30 May 2012

Doctors to go on strike. I hope it is a long one!

Doctors strike -- and death rates fall

Doctors don't often go on strike, but it has happened sufficiently often for a disturbing trend to be noticed. During the rare times that they have gone on strike -- in several countries -- the death rate has always gone down.

In 2000, Israeli doctors employed in public hospitals pursued a course of industrial action. This included the cancellation of outpatient clinics and the postponement of all routine surgery. And this limited strike action had some unusual consequences. Throughout Israel, while the doctors were on strike, death rates fell. The coastal city of Netanya has only one hospital whose staff members had a 'no strike' clause in their contracts. As a result, doctors in Netanya continued to work normally -- and death rates remained stubbornly the same, failing to reflect the reduction that was shown in almost all of the rest of the country.[1]

And it wasn't the first time; doctors in Israel went on strike in 1973, and reduced their total daily patient contacts from 65,000 to just 7,000. The strike lasted a month and during that time the death rate, according to the Jerusalem Burial Society, dropped by half.

It doesn't just happen in Israel. The 1960s saw physicians in Canada go on strike and the mortality rate dropped. In 1976, in Bogota, Colombia, doctors refused to treat all but emergency cases for a period of 52 days, and in that time the death rate fell by 35%.[2]

In the same year the death rate dropped 18% during a 'slow-down' by doctors in Los Angeles. After the strike, deaths rates jumped to 3% above normal for more than five weeks as the Los Angeles doctors caught up on their paperwork.[3]

And it is a standing joke among cardiologists that death rates fall during their conferences because fewer of them are attempting to cure moribund patients by doing dangerous surgery.

So, it's a fair assumption that the longer doctors strike, the safer we are likely to be.

1.    Siegel-Itzkovich J. Doctors' strike in Israel may be good for health. BMJ 2000; 320:1561.
2.    Horne, Ross. Health & Survival In The 21st Century. HarperCollins Publishers Pty Limited, Australia, 1997. Chapter 11.
3.    Science News, 28 Oct 1978; 114: 293.

See Chapter one of Trick & Treat: How 'healthy eating' is making us ill


Anonymous said...

This is like saying, "if I don't have an operation to fix a very dangerous heart condition I won't die (today)"

Barry Groves said...

I understand what you mean, Anonymous, Except, you will know if you have read the first chapter of Trick & Treat, that hospital doctors are officially the third leading cause of death in the US, and the fourth leading cause of death in the UK.

clearmiddle said...

Well I do realize that doctors are the third leading cause of death -- I have nearly been dead that way twice myself -- but I also know that correlation does not imply causation.

Still, these numbers might deserve a closer look.

LeonRover said...

Hey Anonymous,

A death delayed is extra life lived.

Iatrogenic death is on the rise.

And bacteria have gone thro' the bacterial equivalent of Europe's Late Medieval Black Death.

MRSA is the march!

BTW correlation IS causation when one finds the mechanism of association - in this case heart surgeons sticking knives in people. So the judgement call here is "Is this a reasonable mechanism?"
That does depend on whether ya love 'em or hate 'em.


Angel said...

These results are not surprising. Medical errors are extraordinarily common, and cause a tremendous amount of suffering and death. The real problem is the unquestioning hero worship of medical personnel. They need to be held to some very strict transparency standards before this situation will improve for patients.


Angel said...

Ooops ... forgot to mention that the link above is to "Roar of Wolverine" - a blog post written by someone who suffered from a tremendous number of medical errors.

Anonymous said...

Dr. Here is the latest from Sweden. So many questionable assertions and yet as I read it, the conclusion the media is spouting seems rather incorrect: high fat = high cholesterol.

They fail to note numerous inconsistencies: huge alcohol intake, use of cholesterol lowering drugs, high use of margarine and seed oils, ect.



Laura McCormack said...

Dear Barry
First of all I wanted to say that I am surrently reading and much enjoying your book Trick and Treat.
I am Geneticist (PhD) who sadly has taken 40 years to realise that grains/sugar/starches are bad for me as an individual and for us as a species. I have now embraced a paleo type high fat diet (but now dairies)lost lots of weight and become much fitter and healthier! Feeling amazing!
Before this I was vegan and an avid soya consumer for some 16 years (Now it is way up there with the banned non paleo foods). On this I wanted to comment on a slight inaccuracy in your book about the r/ship between soya milk and tofu in chapter 10 pg 158. You say that "soya milk is a waste product of tofu production..." quite the opposite I am afraid. SOya milk is hybdrolised soya beans and is the starting material for making tofU jsut add a curdling agent even lemon juice will do. SOya milk (hydrolised whole soya bean)is what the CHinese and food industry (and overzealous consumers) use to make tofu.
Anyway thanks again for your book I have worked my way through dozens of low carb/paleo books but I enjoy the factual and provocative tone of T&T.

Barry Groves said...

Hi Laura
I'm glad that you like Trick and Treat.

Perhaps I should have been clearer about soy milk. When I wrote that it was 'originally' a byproduct, I was talking of centuries ago.

The information I have is from William Shurtleff. Chronology of Soy Milk Worldwide, Part 1: 220AD to 1979.


I can remember when I was a theatre nurse and all nurses went on strike. On a regular day there would be at least 2 emergency operations (such as emergency appendectomy, rather than let patient wait and see what happens), while striking there were no emergencies for one week, and no complications from not doing the surgery.

LN said...

We saw a recent example in the news, when a woman in labour was airlifted by helicopter to be taken for emergency treatment and before they made it to the mainland delivered spontaeously in the aircraft. Now had she waited even a few minutes more who knows what interventions would have been performed, leading to a violent delivery instead of a normal one. Everyone was delighted it seems. I am told that 2/3 to 3/4 deliveries are now high risk, high risk is now normal.