Monday, April 11, 2011

More ... Questioning

I certainly didn't intend to get anyone's dander up with my last post, but it appears that I stirred the proverbial hornet's nest :).

For the record, I do not think that all doctors are evil or even bad people. I don't think that people enter into the medical profession with the intention of keeping people sick so that they can get rich. I'm sure that many people who enter the medical profession do so with a genuine desire to help.

I will say, though, that the stereotype of doctors as being "rich" is pretty prevalent in our society. In fact, when I was growing up, those young people whose parents wished them to have profitable careers encouraged medical school. How many of us have heard that stereotype of the rich doctor in our lifetimes? Be honest.

So, if that's true, if doctors are getting rich, if the medical profession is so profitable ..., but wait ...

Why is the medical profession so profitable? And why do we allow people to profit off of our illness?

A couple of people commented that we need "healers", and I don't disagree with that. There is a time and place for all things, and yes, people do get sick, but I want to point out that I said, "Most doctors ... would be out of work." Not all, by any means. We still need people who understand how the body works, be they doctors, or midwives, or herbalists, or Shamans, because, yes, sh*t happens, and it can be very ugly and very scary.

My point was that, too often, those in the medical profession behave as if they are gods, which they are not. *We*, the American public, are not simple innocent bystanders who have been duped by the medical system, however. We are just as culpable, and we often treat doctors as if they are miracle workers (instead of human beings like the rest of us), and we smoke and drink and live outrageously, believing that doctors can give us new lungs and new livers and new limbs if we mess up the ones we were born with. And if they can't? We blame them for our irresponsible behavior and stupidity.

There are two facts of life in the medical field. The first is that a pregnancy will result in a birth, not necessarily a live birth, but a birth nonetheless. The second is that people die. The only two givens in life are that we are born, and we will die. Nothing else is guaranteed.

But at the risk of causing further offense, I want to say that in my opinion there are worse things than death. Sure, we're living longer ... but at what cost? And are we happier? Are we, as a society, more fulfilled with our longer lifespans than our grandparents ... our great-grandparents ... our distant hunter-gatherer ancestors? In short, in keeping us alive longer (often with expensive drug therapies and "miracle" cures) has the medical establishment really done us any favors?

According to this blog a display at the Rueben Fleet Science Museum on San Diego showed the leading causes of death over the last century and a half as follows:

Leading causes of death in 1850:

1. Tuberculosis
2. Dysentery/diarrhea
3. Cholera
4. Malaria
5. Typhoid Fever
6. Pneumonia
7. Diphtheria
8. Scarlet Fever
9. Meningitis
10. Whooping Cough

Please note that ALL of them were from infectious diseases of which we only vaccinate against two. For the most part, these diseases were eradicted due to improved sanitation - most markedly being the availability of clean water and waste disposal.

By 1900 - fifty years later - only four of those infectious diseases were still in the top ten causes of death, and yet, vaccinations weren't widely used until the 1940s, and then, only two of the top ten killers were made into a widely used vaccine (please note that several of the others had vaccines developed, but none of those vaccines were ever widely used and in fact, use of the choloera vaccine was discouraged due to the severe side effects, and the vaccine for Scarlet Fever was discontinued, when penicillin was discovered).

Top ten causes of death in 1900 were:

1. Pneumonia
2. Tuberculosis
3. Diarrhea
4. Heart disease
5. Stroke
6. Liver disease
7. Accidents
8. Cancer
9. Normal aging
10. Diphtheria

Please note that half of them could be deemed as being directly related to industrialization, and the ninth most common cause of death in 1900 was normal aging. Does anyone today even die from that?

Looking at the causes of death in 2000 would certainly seem to imply that most of us do not die from "normal aging." Apparently, we have bigger problems, namely:

1. Heart disease
2. Cancer
3. Stroke
4. Lung disease
5. Accidents
6. Diabetes
7. Pneumonia/Influenza
8. Alzheimer’s disease
9. Kidney disease
10. Blood poisoning

Please note that the top six could be considered lifestyle related (assuming the fatal accidents are via automobile).

Obviously, I offended some people with my rather terse post about how the medical system is trying to keep us sick, because wellness is not profitable, but I stand by my belief that having an overweight, sedentary, mindless, and unhealthy population is far more profitable than an energetic, thinking, healthy one. And when money is the bottom line, *we*, the people, don't matter.

11 comments:

  1. I think you make a lot of good points, actually. I am a little biased, because I have a sister in law who is a terrible doctor who got into the profession because a) he parents pressured her to do so, because they wanted her to become rich and b) she and her parents are elitists who feel that any other profession would be 'beneath her' because they consider being a doctor the most prestigious profession there is.

    My sister in law HATES being a doctor, and loathes most of her patients. She has no sympathy for their ailments, and is happy to pass a pill along to quiet them. She has very little interest in actually CURING anything her patients have.

    I am not saying she is representative of all, or even any other, doctors. I am just saying that I have watched her over the years and noticed that she acts frighteningly a lot like my old doctor. That's why I don't go to my old doctor anymore!

    I think that many indigenous cultures had it right. They were more in tune with their own bodies, and so therefore they played a very active role in their own healing. A healer or shaman would be consulted for serious things, but families worked together to create salves, tintures and plain-old 'medicine as food' cures for their ailments.

    I feel that if we listened to our bodies more, we could avoid 90% of the trips we take to the doctors (and by 'we', I mean as a society. Personally, I have only seen a doctor twice since giving birth to my last child - once for the 6 week check up, and then for a bladder infection that I could not get on top of on my own...which was really a case of me not listening to my body's need for water in the first place (and my body's warning that I had had too much soda that month - a bad habit I am working on).

    I appreciate that we have specialists and even family doctors, I really do...but if we all only had to visit once a year (or less!) because we paid more attention to our own body's needs and worked together as a family/community to eat better, swap herbs, heal each other, then most people could cut waaaay back on trips to the doctors.

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  2. Your list is misleading. You do not include accidental death. We get in lots of car wrecks and the severity of the accidents at high speeds generally means that your best hope of living, and especially living without being crippled, is to get to a hospital emergency surgery.

    If you look at deaths on the battlefield, you will see that as our ability to get soldiers to modern medical care has increased the death rate has dropped dramatically. Some of these people who would have died may have some sort of crippling injury. But numerous studies have shown (contrary to intuitive thinking) that after a period of adjustment, people who survive these debilitating injuries are just as happy with their lives as prior to the injury.

    I have posted a few times on problems with modern medicine. But it is more a problem of diminishing returns. We have figured out how to fix all the easy stuff.

    Your criticisms are far too strong.

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  3. I think doctors being rich is a thing of the past. Do they earn a solidly middle class income? Sure. All those parents encouraging their kids to become doctors in the last couple decades were operating on outdated information. The average medical student gets a license along with 6 figures of student loan debt. - A lot more than the average loans for say, an engineering degree. Then they pay malpractice insurance for as long as they practice, which is extremely expensive. Then the insurance companies - which you've rightly referred to as scams - chisel away at their net income, while adding absolutely no value to either doctor or patient. I've worked in a physician's office. I know there is plenty wrong with health care in this country, but I don't blame the doctors. A medical practice is no longer a ticket to what is generally considered wealth in this country.

    My higher education was in anthropology; here's what it helps me see about culture. The US is a vast society, without one unifying, uniform culture, or even one unifying government. But there is an overarching base culture, and it encompasses a huge number of people. So large a culture cannot be steered by any one person or organization. Under certain conditions a culture composed of this many people can be nudged in one direction or another by concerted effort, but humans don't possess the ability to dramatically alter so large a culture according to their own desires. Even if the nudging is effective, the culture is too large, amorphous, and dynamic for any nudge to accomplish exactly what the nudger intended. Cultures this big aren't biddable. For this reason, I'm deeply skeptical of conspiracy theories (not that I'm saying your post was a conspiracy theory - this is sort of an aside.) I think what we've got as a culture is a heaping pile of unintended consequences.

    I don't think anyone purposely decided to keep people unhealthy to make more money, and then created the circumstances where that could happen. But that's an economic niche that can be exploited in some cases. The exploiters didn't singlehandedly create that niche though. The niche was an unintended consequence of other factors in the culture.

    Consider your example of shoulder pain and a doctor who took the easy way out. Were his options open ended? Probably not. He was likely constrained, or at least trained, by the HMO's he's contracted with, to see a patient every 15 minutes. If he were so inclined to take a more holistic approach with you, what did his experience with other patients lead him to expect? Had he found, in dealing with other patients in this culture, that people want to do exercises, change their behavior, fix a problem over the long term? Or has he found that people pretty much want some pills to treat the symptoms? Would you do any differently if years or decades of experience taught you that 998 of 1000 patients just want the drugs? Whatever the answers, the doctor wasn't the creator of the culture that leads to this type of interaction, just one participant in it. Could he have done otherwise? Yes. Was his behavior and attitude shaped by his personal and professional experience within this culture? Yes.

    Cultures are always dynamic. To the extent that the US has an overarching culture, it is shaped by hundreds of millions of members, as well as powerful corporations which have access to mass media. It is not under the absolute control of any one person or group. That can be frustrating for those who want to see change. It could also be a hopeful thing for those who want to resist the attempts to nudge us where we don't want to go.

    Also, about dying of old age. My understanding is that old age is no longer a legally valid cause of death. Coroners can't put that on a death certificate. A more medically precise cause of death must be given.

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  4. Actually, russell1200, "accidents" is listed as Number 5 on the causes of death for the year 2000 :).

    And for complete clarity, I should point out that these are not *my* lists. In the first paragraph, I cited my source for the information, which I assume is correct.

    You suggest two ways that our medical institutions are beneficial, and I won't argue with either of them, but I will say that only 2% (about 5 million people) of our population is currently serving in the military. According to a 2004 census report, we have a total of 2.6 million disabled Veterans (which is less than 1% of the population of the US).

    As for car accidents, in 2003, there were six million car accidents in which 2.9 million people were injured and just over 40,000 were killed. If we combine the number of disabled Veterans with the number of car accident victims, we still only have 2% of the population.

    In short, the types of medical interventions you cite are enjoyed by a very small portion of the population, and I would wholly agree that those types of medical miracles are both necessary and appreciated.

    But I'm not talking about life-saving surgeries. I'm talking about every day medical interventions that do nothing to improve our health and everything to increase our dependence on a medical establishment that's simply making a lot of money and not improving health.

    Did you see the comment on the previous post about the c-section rate in the US? It's up over 32% now. My question is, don't you think that the average woman's body is designed to have children without a doctor's help, and perhaps there's something terribly wrong when one in three women who enter the hospital to give birth comes out with a scar across her belly? It certainly hasn't improved our infant mortality rate. The US has a 6% infant mortality and a 32% c-section rate. Iceland has 2% infant moratlity and a 15% c-section rate.

    The birthing "industry" is my biggest criticism, but let's talk about drugs, too, because that's a significant issue. According to data available on the Internet, 45% of Americans take at least one prescription drug per day. Forty-FIVE percent?!? That's 136 MILLION PEOPLE who are taking some kind of prescription medication - EVERY DAY. Both the percentage and the number of medications increase with age. The average number of medications for a person over 65 is three.

    The top five drugs sold in the US in 2009 were Lipitor, Nexium, Plavix, Advair, and Seroquel. Lipitor and Plavix are both used to treat heart disease, and yet, heart disease is still the #1 killer in the US. Nexium is used for gastroesophageal reflux (it's a high powered antacid). Advair is used for asthma and COPD. Seroquel is an anti-psychotic drug.

    Both heart disease and gastroesophageal reflux are diet and lifestyle-related illnesses. The American Heart Association claims that 81 MILLION Americans suffer from some sort of cardiovascular disease. Really? This is normal? Having cardiovascular illness is the normal state of human existence? Or is something else playing out here?

    I'm not saying that doctors don't do miraculous things, but less than 5% of the population has benefitted from medical miracles, like limb reconstruction following a near-fatal car accident. By contrast, nearly 50% of the population is taking at least one prescription drug per day and the top selling prescription drug in the United States in 2009 was a medication used to treat heart disease, and, yet, heart disease is (still) the #1 killer in the US.

    You say my criticisms are too strong. I say, something is very wrong when so many women can't have babies without surgery and the most aggressively treated illness is the one that kills most of us.

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  5. Kate - I don't know what's more sad - to believe that we're all just stupid sheep wandering aimlessly through life with no direction and no leadership and managing to find the same destructive paths or that we're being led by some master schemer bent on our destruction.

    At least with the latter, there's something to fight against. We can't fight simple human stupidity and apathy.

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  6. According to the Department of Labor, eight of the top 10 highest-paying professions were in the medical field. source.

    The 20 highest paying careers according to the US Dept of Labor are (ones in the medical profession are bold faced):

    Surgeon: $181,850
    Anesthesiologist: $174,610
    OB/GYN: $174,610
    Oral and maxillofacial surgeon: $169,600
    Internist: $156,790
    Prosthodontist: $156,710
    Orthodontist: $153,240
    Psychiatrist: $151,380
    Chief Executive Officer: $140,880
    Engineering Manager: $140,210
    Pediatrician: $140,000
    Family or general practitioner: $137,980
    Physician/surgeon, all other: $137,100
    Airline Pilot: $134,090
    Dentist: $132,660
    Podiatrist: $111,130
    Lawyer: $110,590
    Dentist, any other specialist: $106,040
    Air Traffic Controller: $100,430
    Computer and Information Systems Manager: $100,110

    Insurance and education costs included, doc ... er, those in the medical profession still make a great deal of money.

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  7. It's easy and partially correct to blame doctors and insurance companies, but it's not just them. At the same time I've heard many otherwise smart people complaining when a doctor's visit doesn't result in a prescription, even if what sent them to the doctor is an annoying cold best treated with hot liquids and rest. My brother-in-law, who's far from dumb in other ways, figures as long as he takes his medication, he doesn't need to worry about the fact he had a multiple bypass in his 50s or try to get more exercise and less stress. I know someone who insisted on a c-section so she could have the baby "on time for Thanksgiving." And doctors go along with it because it's easier and probably more profitable to go along than to educate. Vicious cycle.

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  8. Teresa - I don't disagree with anything you say. In fact, this is the point I've been trying to make: doctors go along with it because it's easier and ... more profitable to go along than to educate..

    And, also, please note that I said in the seventh paragraph of the original post "We*, the American public, are not simple innocent bystanders who have been duped by the medical system. We are just as culpable, and we often treat doctors as if they are miracle workers ".

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  9. Ahh, why is it so few of us read/understand the INTENT of a post and choose instead to argue our assumptions of what you posted?

    Translation: "I GET it." Thanks.

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  10. Pei pa koa is pretty decent cough medicine (from herbal as I remembered), great non alcoholic medicine, some western cough medicine are more effective, but this is non drowsy.

    You can access info online @
    en.wikipedia.org/wiki/Nin_Jiom_Pei_Pa_Koa
    http://ninjiom.50webs.com/

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  11. Hi Wendy,

    I'm reading back through your blog, it wonderfully written, really sharp and intuitive. I think any society that is built on greed and individualism is doomed to fail eventually. Capitalism has made people fat and unhealthy and capitalist doctors make them selves 'fat' keeping them like that. You may have a minority view amongst your countrymen/people but your views are commonplace in the rest of the world. The 'US' view is becoming something that fewer people want to follow, simpler communities have some of the answers and as you say, we need healers.

    Love froogs xx

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