Not a day passes without our media, both in print and electronic, praising modern medicine and its achievements. Usually in all these commercial advertisements, the first casualty is the truth. Many times the advertisements are a lot more impressive than the real stuff that they are trying to sell to the gullible public. Even if one tries to get at the truth there are very few takers for truth these days. The comforting feeling is that truth has always been at a premium. Aristotle wrote that “truth can influence only half a score of men in a century while falsehood and mystery would drag millions by the nose.” This is more than true in the case of modern medicine. Plato, in his celebrated book The Republic, refers to his teacher Socrates’s efforts to change society when, at that time in Greece, injustice was justice and justice was the convenience of the powerful. Socrates did not succeed, though. I am only trying to indicate the inherent drawbacks in the system lest people should be taken for a costly ride!



Lucien Leape of the Harvard Medical School in his excellent article Errors in Medicine published in 1994 in the prestigious Journal of the American Medical Association (Vol 272; page 1851-1857) gives a very graphic description of all the errors that we have been committing. This has been updated recently by Barbara Starfield in her excellent article in the same journal in the year 2000 (JAMA 2000;284:483-485) which reiterates the same, adding many more glaring dangers to the list already given by Leape. To date, I have been able to trace more than seven thousand articles showing the mistakes of modern medicine in the best western journals. The summary of all those articles is as follows.

Rate of increase of adverse and side effects









Rate of increase of medical errors



(Herron R and Cavanaugh K…in press.)







Nearly 2,25,000 people have died in one year in the US alone due to iatrogenic diseases. Of these 1,00,000 has been exclusively due to adverse drug reactions. There have been three million injuries due to medical interventions in a year with 44,000 to 98,000 deaths annually. Nosocomial infections alone caused 80,000 deaths in one year in hospitals. One hundred million people suffer from chronic debilitating illnesses partly due to medical interventions. These figures look horrible if one takes into consideration the population of US which is roughly one third that of India. This sad story does not include the escalating costs of modern medicine. Modern medicine today can only be accessed by the rich.



One of the reasons why this sordid drama unfolds in that country is the advertisement about screening the apparently healthy people in the fond hope of keeping them healthy for long periods of time. However, all the audits of screening efforts have shown that screening of healthy people could be one of the most dangerous activities in society. Time evolution in the human system does not follow linear laws of predictability. The screening industry is the biggest money spinner in medicine. A very recent editorial in the prestigious British Medical Journal entitled The Screening Industry bares the true picture in all its ramifications. Screening probably is the main source of the above sickening numbers mentioned earlier. If doctors confined themselves to cure rarely, comfort mostly, but to console always, they would be doing a great service to the public. When they try and intervene in healthy segments of society problems start. Sir William Osler, a celebrated brain in medicine in the last century, was right when he said: “Patient doing well do not interfere.”



In this scenario, which is being replicated in India today, how does the common man survive? One can not avoid doctors completely, though. The best bet would be to have a very good family doctor who understands every aspect of one’s life to make the best judgment during any crisis. He/she should be very carefully chosen keeping in mind his/her human qualities of head and heart. A good doctor is one that cares for his patients, treats them the way he wants to be treated himself in a crisis bestowing all attention, care and empathy. Having chosen a good family doctor one could follow his advice regarding healthy life style in work, food and exercise avoiding the usual risks like smoking and drinking alcohol to remain healthy as long as possible. One should never try to live here for ever as it is impossible to do so. There are situations when one has to consult the doctor without losing time, but must avoid doctors and hospitals to keep healthy. The common situations where a visit to the doctor or hospital is inevitable are listed below.



* Any abnormal bleeding from any source.

* Headaches that last for a more than a day.

* Headache with blurred vision and/or vomiting.

* Intense sudden headache.

* Vertigo of any type.

* Breathing difficulty.

* Any abnormal lump in the body, painful or otherwise.

* Sudden visual changes.

* Diarrhoea that does not stop with usual precautions.

* Bloody diarrhoea.

* Fever with breathing difficulty.

* Fever with chest pain on breathing.

* Any pain in the chest with tightness in the chest.

* Sore throat that does not ease in a week’s time.

* Any ulcer that does not heal in the usual time.

* All pregnant girls must see their doctors regularly.

* Children for their immunizations.

* Animal, snake or severe insect bites.

* Sudden loss of vision, speech or use of a part of the body.

* Unusual loss of appetite lasting for more than a week.

* Unusual loss or gain of weight.

* Sexual problems.

* Pain, anywhere, that lasts for more than a few hours.

* Accidents.

* Skin lesions that do not heal within two weeks.

* Sudden change in the quantity or quality of urine.

* Cough that lasts for more than a week, especially with large spit.



Patients should never, ever, see a specialist directly as it might lead to lot of unnecessary interventions and trouble at the end. The family doctor is one’s friend, philosopher, and guide in these matters.



Modern medicine is slowly becoming unpopular in the west. In the year 1997 alone 629 million people took treatment from alternative systems of medicine in the US paying from their own pockets. This is more than the number of people that saw their family doctors in the same year, according to a survey done by Eisenberg and colleagues in 1998. India should take note of this as we have one of the best systems of health care in Ayurveda. If this could be judiciously clubbed with the emergency care methods of modern medicine complementing modern medicine we could bring down the costs of medical care to almost one tenth of its present level with less danger to the public.



The future lies in emphasizing promotive health. We should change the present teaching in medical schools to that of patient centred education rather than the disease centred education of today. We should use statistics sparingly in medical research. One of the drawbacks of applying disease statistics to the healthy population is that the latter throws up a very high percentage of false positives, resulting in epidemiologists predicting and producing epidemics of diseases. The fear of an illness could help the illness to take a firm root in a healthy person. Modern medicine has realized that the human mind plays the vital role in disease causation as well as its control. Hence there is a need for doctors to train themselves in human psychology and behavioural sciences. Health is one’s birth right. Diseases are accidents. If one follows the correct rules of healthy life style, accidents (diseases) will be rare indeed!



We are being deluded into believing the drug company sponsored crude epidemiologic studies published everyday to show that developing countries are being invaded by killer diseases in large numbers. Although this is frightening the truth is that the drug companies want more and more people to be afraid and come into the net of routine screening procedures for the drug manufacturers to get more people labeled. This would be a very good business to sell drugs. The numbers of iatrogenic diseases reported earlier makes lot of sense if one knows the tricks of the pharmaceutical trade. Western pharmaceuticals have even started manufacturing new diseases to sell their wares. Female impotence and the close relation between the HIV virus and the infamous AIDS syndrome are some of the glaring examples.



Doctors should sit up and take note. Although the present western system looks good for doctors for short time gains, in the long run this will ruin modern medicine and make us look foolish in the eyes of the public. This will also rob us of our “rice bowl” at the end. Let us, for the good of society, get our act together and try to do most good to most people most of the time. Doctors are not trained to only make money. Doctors are primarily trained to keep society’s health. Let us do just that and get back our lost glory as the champions of human health and wellbeing.



“That which is won ill, will never wear well, for there is a curse attends to it, which will waste it; and the same corrupt dispositions which incline men to sinful ways of getting, will incline them to the like sinful ways of spending.”

Mathew Henry.