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Medical Industrial Complex (The Underground Knowledge Series, #3)
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MEDICAL INDUSTRIAL COMPLEX > Medical tests you may not need and procedures that may kill you

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message 1: by James, Group Founder (last edited Jun 07, 2017 02:12PM) (new) - rated it 5 stars

James Morcan | 11187 comments Excerpt from MEDICAL INDUSTRIAL COMPLEX: The $ickness Industry, Big Pharma and Suppressed Cures:

A Reuters report headed ‘Unnecessary repeat cholesterol tests common’ perhaps provides an insight into how the medical system, or machine, works.

Dated July 1, 2013, it advises that one-third of people with heart disease have their cholesterol levels checked more often than guidelines recommend, and reports that research suggests such extra testing may be a waste of time and money if it doesn't lead to improvements in patients' health.

More about those over-the-top cholesterol-level checks later in this chapter. Meantime, that Reuters report got us thinking…

How many medical tests and hospital procedures are unnecessary?

An exhaustive search of published medical documents, mainstream media releases and medical websites reveals the answer to that question is: far, far too many.

Even the medical profession, it seems, admits many medical procedures are unnecessary or over-used; an article dated March 5, 2013 on the well-respected Scientific American site states that the routine use of 130 different medical screenings, tests and treatments are often unnecessary and should be scaled back; that’s according to 25 medical specialty organizations whose findings are reported on in the article.

The writer quotes a 2012 report by America’s Institute of Medicine, which estimated that “in 2009 some $750 billion, or about 30 percent of all health spending, was wasted on unnecessary services and other issues, such as excessive administrative costs and fraud”.

Many of the services deemed unnecessary appear on lists released by Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation aimed at reducing needless medical interventions that waste money and can actually do more harm than good.

The Scientific American article reports that some of the items on the lists are familiar, giving as one example the recommendation that patients should avoid scheduling non-medically indicated labor inductions or cesarean sections before 39 weeks. It states other items are designed to reduce the use of expensive and often unnecessary imaging tests, such as early use of magnetic resonance imaging (MRI) or computed tomography scan (CT) scans for complaints that will likely go away on their own.

The report continues, “Other list items may surprise patients. The American College of Obstetricians and Gynecologists recommends that women 30 to 65 years old who are not at high risk for cervical cancer skip the annual pap smears; the research shows that conducting screenings every three years works just as well”.

Professor Virginia Moyer, chair of the U.S. Preventive Services Task Force, is quoted as saying that mammography use is responsible for around one fifth of the cases of over-diagnosis of breast cancer. “Sometimes a screening leads to a false positive, after which additional tests can expose patients to unnecessary radiation or even biopsies, which carry their own risks,” she says.

“Moyer points out that women have gotten mastectomies to treat small, nonaggressive cancers that were never going to affect them. ‘That’s a huge harm,’ she says. ‘Yet it can be difficult to convince people that it’s okay to simply live with a cancer’.”

In an article dated June 27, 2013, the Huffington Post lists four medical tests you may not need. Quoting a report in the Archives of Internal Medicine, it claims that 28% of primary care physicians admit to over-treating patients, including by ordering potentially unwarranted tests as a precaution against malpractice suits. “Unfortunately, excessive screening can open the door to unnecessary surgeries and medications -- not to mention needless anxiety”.

The four tests Huffington Post readers are invited to reconsider (with the reporter’s abridged comments in quotes) are:

• Electrocardiogram, or ECG, to detect heart abnormalities that can indicate cardiovascular disease – “There's no evidence that an ECG will reduce your risk of having a heart attack, according to…the U.S. Preventive Services Task Force”.

• Upper endoscopy to diagnose conditions like gastroesophageal reflux disease – “ ‘You could be better off... trying proton pump inhibitors for four to eight weeks,’ says Amir Qaseem, MD, PhD, director of clinical policy at the American College of Physicians”.

• Imaging (MRI, CT scans) for lower back pain to pinpoint the source of your discomfort – “MRIs not only don't improve recovery, but can increase a patient's likelihood of having surgery as much as eightfold…(and) may increase your risk for cancer”.

• Bone mineral density scan to screen for osteoporosis – “If the test reveals mild bone loss, you may be prescribed osteoporosis medication, even though evidence suggests it would have little effect…You could be better off…waiting until you're 65 (before being screened)”.

“Whenever a doctor cannot do good, he must be kept from doing harm. –Hippocrates

Hospitals can also be dangerous places, according to another article the Huffington Post ran on April 3, 2013. Quoting the Institute of Medicine, it reports, “100,000 people die every year due to medical error -- more deaths than from car accidents, diabetes, and pneumonia. Far more patients are victims of medical error”.

The report also quotes “a stunning” 2011 Health Affairs article in which researchers apparently discovered that medical errors occurred in one-third of all hospitalized patients. “A separate study of Medicare patients found that one in seven people in the hospital experience at least one unintended harm”.

The Huffington Post report identifies the following as “the 10 common medical errors that can occur in the hospital”: Misdiagnosis, unnecessary treatment, unnecessary tests and deadly procedures, medication mistakes, ‘never events’ (events that should never happen), uncoordinated care, infections (from hospital to patient), not-so-accidental ‘accidents,’ missed warning signs and premature discharge (from hospital).

According to the report, misdiagnosis is the most common type of medical error in a hospital; $700 billion is spent every year on unnecessary tests and treatments; medication mistakes affect 1.5 million Americans annually; ‘never events’ (such as scissors being left in patients’ bodies) happen all too often; hospital-acquired infections, according to the Centers for Disease Control, affect 1.7 million people annually and cause nearly 100,000 deaths every year; and malfunctioning medical devices cause tens of thousands of “accidents” in hospitals every year.
Choosing Wisely, that worthy medical initiative referred to earlier, reports that “three out of four US physicians say the frequency with which doctors order unnecessary medical tests and procedures is a serious problem for America’s health care system—but just as many say that the average physician orders unnecessary medical tests and procedures at least once a week”.

If that admission (by US physicians) has been accurately reported – as appears to be the case given Choosing Wisely’s impressive credentials and reputation for accuracy – then that raises alarm bells. We suspect the estimates are very conservative and the actual incidence of doctors going overboard on medical tests is even higher. Possibly much higher.

Returning to those “unnecessary repeat cholesterol tests” we touched on at the start of this chapter, Choosing Wisely’s summation of cholesterol testing, and the statins used in those tests, is interesting. It reports that Statins are drugs that lower your cholesterol, but if you are age 75 or older and you haven’t had symptoms of heart disease, “statins may be a bad idea”.

The writer points out that many older adults have high cholesterol and their doctors usually prescribe statins to prevent heart disease even though, for older people, “there is no clear evidence” that high cholesterol leads to heart disease or death.

“In fact, some studies show the opposite—that older people with the lowest cholesterol levels actually have the highest risk of death…Statins can cause muscle problems, such as aches, pains, or weakness (and) may increase the risk of diabetes, cataracts, and damage to the liver, kidneys, and nerves”.

This is reinforced by the Reuters report also referred to earlier. It quotes Dr. Michael Johansen, of the Ohio State University in Columbus, who says doctors may order more tests to meet or even exceed performance measures “and because they get paid for running a cholesterol panel”.

The report refers to a US study, led by Dr. Salim Virani, of the Michael E. DeBakey Veterans Affairs Medical Center, in Houston, which tracked over 35,000 people with heart disease, and found all had their LDL (‘bad’) cholesterol under control even though they hadn't recently started taking any new cholesterol drugs.

“Over the 11 months after patients' most recent cholesterol test, one in three underwent a repeat test. Very few of those patients - about six percent - had any changes made to their treatment regimen as a result of the second test…People with additional health problems, such as diabetes or high blood pressure, were most likely to get their cholesterol panel repeated…The average cost of a cholesterol test is about $16…That works out to almost $204,000 in early tests in their study population - not including the cost of both patients' and doctors' time”.

We haven’t devoted much space in this chapter to the unseemly subject of money. (Unseemly in this case because certain factions in the Medical Industrial Complex are clearly creaming it financially while many of its customers/patients are struggling to pay for, or meet, the cost of their healthcare).

However, the Reuters report referred to above reminds us that someone is paying for every doctor’s appointment, test and screening. Throw in the cost of unnecessary tests and repeat tests (around $16 in the case of a cholesterol test) and you begin to understand the amount of money we are talking about. It’s huge!

Thankfully, as we’ve shown, the medical profession acknowledges there’s a problem, but it will be interesting to see what the powers-that-be do about it. We suspect it will be left to us (Joe/Jo Citizen) to keep them honest.

MEDICAL INDUSTRIAL COMPLEX The $ickness Industry, Big Pharma and Suppressed Cures (The Underground Knowledge Series, #3) by James Morcan

message 2: by Lance, Group Founder (new) - rated it 5 stars

Lance Morcan | 2766 comments ABC: Unnecessary antibiotics, medical tests, procedures may harm patients: NPS MedicineWise http://www.abc.net.au/news/2016-03-16...

FORBES: Just Say No: 10 Common Medical Tests That May Do More Harm Than Good https://www.forbes.com/sites/melanieh...

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