Doctors do more harm than good

April 24, 2024 by Doctor Vernon Coleman

The following essay is taken from `Betrayal of Trust’ by Vernon Coleman (first published in 1994 and now available again as a paperback).

Doctors do more harm than good

We now spend more on health care than ever before, and the medical profession is apparently more scientific and better equipped than ever before, so 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.

It is true, of course, that doctors save thousands of lives by, for example, prescribing life-saving drugs or by performing essential life-saving surgery on accident victims.

But when the medical profession, together with the pharmaceutical industry, claims that it is the advances in medicine which are responsible for the fact that life expectancy figures have risen in the last one hundred years or so they are wrong. It is, for example, commonly claimed that modern scientific medicine has led to improvements in life expectation in most developed countries from around 55 at the start of the century to over 70 today.

The evidence, however, does not support this claim.

Any (small) improvement in life expectancy which has occurred in the last hundred years is not related to developments in the medical profession or to the growth of the international drug industry. However, but the increase in iatrogenesis is related to both these factors.

Whichever facts you look they at seem to support my contention that although doctors may do a limited amount of good they do a great deal more harm.

If doctors really did help people stay alive then you might expect to find that the countries which had most doctors would have the best life expectation figures. But that isn’t the case at all.

In America there is one doctor for every 500 people and life expectancy for black males is around 65. In Jamaica there is one doctor for every 7,000 people and life expectancy for men is around 69. In North Korea there is one doctor for every 400 patients and life expectancy for males is 63 years. In South Korea there is one doctor for every 1,500 people and life expectancy is 64 years. America spends more per head on health care than any other nation in the world and yet its citizens have one of the lowest life expectancy rates in the western world. (It is, of course, possible to argue that there are many other differences other than the number of doctors between South Korea and North Korea but it is reasonable to expect doctors to influence those factors. Moreover, if doctors as a group are going to claim responsibility for health care successes (which they do) then it is surely also fair that they should take overall responsibility for mortality and morbidity rates.)

The Americans spend around $2,000 per person per year on health care and yet out of every 1,000 live births twelve children will die before they reach their fifth birthday. In Japan, where the expenditure on health care is considerably less than half that in America, the number of children who will fail to reach their fifth birthday will be eight out of every one thousand born. The Americans spend around 12-14% of their gross national product on high technology medicine but, on average, they are sicker and die younger than individuals in most other developed countries.

Infant mortality rates in Asia are lower than those in Western Europe while estimated life expectancy at birth is higher in the Far East than it is in the over-doctored West.

Only when severely underdeveloped countries are compared to developed countries are there clear differences in infant mortality rates and life expectation figures and in these instances it is the differences in the infrastructure of the countries which explains the difference. My view may sound startling and controversial but it is a view shared by a growing number of independent experts around the world. These figures hardly support the image of doctors as an effective healing profession.

Even more startling, perhaps, is the evidence of what happens when doctors go on strike and leave patients to cope without professional medical help.

You might imagine that without doctors people would be dying like flies in autumn. Not a bit of it. When doctors in Israel went on strike for a month admissions to hospital dropped by 85% with only the most urgent cases being admitted, but despite this the death rate in Israel dropped by 50% – the largest drop since the previous doctors’ strike twenty years earlier – to its lowest ever recorded level. Much the same thing has happened wherever doctors have gone on strike. In Bogota, Colombia doctors went on strike for 52 days and there was a 35% fall in the mortality rate. In Los Angeles a doctors’ strike resulted in an 18% reduction in the death rate. During the strike there were 60% fewer operations in 17 major hospitals. At the end of the strike the death rate went back up to normal.

Whatever statistics are consulted, whatever evidence is examined, the conclusion has to be the same. Doctors are a hazard rather than an asset to any community. In Britain the death rate of working men over 50 was higher in the 1970s than it was in the 1930s. The British were never healthier than they were during the Second World War.

Figures published by the United States Bureau of Census show that 33% of people born in 1907 could expect to live to the age of 75 whereas 33% of the people born in 1977 could expect to live to the age of 80. Remove the improvements produced by better living conditions, cleaner water supplies, and the reduction in deaths during or just after childbirth and it becomes clear that doctors, drug companies and hospitals cannot possibly have had any useful effect on life expectancy. Indeed, the figures show that there has been an increase in mortality rates among the middle aged and an increase in the incidence of disabling disorders such as diabetes and arthritis. The incidence of diabetes, for example, is now reported to be doubling every ten years and the incidence of serious heart disease among young men is increasing rapidly. Today death rates from heart disease among adults are 50 times higher than they were at the start of the century. In countries such as America where there has been a slight fall in the incidence of heart disease it is clear that the improvement has been a result of better eating habits (by and large this simply means consuming less fatty food) rather than any improvement in medical care. The explosion of drugs and surgical treatments for heart disease has had no positive effect on death rates. On the contrary there is a considerable amount of evidence to show that the increase in the use of such procedures as angiography, drug therapy and heart surgery has resulted in more deaths. People in the West are being doctored and drugged to death.

Four out of five people in the world live in underdeveloped countries but four out of five drugs are taken by people in developed countries. Despite the expenditure of enormous amounts of money on screening programmes deaths of young women from cancer continue to go up and every time one infectious disease is conquered another seems to take its place. Bacteria are becoming increasingly resistant to antibiotics and the number of disabled and incapable citizens in developed countries is increasing so rapidly that it is now clear that by the year 2020 the disabled and incapable will outnumber the healthy and able bodied.

In Britain, where free access to doctors and hospitals is available to everyone, life expectancy for 40-year-olds is lower than almost anywhere else in the developed world. In America 6% of hospital patients get a drug resistant, hospital induced infection and an estimated 80,000 patients a year die in this way. This puts hospital infections high among the top ten causes of death in America.

When doctors and drug companies produce figures which show that there has been a (usually slight) increase in life expectation during the last one hundred years or so they invariably overlook the massive contribution made by improved living conditions, cleaner drinking water, better sewage disposal facilities, more widespread education, better (and more abundant) food and better and safer methods of transport. All these factors have had a far more dramatic influence on mortality and morbidity rates than the provision of health care services.

Relief organisations working in underdeveloped parts of the world are well aware that they can make an impact on mortality rates far more speedily by providing tools, wells and shelter than by building hospitals or clinics or importing doctors and nurses. Sadly, the governments receiving help are often loathe to accept this and are frequently much more enthusiastic about building state of the art hospitals complete with scanners, heart transplant teams and intensive care units than they are about building homes, installing irrigation systems or planting crops.

This obsession with high technology leads to problems in all areas of health care. For example, the control of malaria was going well for as long as stagnant pools of water were removed, but when it was discovered that the mosquitoes could be killed by spraying DDT and that the disease could be controlled by using drugs such as chloroquine the authorities stopped bothering to remove stagnant pools. Today mosquitoes are resistant to DDT and the parasites which cause malaria are becoming resistant to the drugs: malaria now kills around 1.5 million people a year.

Those who argue that doctors are responsible for any improvement in life expectancy which we may enjoy overlook the fact that from the dark ages, through the Renaissance and up to the first few decades of the 20th century, infant mortality rates were absolutely terrible and it was these massive death rates among the young which brought down the average life expectation.

The Foundling Hospital in Dublin admitted 10,272 infants in the years from 1775 to 1796 and of these only 45 survived. In Britain deaths among babies under one year old have fallen by more than 85% in the last century. Even among older children the improvement has been dramatic. In 1890 one in four children in Britain died before their tenth birthday. Today 84 out of every eighty five children survive to celebrate their tenth birthday. These improvements have virtually nothing to do with doctors or drug companies but are almost entirely a result of better living conditions. In 1904 one third of all British schoolchildren were undernourished. Poor diets meant that babies and small children were weak and succumbed easily to diseases. Older children from poor families were expected to survive on a diet of bread and dripping and many women who had to spend long hours working in terrible conditions were unable to breast feed their babies, many of which then died from drinking infected milk or water.

When the improvements in child mortality figures are taken out of the equation it is clear that for adults living in developed countries life expectation has certainly not risen in the way that both doctors and drug companies usually suggest.

And it isn’t possible to credit vaccination programmes with the improvement in life expectation since the figures show quite clearly that mortality rates for diseases as varied as tuberculosis, whooping cough and cholera had, as a result of better living conditions, all fallen to a fraction of their former levels long before any of the relevant vaccines were introduced.

Note
This essay is taken from Vernon Coleman’s book `Betrayal of Trust’ – which is available from the bookshop on www.vernoncoleman.com