The Doctor Shrugged

I find the show "ER" fascinating. On it, the people in white coats actually rush around as if something is at stake. Their faces show expression, often of concern, as if they're worried whether a patient lives or dies. It isn't like any emergency room or doctor's office I've ever seen.

In real life, one goes to a hospital if he or she is curious to have a near death experience. Medical treatment is the third leading cause of death in the United States, after heart disease and cancer, according to a 2000 Journal of the American Medical Association article by Dr. Barbara Starfield (search) of the Johns Hopkins School of Hygiene and Public Health. Starfield places medically-related deaths at 225,000 a year, while a more conservative estimate by a 1999 Institute of Medicine report placed the number of deaths by medical error at 100,000 a year.

The subsets of statistics behind these numbers are even more alarming. Starfield's JAMA report claimed that 106,000 deaths are caused by correctly prescribed medications, while prescription error accounts for 7,000 annual deaths. (Meanwhile, a 1998 JAMA study claims prescription error seriously injures 2.1 million patients every year.)

Last week, ABC's "Primetime Thursday" attributed 100,000 annual deaths to hospital infections alone--at least 50,000 of them preventable through the practice of basic hygiene by hospitals. The report mentioned that ABC sportscaster Dick Schaap (search) died two years ago from a hospital infection he got after routine hip replacement surgery because the medical staff at New York's prestigious Lenox Hill Hospital couldn't be bothered to wash their hands between patients.

My former college professor, who has a heart condition, caught on early. Whenever hospital staff  enter his room, he asks, "What is my name? And what am I here for?" Otherwise, he fears, healthy organs may get removed and the wrong appendages amputated. But even this kind of diligence would not have helped a former colleague of mine, a 115-pound woman who went into the hospital for a colonoscopy and wound up in the intensive care unit after being injected with enough local anesthetic for a 220 pound man.

When I was paying out-of-pocket for an HMO (search) that didn't cover medication, I was given a prescription for medicine to treat a condition opposite of what I had. After the mistake was discovered--and after I had paid for and ingested the pills-- I asked the substitute doctor if I could get reimbursed for the expensive but incorrect prescription his partner prescribed.  He condescendingly defended the erring doctor saying, "Doctors are only human. We make mistakes. Haven't you ever made a mistake?" Needless to say, I got a new doctor, an obstetrician with whom I was very happy until one day, after delivering a patient's baby via cesarean section, he decided to carve his initials into the woman's stomach.

Consider that when medical doctors in Israel went on strike (search) in early 2000, the funeral industry tanked. The burial association complained to the government to increase doctors' salaries. The only city that did not see a decline in its death rate was Netanya, where doctors had a no-strike clause in their contracts.

Doc, when your parents sent you to medical school so you could make a killing, they didn't mean literally.

The frightening statistics, coupled with the negative doctor-patient experiences behind them (35 percent of doctors themselves complain about the doctor care they or their families get, according to the IOM report) might explain why there is something called alternative medicine (search). It gives people an alternative to dying.

Don't think I wasn't skeptical when my homeopath (search) told me the pain in my neck was being caused by a troubled gall bladder. But sure enough, after she treated my gall bladder, I could move my neck. That's because holistics know how one body part can "refer" pain to a seemingly unrelated body part. Conventional doctors don't know that one body part has anything to do with another. If they did, they wouldn't operate on the wrist for carpal tunnel syndrome (search) when the pain and tingling in the forearm usually stems from a pinched nerve in the neck or back.

But mention to a physician that you see a holistic practitioner (search) and he may well call such party a "quack." That was the response of my primary care physician after he discovered  I'd been seeing a holistic chiropractor (search) for chronic back trouble. Sounding a bit like a spurned lover, he whined, "You didn't have me look at your back."

 But why see an MD for a misaligned back? So he can say, "It's not fractured. Do you want a painkiller?" Indeed, to be a doctor in America all you need to know is the word "painkiller."

 "We're basically pill pushers," one young physician admitted at a party, adding that, much like a diner waitress hoping you'll stick to the menu, doctors are looking for the path of least resistance. 

Unless you demonstrate classic symptoms of one of the six or so conditions that fall into a medical doctor's limited repertoire of common, recognizable conditions, he won't really know what's wrong with you until the autopsy. You get more answers from a veterinarian, for crying out loud. (Which would explain the expression "healthy as a horse.") From the physicals to the check-ups to the trial-and-error means of diagnosing, coming into a doctor's office for any reason other than antibiotics is an exercise in futility. It's a running joke that a primary care physician's competence is best measured by how expeditiously his staff fills out referrals.

God bless Western medicine for all the breakthroughs--the vaccinations, the transplants, the emergency life-saving procedures and cutting-edge modern miracles. But these days its practitioners perform best for those on the brink of death, and that's where you'd better be when you come to these people, or they'll bring you there.

I'm not saying doctors have to be flawless. I'm just asking them to appreciate the difference between a patient and a piece of furniture. Because there are errors, but there is also apathetic negligence, not to mention an arrogance that is buttressed by a rigid hierarchy at hospitals, wherein ranking doctors can't be questioned or corrected by nurses or lower doctors. It's not uncommon for nurses to sneak around doctors' orders to keep from killing the patients, as a nurse I knew observed another nurse do when the doctor was overdosing a patient on intravenous medication.

Doctors must stop discouraging patients from seeking alternative care--whose purpose is not to compete with, but to supplement, traditional care. Thankfully, there are the "radicals" of the profession bridging the Western model and the Eastern model, some practicing both, others referring patients to alternative care specialists (which insurance companies are increasingly covering). There is a place for both conventional and alternative medicine, and MDs should know their place.

If any of the symptoms mentioned here hit too close to home for some doctors, they should read this twice and call each other in the morning. And if the truth still hurts, take a painkiller and ignore the problem.


Julia Gorin is the author of the newly released "The Buddy Chronicles," available through, and a contributing editor to She is the featured comedian in Republican Riot, a monthly comedy show in New York.

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