Officially, the big three killers today are cancer, heart disease and stroke. Things are much the same in all developed countries. Cancer kills rather more than 150,000 people a year in the UK. Heart disease kills just under 100,000 a year and stroke kills just over 50,000. Smoking (which kills largely through cancer and heart disease) is reputed to kill around 100,000 people a year. (The official annual death rate in the UK is around 300,000 which rather suggests that someone in charge of Government statistics can’t add up very well but some deaths are, of course, listed as having more than one cause.) The ‘big three’ killers are responsible for the vast majority of deaths. Infectious diseases, the next big group of killer problems, are responsible for relatively few deaths. However, these official figures are misleading for one simple reason: doctors, the people who write death certificates and who decide a patient’s cause of death, rarely admit that they themselves are responsible for killing a patient. Not many doctors are prepared to write ‘Me’ on the line that asks for ‘Cause of death’. And you can’t really blame them. Doctors, just like car mechanics, plumbers, interior decorators and everyone else, hate admitting that they’ve made a mistake. Most, as the old joke goes, just prefer to bury them quietly and hope no one notices. Iatrogenesis (medically induced illness) does not officially exist as a cause of death. But every doctor with more than half a brain knows that many of the patients listed as dying from ‘cancer’ or ‘heart disease’ or ‘stroke’ or ‘pneumonia’ (or whatever else) died not because of an uncontrollable, untreatable disease but because a doctor, or a group of doctors, working alone or together with a nurse, or an entire hospital, screwed up. However, doctors are in such denial that iatrogenesis is not an official (or even an unofficial) medical speciality. It’s as though heart disease were not a recognised speciality. Through a toxic mixture of hubris and self-denial, doctors underestimate the incidence, significance and consequences of iatrogenesis and the dangers of overprescribing prescription drugs. Despite all the evidence that exists iatrogenesis remains officially unrecognised as a problem. Why? Simple. To recognise it would be economically and professionally inconvenient.
Nevertheless, medical journals do occasionally publish articles in which attempts are made to estimate the number of people killed by doctors. There are never any precise figures because doctors don’t put themselves down on the death certificate as the cause of death.
But objective assessments make it pretty clear that doctors are, without a doubt, a major cause of disease, injury and death. Doctors kill a thousand times more people than terrorists, murderers or criminals. Far, far more people are killed by doctors than die in road accidents or train or aeroplane crashes. Doctors kill people by doing the wrong thing, by not doing the right thing or by not doing anything.
There are many ways to kill a patient by mistake. And as procedures become more complicated, and drugs become powerful, so the number of ways in which doctors kill patients grows, grows and grows. The quality of medical care is now so low that I seriously doubt if one in every two consultations results in treatment that is timely, well-chosen, efficacious and genuinely certain to do more harm than good.
To a certain extent, things have always been this way, of course.
Doctors have always killed patients. Most of them don’t do it on purpose. The number of Dr Harold Shipmans around is, thankfully, quite small. But a patient killed by a mistake is just as dead as a patient who has been deliberately killed.
What really should worry us all is that things are constantly getting worse.
They are getting worse for several reasons. One reason is, undoubtedly, that drugs are more powerful and procedures more complicated. But the main reason that they are getting worse is that doctors are becoming increasingly incompetent.
The big question is, of course, how many patients do doctors actually kill? How many patients end up in coffins instead of going home because doctors screwed up?
Difficult question.
But I can guarantee one thing: it’s far, far more than you thought it was. Doctors kill far more people than even the most pessimistic observer would imagine. Doctors are now a major cause of illness and death. Study the statistics and it becomes clear that throughout the ‘civilised’ world doctors are right up there alongside heart disease and cancer as the big-time killers of the 21st century. A study in Australia showed that 470,000 Australian men, women and children are admitted to hospital every year because they have been made ill by doctors. The figures also show that every year 280,000 patients who are admitted to hospital suffer a temporary disability as a result of their health care. Around 50,000 of these suffer permanent disabilities. A staggering 18,000 Australians die annually as a result of medical errors, drug toxicity, surgical errors and general medical mismanagement. What a terrible indictment of the medical profession.
In America, the official death rate from medical ‘accidents’ is running at around 200,000 a year. When doctors from the Harvard School of Public Health studied what happened to more than 30,000 patents admitted to acute care hospitals in New York they found that nearly 4% of them suffered unintended injuries in the course of their treatment and that 14% of the patients died of their injuries. This survey concluded that nearly 200,000 people die each year in America as a result of medical accidents. This means that more than four times as many people officially die from injuries caused by doctors as die in road accidents. I believe the real figure is probably considerably higher than this and there can be little doubt that many of the injuries and deaths are caused by simple, straightforward incompetence rather than bad luck or unforseen complications.
Figures in Europe are no better. In my book Betrayal of Trust I revealed that one in six British patients in hospital is receiving treatment because he or she has been made ill by doctors.
Unfortunately, there are no official figures for the number of people killed by British doctors. Doctors in the UK don’t accept that they ever make mistakes. (Although when I was last invited onto a radio programme to talk about the fact that one in six patients in hospital are there because doctors have made them ill, a doctor representing the medical establishment came into the studio to defend his profession and argued that patients could take comfort from the fact that the figures showed that five out of six hospital patients were not sick because they had been made ill by doctors.) Coronary bypass operations are immensely popular among heart surgeons (and extremely profitable) but a major study conducted in Europe showed that many patients who don’t have surgery live longer than those who do. Twenty years ago, American surgeons performed 350,000 coronary bypass operations and charged $14 billion for them. When one researcher studied 300 patients who’d had bypass operations at several hospitals in California he discovered that 14% of the patients would have thrived as well without surgery as with it while another 30% were borderline. Around 50% of lower back disc operations and up to 70% of hysterectomies are probably unnecessary. In America the death toll from unnecessary surgery alone has been estimated to be as high as 80,000 patients per year.
Around half of all the ‘adverse effects’ associated with doctors are clearly and readily preventable and are usually a result of ignorance or incompetence or a mixture of both. The rest would be preventable with a little care and thought (and some better research).
Most people recognise the damage that other doctors can do but like to think that their doctor is an honourable exception. This is entirely understandable. After all, we all like to think that our relationship with our own doctor is special and that we have chosen someone reliable and knowledgeable to look after us. We like to think of our doctor as a personal and family friend. We all need to put some trust in the health care professionals upon whom we rely when we are ill.
But it is just as dangerous to assume that your doctor is entirely safe, sensible, knowledgeable, competent and error free as it would be to assume that you do not need to take care when driving, on the spurious grounds that road accidents only ever affect other people.
The underlying problem is that even good, kind, conscientious doctors – who are honest and honourable, who care about their work and who do their very best for their patients – can still make people ill. And can still kill people.
It has always been diagnostic skills which have differentiated between the good doctor and the bad doctor. Treating sick people is easy. If you are a doctor and you know what is wrong with your patient you can look up the correct treatment in two minutes. It’s diagnosis that is difficult and since the days of cupping and leeches it has been diagnostic skills which have differentiated between the good doctor and the bad doctor. Sadly, doctors have handed that particular art over to machinery – with disastrous results. Modern doctors are now useless at making diagnoses. Young, newly trained doctors are the worst – partly it is true because they are inexperienced, but mainly because they have been trained to rely on tests and investigations rather than on developing their own diagnostic skills. One in four cancer cases is missed simply because doctors don’t know what to look for, don’t know what questions to ask and don’t listen when patients hand them clues that should really start alarm bells ringing. It’s hardly surprising that more and more patients are described as having a ‘mystery illness’.
All this is terrifying.
For if the doctor doesn’t make the right diagnosis then it doesn’t matter how many wonderful drugs he has at his disposal.
When researchers examined the medical records of 100 dead patients who had been shown by post-mortem to have had heart attacks they found that only 53% of the heart attacks had been diagnosed. What makes this even more alarming is the fact that half the patients had been looked after by experts in heart disease. A study across 32 hospitals which compared the diagnoses doctors had made when treating 1,800 patients with the diagnoses made after the patients had died (and could be examined more thoroughly) showed that doctors had an error rate of nearly 20%. When 80 doctors were asked to examine silicone models of female breasts they could only find half the hidden lumps. That’s a 50% failure rate even though the doctors knew that they were being tested and observed. Another study showed that doctors had missed diagnoses in dying patients up to a quarter of the time. Experts concluded that one in ten patients who had died would have lived if the correct diagnosis had been made. Yet another group of researchers revealed that in two thirds of patients who had died, important, previously undiagnosed conditions were discovered in the post-mortem room. A report published after pathologists had performed 400 post-mortem examinations showed that in more than half the cases the wrong diagnosis had been made. The authors of this report said that potentially treatable pathology was missed in 13% of patients; that 65 out of 134 cases of pneumonia had gone undetected and that out of 51 patients who had suffered heart attacks doctors had failed to diagnose the problem in 18 cases.
Some years ago it was estimated that inexperienced doctors working in casualty units killed at least one thousand patients a year. Now that doctors are even less experienced, and even more poorly trained, I suspect that the figure is far, far higher than that.
When it comes to disorders of the mind (the big growth industry of the 21st century) doctors are even more incompetent. A study of 131 randomly selected psychiatric patients showed that approximately three quarters (75%) of the patients had probably been wrongly diagnosed. (It is always difficult to be precise about mistakes in psychiatry because it isn’t a science at all.) In many cases patients are diagnosed as having – and are then treated for – serious psychiatric problems when their symptoms are caused by drugs they have been given for physical problems. Whole wards full of patients have been diagnosed, treated and classified as schizophrenic when in fact they were suffering from side effects produced by the drugs they had been given by prescription happy doctors. The idea that anyone would describe psychiatry as a science is utterly absurd.
Nothing that psychiatrists claim as ‘fact’ can be proved by any means recognised by scientists; there are no proper controls and if an experiment is repeated it rarely produces the same result. The ultimate absurdity is the fact that psychiatrists claim that only they are fit to judge the effectiveness of their recommendations.
Psychiatry is black magic masquerading as science.
The result of the fact that the psychiatric profession has sold itself to the pharmaceutical industry is that patients are now often treated for conditions that sane people would not regard as illnesses.
Patients who feel guilty, worried, or concerned about the state of the world are likely to find themselves labelled and drugged for life.
Those who are too timid, too reserved, too kind (a condition now regarded as akin to weakness) too gullible or too anything are likely to find themselves filled to the gills with some poisonous but enormously profitable concoction. Psychiatrists never suggest that patients might live with their symptoms, or (heaven forbid) find some non-pharmacological solution. There is never any discussion of side effects or any suggestion that the long-term consequences of therapy might turn out to be worse than the long-term consequences of the disorder. Psychiatrists and drug companies have been so successful in convincing politicians of the effectiveness of their so-called ‘speciality’ that virtually all the money available for the care of mental patients is now spent on pills (even though there is invariably no evidence to show that they do any good at all). Institutions caring for the mental ill were closed down (using the excuse that they were politically incorrect) and the patients who needed care were dumped into the community, to wander the streets. It’s difficult to blame drug companies for this sad state of affairs (they exist, after all, solely to make money) but it’s easy to blame psychiatrists.
The sad truth is that psychiatry is the greatest con on earth.
Psychiatrists and general practitioners have become increasingly enthusiastic about drug therapy in recent decades. They claim that they can treat a wide range of disorders with psychotropic drugs and so a goodly portion of the nation now regularly gulps down happy tablets. The result is that the incidence of mental health problems is increasing. Officially, one in two people in Britain is incurably mentally ill. (Despite this the number of beds available for mental health patients is constantly shrinking. This is, of course, because the mentally ill make an ineffective lobby.) Psychiatry isn’t a science at all and it isn’t even an art. It’s more of a confidence trick; a collegiate confidence trick with pretensions of grandeur. The simple fact is that there is no evidence that there is any such thing as ‘chemical imbalance’. Ask any psychiatrist about this and he will agree that ‘chemical imbalance’ is a still unproven theory. It’s never even been properly tested so how could it ever be proven? So how can psychiatrists and drug companies possibly treat the problems which they claim are caused by ‘chemical imbalance’?
The bald truth is that psychiatry is no more a science than witchcraft.
It is a perfect example of pseudoscience running riot. Cinema legend Samuel Goldwyn was right when he said that anybody who goes to see a psychiatrist ought to have his head examined. A big part of the problem lies in the fact that modern medical thinking is based upon the Cartesian principle that the mind and the body can be treated separately. The modern clinician still does not see the mind and the body as a single unit (that is why orthodox practitioners don’t believe in holistic medicine) and this leaves the way open for psychiatrists to play around with the human mind.
You may be surprised to learn that psychotropic drugs (widely promoted by doctors who have close links with the companies making them) have no provable, useful effects. They do, on the other hand, have massive and provably serious bad effects (such as death). How are these drugs supposed to work? That’s not exactly known. It is, however, known that they flatten the emotions and cause a numbing and dullness of the mind which make patients taking the drugs less aware of their problems. Patients become so numb that they don’t notice the nasty world around them. These drugs don’t cure mental symptoms; they simply cover them up. The best patients can hope for is that the side effects aren’t too bad. And the damned psychiatrists are constantly finding new excuses to prescribe (and to add to drug company profits). So, for example, they even prescribe drugs for people who are shy. They call it ‘Social Anxiety Disorder’ and there is a powerful drug for it, with appropriately powerful side effects. There are drugs for all shades of neuroticism. Heaven knows what sort of future mankind has when you remember that all great art and all great inventions were the result of neurotic minds.
Psychiatrists have a rapidly growing dictionary of labels which they can apply to their patients. The big problem with their labels (I’m talking about diseases such as ADHD and schizophrenia) is that none of these diseases (none) actually exists. Not in the way that pneumonia and tuberculosis exist, with real signs and symptoms.
Psychiatric disorders are created and agreed upon by groups of psychiatrists who meet together and think up new disorders. I’m not making this up. There is proof that diabetes exists. There is scientific evidence to show that heart disease is real. But there is no proof to show that any psychiatric disorders really exist. They are labels which are often created merely to find a market for a newly invented drug. Diagnoses are made, and treatment begun, without any evidence that a patient has anything wrong that can be treated.
Drugs are prescribed in the vague hope that they will produce an improvement. Most of the time they produce a change – but the change is more likely to be a deterioration than an improvement.
A vast variety of entirely non-existent diseases is becoming forever commoner, taking up a constantly increasing part of a constantly decreasing health service budget. Many psychiatrists claim (apparently meaning it) that we are all mentally ill and that we all need treatment. This is not a social comment so much as an excuse to hand out prescription drugs which do more harm than good. (My own experience of medical colleagues who are psychiatrists is that they are all barking. The Brazilian psychiatrist who shot a patient because ‘they all come in here and just want to think about themselves, no one thinks about me’ wasn’t that exceptional. Psychiatrists are pretty screwed up people; deviants and neurotics. That’s why they become psychiatrists. All the psychiatrists I’ve known have been as mad as hatters. I suspect that they became psychiatrists because they couldn’t deal with the logical science of real medicine. They chose, instead, to drift into the world of psychiatry where nothing is written down in black and white, and where judgements are made subjectively rather than objectively.
Many psychiatrists have such close links with drug companies that they promote drug therapy for all with missionary zeal. Whenever psychiatrists make a suggestion one only has to ask ‘Who benefits?’ to see what is going on. In 2010 a proposal to screen the entire population of Britain for depression was abandoned, possibly because it was realised that a virtually bankrupt nation could not afford to conduct an inefficient but incredibly expensive survey into mental health, possibly because a civil servant somewhere realised that the cost of providing anti-depressants would push the nation further into bankruptcy and possibly because someone realised that the nation was so despairing that a survey would probably show that the whole country was depressed. (That, I am sure, was the plan.
Just think of the profits to be made out of prescribing antidepressants for everyone in the country.) Drug companies concentrate on me-too drugs, the moneymakers, ignoring diseases that affect the Third World and ignoring rare diseases. They want long-term medications for long-term problems and psychiatric drugs are the most profitable. Drug companies love mental illnesses. Patients don’t die from them. They live long, healthy lives and so, once diagnosed, can be given drugs for decades. Patients never get better and so the drug therapy is eternal. These disorders are self-reinforcing. When told they are ‘mentally ill’ people tend to become anxious, introspective, less interested in the outside world and more self-obsessed. Doctors talk about exogenous and endogenous depressions but the only real difference between the two is that in one the cause has been found and in the other it hasn’t. The two varieties of depression are basically identical. Both are caused by stress.
So much money is spent on utterly worthless psychotropic drugs that there isn’t any money left for the long-stay hospitals that the vulnerable and the unstable desperately need. Community care doesn’t work, and everyone knows it doesn’t work, but it’s cheap.
Very cheap. The NHS has dumped thousands of mentally ill patients on the streets. It has also put a huge and intolerable burden on the families of the chronically sick. Sad though it may be there will always be some people who need to live permanently in institutions and who benefit from attending workshops and properly run day centres. The State has abandoned the mentally ill because they don’t vote as a group, don’t employ lobbyists, don’t have support from television celebrities and aren’t considered photogenic.
The sad truth is psychiatry is a nonsensical speciality. And all its treatments are unproven rubbish. Aversion therapy, behaviour therapy and hormonal rebalancing are nonsense. Drug therapy is as dangerous, in its way, as psychosurgery. Diagnoses are made without evidence existing. Treatment is prescribed in a purely subjective way. And the diagnostic symptomology is so vague and far reaching that I could, without much difficulty, find some definable mental illness in every person in the UK.
Some people make friends when they travel. I have an acquaintance who can’t pop into the local supermarket without finding new chums to add to his formidable Christmas card mailing list. If he goes for a walk in a deserted park he will somehow come back with half a dozen new pals. I’m not good at making friends. Too shy, I suppose. But this means that I am suffering from quite a number of mental disorders. According to the official definitions and symptom lists I reckon I am suffering from autism, ADHD, ODD, obsessive compulsive disorder and several dozen other psychiatric disorders. And I don’t mind betting that you are too. Today, just about every human emotion or behavioural pattern is a psychiatric disease;
an official medical diagnoses. Shyness, homesickness, suspicion, having ups and downs and distractibility are all diseases. There are special drugs for all these disorders. New diseases soon likely to be classified include: ‘apathy disorder’, ‘compulsive shopping disorder and ‘Internet addiction disorder’. If your doctor says you have one of these then you’re officially mentally ill. Lack of self control and impatience are now officially recognised as diseases. Welcome to the worldwide club. There’s a drug with your name on it. And a long-term sick note just a scrawl away. Many of the new diseases relate to children. There’s a good reason for this. Once a child is started on a drug there are likely to be decades of prescribing (and profits) ahead.
How do psychiatrists define new diseases? Easy. A bunch of 27 of them (most of them with links to drug companies) simply decide what is officially a disease. Psychiatrists actually have meetings to vote on whether diseases exist or not. Homosexuality used to be a disease, but political correctness pressures resulted in a vote deciding it was not. That’s what psychiatrists call ‘science’. Thanks to their efforts, everyone can be diagnosed as mentally ill and everyone diagnosed will be treated. Providing drugs for mental illness is an industry worth a third of a trillion dollars a year. It’s hardly surprising that new mental diseases come thick and fast. There is no evidence that any of the drugs prescribed can ‘cure’ anything (partly because none of the diseases being treated can be properly diagnosed or specifically identified) but there is plenty of evidence showing that the drugs being used produce a huge variety of known, and sometimes deadly, side effects.
There are now nearly 400 psychiatric medical diagnoses in the official lists. There are specialists and drugs for all these diagnoses.
And not one of the 400 has been tested or proven to exist. If you ever have a dull moment in your life get yourself a copy of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders and flick through it looking for the daftest diseases. It’s hardly surprising that no one is now truly normal. These diseases aren’t found in a laboratory or identified by epidemiological studies: they are created in marketing departments. And why not? Drug companies can make 500,000% profit on the drugs they sell.
Psychiatrists, apparently blind to what is going on around them, seem deliberately unaware that we live in a society where toxic stress is endemic and the human consequences inevitable. ‘Our contemporary Western society, in spite of its material, intellectual and political progress, is increasingly less conducive to mental health, and tends to undermine the inner security, happiness, reason and the capacity for life in the individual,’ wrote Dr Erich Fromm. ‘It tends to turn him into an automaton who pays for his human failure with increasing mental sickness, and with despair hidden under a frantic drive for work and so-called pleasure.’ Drug companies use marketing experts to persuade well people they are ill and need to take a pill, preferably permanently. Patients’ groups are set up and funded. In the UK, one of the big groups catering to autism sufferers takes drug company money. Journalists are bought and diseases created. In the business this is called disease mongering. It’s big business. Research is funded by drug companies and not surprisingly, the research with embarrassing or inconvenient results never gets published. Medical journals (which rely on drug company advertising) are often bent as are journalists.
The medical community is corrupt and up to its eyes in drug company money. When TV programmes want to speak to a doctor about drugs they invariably contact one of the ‘hired hands’ recommended by the drug companies. Doctors who tell the truth are banned and marginalised. Governments say they can’t find any doctors without conflict of interest to sit on committees assessing drugs. (Well, I’m here. An acknowledged expert on drugs and iatrogenesis and a licensed, registered medical practitioner. But, surprise, surprise, they never approach me.) Doctors go to conferences run and or paid for by drug companies. No doctor who is likely to oppose or question drug therapy will be invited to speak.
(The last time I was invited to speak to NHS personnel I was quickly uninvited when my name was spotted on the list of speakers.) Many of the commonest problems are behavioural conditions associated with children. These are diagnosed subjectively and can increasingly be diagnosed by nurses and teachers rather than by psychiatrists. The doctors are too busy signing the prescriptions to bother with actually seeing patients. ADHD, autism and Asperger’s syndrome will all become default conditions soon. Their incidence is increasing so absurdly fast that children without one of these conditions will be regarded as abnormal and will, of course, need treatment. Autism became popular because it’s a damned sight more convenient for drug companies to create a new disease than it is to accept that children can be brain damaged by vaccines (another drug company product). For drug companies it is a double whammy.
They avoid the vaccine lawsuits. And the new diagnosis enables them to sell treatments for a newly created and non-existent disease.
Parents are often enthusiastic and don’t seem to care that the evidence shows that a walk in a park is better than drugs for children with ADHD. Pushy, expectant parents with not very bright children temper their disappointment by accepting that their children have a new and fashionable disorder. A doctor’s note showing that a child has ADHD enables him and family to jump to the front of the queue at theme parks, and to jump the queue for school lunch. It’s hardly surprising that one in 20 in Britain has ADHD. And yet the symptoms are so vague that I doubt if there is a child in Britain who doesn’t have it. The more intelligent doctors who prescribe drugs for ADHD and other entirely imaginary diseases know damned well that the whole thing is a scam: useless products for imaginary disorders;
non-existent solutions for non-existent problems. I suspect that many patients know it’s emperor’s new clothes stuff; the intelligent ones anyway. They go along with the con because it is easier to accept (and to tell their friends and relatives) that their child is rude and badly behaved because he has a brain disease, rather than because he is, well, rude and badly behaved. And poorly brought up. And they get extras too. Sympathy, care, even extra money. A disabled sticker for the car. No need ever to wait in queues. Only the stupidest doctors, together with social workers and school teachers of course, are unaware that it is all a scam; an expensive, dangerous but massively profitable scam.
New diseases are being invented almost daily. There’s another exciting disease around now. It’s ODD (Opposition Defiant Disorder).
The symptoms are an absence of respect for authority and anger management issues. Those with ODD are surly, defiant, uncooperative and hostile towards authority figures. Psychiatrists believe that ODD affects between 1% and 16% of all school age children (nice of them to be so precise).
I’ve no doubt that many of these children need help. But some need help to deal with real problems (deafness, low IQ etc.) and most need help to deal with the overwhelming stress and pressure in their lives.
I can’t prove my theory. But they can’t prove any of theirs either.
And I have two advantages. First, my theory is not based on commercial expediency. I profit not at all from it. The psychiatric profession cannot say the same. Second, I am prepared to match my track record at spotting dishonesties and medical trickery against that of any ten psychiatrists the medical profession wishes to offer.
So, what the hell is really going on? Is all this just about profits?
Well, here’s an interesting quote from the National Association for Mental Health: ‘Principles of mental health cannot be successfully furthered in any society unless there is progressive acceptance of the concept of world citizenship. World citizenship can be widely extended among all peoples through applications of the principles of mental health.’ And here’s a quote from Dr G Brock Chisholm, psychiatrist and co-founder of the World Federation of Mental Health: ‘To achieve world Government, it is necessary to remove from the minds of men their individualism, loyalty to family traditions, national patriotism and religious dogmas.’ Ah yes, of course.
The bottom line, of course, is that since the psychiatrists and the drug companies decide what mental illness is and is not, the incidence of mental illnesses will continue to soar. The lunatics have truly taken over the asylum. Psychiatry enables doctors to offer specific solutions (and treatments) for all the symptoms and signs they cannot explain any other way. It isn’t patients who are the nutters, it is the doctors, nurses and administrators who believe this mumbo jumbo.
No one ever does anything about any of this. The incidence of iatrogenesis is the fastest growing problem in healthcare but most members of the medical establishment deny that it exists and the rest just close their eyes and hope that no one notices. Everything is going to get worse before it gets better.
Modern medical education is often lamentable and frequently appalling – with lecturers too often teaching medical students about organs and tissues rather than living patients. Students are taught plenty of facts but very little vision. They are given directives but never directed. The whole programme seems designed to test a student’s ability to memorise information (some of it easy to look up and much of it purely arcane and irrelevant in 99.99% of real life) instead of teaching students how to develop their instincts and their innate healing skills. Modern medical education is dangerously narrow and unimaginative; designed and managed by people who are so deep inside the establishment that they might as well be living on Mars (or Venus). The real world, the real lives of patients, the real problems people face are all dismissed or ignored. The problem starts at secondary school, of course. The target culture has encouraged schools which are keen to stand high on the list of successful establishments to persuade pupils to take GCSEs in easy subjects such as ‘media studies’, ‘food technology, ‘outdoor pursuits’, sports leadership’ and so on rather than proper, crucial subjects such as English (Language or Literature), mathematics, a foreign language, history or geography. Children leave school with a handful of irrelevant and entirely useless qualifications and a less than rudimentary education. Never before has a country produced so many students with so many qualifications and so little learning. A diploma in horse care is officially ranked as equivalent to four good GCSEs. A diploma in hairdressing is officially worth six good GCSEs. Schools churn out illiterates and innumerates as though they were in demand. I have, for many years, received a huge amount of mail and it is possible to tell the age of correspondents not by the shaky handwriting of the octogenarians but by the quality of writing and spelling. When these children end up cutting hair, writing writs or running Government departments their illiteracy is of little consequence but for doctors-to-be it is vital that they know how to read and to understand the meaning (and hidden meaning) of what they read. It is the low level of starting education which is at least partly responsible for the low standards of medicine practised by young doctors today.
Today, medicine attracts the half-hearted, the half-witted and the half-interested. Medical schools don’t teach knowledge (though they think they do, and certainly like to give the impression that they do);
instead, they teach prejudice and propaganda and black magic and they at best studiously avoid, or at worst positively forbid, the study of evidence outside the mainstream which shows, for example, that serious heart disease can be most effectively treated without drugs or surgery and that the placebo effect is crucial to the effectiveness of the doctor patient relationship.
Students are not taught that judgement isn’t derived solely from numbers and graphs and charts and laboratory results. They aren’t told that judgement is a combination of conclusions drawn from evidence; it is derived from instinct and intuition as much as learning and knowledge.
Modern medicine has become focused on narrow issues and doctors are not taught or encouraged to study the alternatives (both those within and those without orthodox medicine) and to then assess the options wisely and with an open mind.
Inspiration is an essential part of creativity but modern doctors are trained to exclude inspiration and therefore to exclude creativity.
Students are ‘protected’ from anyone who doesn’t toe the drug company party line. These restrictions mean that today’s doctors can only make diagnoses by rote. That’s a fundamental problem with medical education. Medical schools suppress imagination and creativity. The establishment crashes down heavily on anyone willing to question authority or to disobey the rules. And the further a student goes within the system the stronger these restrictions (these failings) become.
Doctors have become obedient, unquestioning tools of the establishment; accepting information and advice as though it were factually based, and merrily prescribing whatever junk they are told to prescribe. Doctors are controlled by bureaucrats so they think and behave like bureaucrats. The vast majority of modern doctors have no instinct, no intuition, no inspiration, no courage, no truth, no dignity, no common sense and no passion. The profession has created a generation of doctors who are quite incapable of thinking for themselves and who have been beaten into intellectual and ethical submission by a medical system which is controlled by a grotesque mixture of drug companies, politicians, spiritually and ethically dead doctors, and bureaucrats who regard patients as a damned nuisance. Most doctors are trained to be incapable of original thought and incapable of lateral thinking. They follow the pre-determined system and plod their way through their caseloads without ever thinking for themselves.
The ability to work, and to learn, is a talent as much as any other and all the great medical thinkers have been hard workers. They didn’t spend their days filling in their forms or attending meetings with bureaucrats or social workers. They had ideas, tried them out and learned. That doesn’t, and cannot, happen today. It is not surprising that young doctors find it difficult to make decisions. You can teach the science of medicine but you can’t teach the art, the instinct, the passion or the dedication. These have to be discovered through time and by being nurturing. Today, there is no time and no nurturing. Today’s doctors are not bright enough or creative enough or imaginative enough to have doubts and without doubts you are lost. Modern doctors spend far less time in training than their predecessors. New rules and regulations limiting the amount of time doctors can spend working mean that the modern consultant or general practitioner will be put in a position of responsibility when still relatively inexperienced. At schools everywhere the reliance on multiple choice tests (which can be marked by computer and therefore liberate teachers and allow them to enjoy their hobbies) has destroyed imagination, initiative and literacy.
Another problem is that the Internet has encouraged cheating among students. For example, 234 candidates attempting to study medicine all wrote that their passion for the subject had been sparked after: ‘burning a hole in my pyjamas at age eight with a chemist set’ and 166 began with: ‘For as long as I can remember, I have been interested in...’. Around 275 applicants to become nurses all started their applications with the words: ‘Nursing is a very challenging and demanding career.’ When students learn deceit at an early age they will fit easily and quickly into the deceitful world that medicine has become.
(Incidentally, the Internet is now such an unreliable source of information that innocent and naive webusers become over-loaded with misinterpretations, hand me down prejudices and ready made, fit anyone preconceptions.) Sadly, the ignorance didn’t just start with the Internet. Not all that long ago a study of GPs reported in a medical newspaper showed that a quarter of general practitioners did not know about the connection between smoking and heart disease while, amazingly, a fifth of GPs were unaware that cigarettes could cause lung cancer.
(One magazine editor refused to publish an article I wrote quoting this survey on the grounds that he couldn’t believe that doctors could be so ignorant).
But although older doctors have their faults it is the younger doctors who frighten me most. Today, students are desensitised to horror long before they become doctors. They have been exposed to years of watching violence on television, on DVDs and in games (and although there is a watershed which ensures which children are supposed to be protected from the sight of naked breasts on their television screens they are still exposed to endless hours of violence in taxpayer subsidised programmes such as Eastenders).
Moreover, young doctors do not listen to their own voices. They do not know they have voices of their own. They do not even know they are entitled to voices. They do not know that they are entitled to think for themselves. It is hardly surprising that doctors behave like sheep (though without the natural charm of those gentle herbivores) and stick to the party line, whatever the party line might be, without ever questioning a word of what they are told. Like good civil servants (which modern State-employed doctors assuredly are) they are trustworthy Statists; marching to the party tune and never wavering in their support for their inglorious leaders.
The current generation of medical students learn little and read little. They don’t learn how to think critically or creatively or to reason out problems for themselves. They have very poor general knowledge and no interest in or knowledge of their patients’ lives and so they miss all sorts of diagnostic clues. It is hardly surprising that young doctors find it difficult to make decisions. They are trained to respond to the rules, the whole rules and nothing but the rules.
Modern doctors are taught to make decisions by computer rather than by experience or intelligence or intuition. Actually, come to think of it, modern doctors behave like rather second rate computers.
They feed themselves facts and test results and then spew out answers without regard for the sense they are making.
The best doctor I ever knew didn’t even know how to read an X-ray report let alone an X-ray and when he wasn’t feeling too well he would still do his home visits but he would stand in the downstairs hall and shout questions to the patient in bed. His advantage was that he knew his patients. He visited them at home and saw how and where they lived. He talked to them about their work. He knew their families. He lived within the community. Medicine is a lot easier when you understand a little about people.
That good doctor, whom I remember with fondness, knew that a good doctor needs an open mind, an ability to hear between the lines and an ability to read a silence; an ability to put a patient at ease, to mask the real questions, and sometimes to ask the really important questions as an apparently half relevant afterthought.
He knew that doctors can sometimes diagnose without listening to the words, just the music that comes through is enough. And the silences. The pain in a man’s eyes and in his voice, the way he holds his body; all these things speak volumes. A good doctor needs soft eyes and an ever-open heart.
Those are lost skills.
Studies have always shown that doctors are at their worst when dealing with patients with whom they feel uncomfortable. Narrow training means that doctors feel uncomfortable with a wide range of people. They often have difficulty relating to, talking to or acquiring information from people of ‘different’ races, sexes or social backgrounds to their own. But the biggest problem is surely the fact that modern doctors are taught to rely almost entirely on technology and are rarely encouraged to build up any communication skills of their own.
Old-fashioned doctors used to rely on what their patients told them and on what their eyes, ears, noses and fingertips told them. Most important of all, perhaps, was the sixth sense that doctors used to acquire through years of clinical experience.
Modern doctors rely too much upon equipment which is often faulty, frequently badly calibrated and more often than not downright misleading. For example, nearly every published study on the subject puts the error rate for doctors reading X-rays at between 20% and 40%. Radiologists working at a big hospital disagreed on the interpretation of chest radiographs as much as 56% of the time.
And there were potentially significant errors in 41% of their reports.
Even when X-rays are read for a second time only about a third of the initial errors are spotted.
Another problem is that the vast majority of students never learn how to do research or judge published research. This is largely because the vast majority of doctors, and nearly all university lecturers, don’t know how to do it either. Medical schoolteachers should teach cynicism and have a special course in iatrogenesis.
The first is frowned upon and most doctors have never even heard of iatrogenesis – even though it is, along with circulatory disease and cancer, one of the big three killers.
All this is rather depressing.
But in life it is important to know what we are up against. If you’re going to survive to a good age – and stay healthy – then you need to know something about doctors. Many people are prepared to put all their trust in doctors. That can be a dangerous mistake. Doctors now do more harm than good. They can – and do – save lives. But they kill a lot of people too.
There is nothing new in the fact that doctors kill people. Doctors have always made mistakes and there have always been patients who have died as a result of medical ignorance or incompetence.
But, since we now spend more on health care than ever before, and since the medical profession is apparently more scientific and better equipped than ever before, there is a savage irony in the fact that we have now reached the point where, on balance, well-meaning doctors in general practice and highly-trained, well-equipped specialists working in hospitals do more harm than good.
The epidemic of iatrogenic disease which has always scarred medical practice has been steadily getting worse and today most of us would, most of the time, be better off without a medical profession. Most developed countries now spend around 8% of their gross national products on health care (the Americans spend considerably more – around 12-14%) but through a mixture of ignorance, incompetence, prejudice, dishonesty, laziness, paternalism and misplaced trust, doctors are killing more people than they are saving and they are causing more illness and more discomfort than they are alleviating. Most developed countries now spend around 1% of their annual income on prescription drugs and doctors have more knowledge and greater access to powerful treatments than ever before, but there has probably never been another time in history when doctors have done more harm than they do today.
The bottom line is that doctors are, with cancer and heart disease, one of the three biggest killers today. And doctors don’t just kill people. They also maim and injure and disable. Most people don’t see what is happening, of course. They don’t realise how often doctors miss diagnoses, or make the wrong diagnoses. If you aren’t medically qualified you won’t see exactly what is going on. The inescapable conclusion is that patients should learn to be sceptical about the medical profession. Just about everyone I know who has seen a doctor in the last 20 years has been mistreated. Most of the patients didn’t have the faintest idea how badly they had been treated.
I constantly receive a barrage of case histories of incompetence and cover-ups. A friend today described how his father died after a liver biopsy was performed while he was a day patient. Unbelievably, my reader’s father was taking prescribed aspirin to thin his blood but no doctor told him to stop the aspirin before the biopsy. The man went into hospital as a day patient but when he left he went to the morgue, not to his home. Doctors should have a Government health warning stamped on their foreheads. ‘Beware: This Doctor May Harm Your Health’.
In this hard new world we are all of us at risk. A few years ago I nearly lost a kidney as a result of medical incompetence. Two radiologists who had looked at X-rays of my kidneys told me that I had kidney cancer. They gave me the names of two local surgeons and suggested that I choose one. (When I asked for more information about the two surgeons I was told, very helpfully, that one had a good bedside manner while the other was competent.) I insisted on a scan and a third opinion. I was then told that my slightly misshapen kidney was a perfectly normal variation. The third radiologist showed me a textbook illustration which showed precisely why the other two radiologists had been wrong. If I hadn’t had the third opinion I would have lost a perfectly healthy kidney and undergone totally unnecessary major surgery. Death by medicine has become the default condition; State sanctioned, legal, and professionally approved homicide.
Do Doctors And Nurses Kill More People Than Cancer?
Vernon Coleman
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