The ironic thing is that all the statistics these doctor-bashers have accumulated come from the medical literature that those bashed doctors have written themselves. Scientific medicine constantly criticizes itself and publishes the critiques for all to see. There is NOTHING comparable in the world of alternative medicine.
When errors are identified, doctors take actions to prevent them. We are constantly trying to reduce the number of medication errors, the number of unnecessary surgeries, the overuse of antibiotics, etc. It’s one thing to say that more efforts are needed. It’s something else to condemn all of modern medicine because we imperfect humans have not managed to entirely eliminate all errors.
I’ll be the first to admit that there is a great deal wrong with modern medicine, but it makes more sense to fix what is wrong than to reject the whole shebang. Alternative medicine is not a rational alternative; it’s a belief system with a very poor track record.
If the doctor-bashers want to play statistics, how about comparing death rates with modern scientific medicine to death rates with alternative medicine and death rates with no medicine at all. That might really be interesting!
I think they’ve got it backwards. The biggest cause of death is not medicine, but a failure to use medicine. The blame is shared by patients who don’t follow preventive guidelines, by doctors who don’t practice the best science-based medicine, and by all those who reject science-based medicine in favor of belief-based alternatives.
This article was originally published in the Science-Based Medicine Blog.