Hospitals as Dangerous Places

Ads touting the benefits of particular hospitals are common in big city newspapers, but on a recent day, I was struck by the sheer number of full-page ads for hospitals. In particular, one ad read: “For a healthy heart...eat properly, exercise daily and visit St. Francis, the hospital with more of the best cardiac specialists than any other hospital...”

What do hospitals have to do with disease prevention? Virtually nothing.

Years ago, while researching an article on the Navajo reservation, I learned that Native Americans had a specific word for hospitals – it translated to “the place where people go to die.”

The truth is that hospitals are among some of the most dangerous places in our modern world, and you would do your best to stay out of hospitals. They’re a great place to contract “nosocomial infections,” a euphemism for infections contracted in hospitals. This doesn’t mean that hospitals and surgery don’t help a lot of people. They do, but there are serious downsides – e.g., death – while being hospitalized.

It turns out that whenever physicians go on either a strike or a work slowdown, the area’s death rate decreases. I’m serious. When physicians began a major work slowdown in Israel in 2000, the death rate decreased by 68 percent. When Israeli doctors went on strike for a month in 1973, the death rate during that month dropped by 50 percent. No one had seen such a dramatic decrease in death rates since the previous doctors’ strike 20 years before.

In 1976, doctors in Los Angeles went on strike to protest increases in malpractice insurance. You guessed it – the death rate decreased by 18 percent. That same year, doctors in Bogota, Columbia, also went on strike, and the death rate went down by 35 percent.

The risk of death in hospitals also seems to relate to the magnitude of intervention, with more aggressive interventions increasing the odds of dying. In a recent study, patients were more likely to die when treated entirely by critical-care physicians in intensive care units (ICUs), compared with patients treated entirely by noncritical-care physicians. You might argue that patients in ICUs are more seriously ill, but the researchers accounted for these differences in severity of illness.

The problem lies with the pharmaceutical and surgical interventions that lie at the heart of modern medicine. Aggressive interventions are dangerous – and sometime fatal – compared with more conservative therapies, such as nutritional medicine, especially for chronic diseases. Going to a hospital invites such interventions, and doctors often forget their Hippocratic Oath: First do no harm. –JC

References: Siegel-Itzkovich J. BMJ, 2000;320:1561. Mendelsohn RS. Confessions of a Medical Heretic. Chicago: Contemporary Books, 1979:114. Levy MM. Annals of Internal Medicine, 2008;148:801-809.