In Overtreated–Why Too Much Medicine Is Making Us Sicker And Poorer (Bloomsbury Books 2007) author Shannon Brownlee takes us through modern medicine, how it’s practiced in the United States of America, details what the experts know is wrong with that, and then offers viable solutions that are taking place today in certain areas.
Brownlee’s well researched and well written book gives the facts that show that drug companies have far too much influence in medicine, that most of their fabled research is not for new drugs, but trying to exploit market share. She shows how they spend more on advertising than research. It convincingly shows how drug companies control doctors, medical journals, medical schools, creates new “Non-diseases,” control government, drains the economy and for the most part does more harm than good.
Medicine is like no other business, according to Brownlee. It is like The Field of Dreams. If you built the field, people will come. If hospital beds or costly, expensive, but not necessarily effective procedures are offered, doctors will supply the patients.
Brownlee demonstrates how fee-for-service medicine and reimbursements for such by private insurers and Medicare are driving up the cost of medicine while at the same time lowering the quality of care.
Doctors are poor judges of what really works in medicine and are poorly trained to determine what works, and the facts that Brownlee marshals showing this allow no room for argument. Brownlee also shows how doctors are at the mercy of drug companies and believe in their lies as much as their patients.
Far too many specialists and not enough primary care physicians are lowering the quality of patient care and driving up costs. Brownlee’s data offers little ground to dispute this.
According to experts Brownlee quotes and references, only 4% of percent of medical treatment is evidence based, and another eleven percent is partially evidence based. The other 85% of medicine is discretionary. Most doctors are unaware of this and even fewer patients.
Hospitals in the United States of America are one of the most dangerous places anyone could be. Over 400,000 patients die a year from wrong prescriptions, wrong doses and bad combinations of drugs. This is more than seven times the number of soldiers killed in Vietnam, more than all the deaths from illegal drugs in all the world–not just the USA.
Hospitals, (even the country’s leading medical school hospitals) doctors’ offices and clinics have a chaotic medical records system than generates errors and death.
This doesn’t have to be the case. Formally the Veterans Health Administration was known for its poor quality of care. In 1994 Dr. Kenneth W. Kizer became Undersecretary for Health (i.e. CEO of the VHA). The VHA was in bad shape.
Kizer implemented VistaA. VistaA was developed in secret by VA doctors and other workers in the 1970’s and ‘80s. VistatA is a collection of nearly twenty thousand different programs, each tailored painstaking over the years to the specifications of nurses, pharmacists, doctors and the other people who must use it. Today a veteran can walk into a VHA clinic or hospital anywhere in the country, and his or her medical records are instantly available to any provider who needs to see them. All drugs and doses given to a patient are scanned into the system and tagged if they are wrong or if there is a bad drug combination. It also lists all procedures, ex-rays and tests. There is no duplication and money and lives are saved.
The VHA has opened 500 clinics nationwide and doubled the number of veterans who are seen by primary care physicians on a regular basis while at the same time saving money and lives.
VistaA is available for free to any hopsital, clinic or doctor’s in the country, meanwhile software companies are trying to market systems that are not compatible with one another. Such is the free market.
This is socialized medicine in the USA and it works and costs 40% of conventional care while delivering much better and safer care. Everyone involved in the system sings its praise, from doctors to nurses to patients.
Doctors left the field in droves during the 90s when managed health care disillusioned both doctors and patients and ultimately raised costs. This was especially true of primary care phsyicians.
Brownlee cites the Mayo Clinic, Kairser Permanente, Group Health of Puget Sound and Inter Mountain Health Services as organizations that providing excellent and inexpensive health care.
Doctors in conventional practices and fee -for-service- providers and hospitals are opposed to this type of better and much more inexpensive health coverage because it cuts into their income.
What Brownlee does not cover, and it is considerably outside the scope of her book is that most all medicine as practiced in the US is simply symptom management, and does not look or seek a cure.
This is partially being addressed by the VHA and the flagship organizations mentioned above. They are offering their patients nutritional advise, lifestyle change suggestions, and personalized follow-up care by nurses and other trained personal.
Everyone serious about their own health, wondering how to protect themselves from the health care system, and interest in reform needs to read this lovingly and meticulously written book.
One item that Brownlee doesn’t mention, but is worth noting is that every time that there has been a strike of doctors in a major city in the USA the morality rate has dropped dramatically.
Beware of your doctor! You may not be aware of it, but he or she is out to kill you, though that’s certainly not their intention.