Posted by Bill Sandweg on 27 February 2017.

I have written in the past about patients getting unnecessary surgery or other unnecessary medical treatment.  You can find some of the posts here, here and here.  Why does this happen?  To be charitable, sometimes it is the result of doctors not being familiar with the latest studies about what works and what doesn’t.  More often than not, however, it is driven by the fact that doctors get paid for treating you and do not get paid (or not paid very much) when they don’t do something to you.

Here is a link to a story about efforts to investigate why some areas of the country have back surgery rates that are far higher than in other areas of the country and for which there is no easy explanation.

There were some interesting findings.  One was that patient preferences made little differences in the rate of spine surgeries.  This is important because it means that even if you don’t want spine surgery, if your doctor wants to do it, you are likely to have it done.  Don’t let this happen to you.  This means not to be afraid to get a second opinion and maybe even a third.  According to the story in the link, when Walmart became concerned about how much money it was spending on spine surgery for its employees, it started sending spine surgery candidates to nationally recognized spine centers for evaluation at the company’s expense.  It found that about a third of the workers referred to these centers did not need spine surgery after all.

Another interesting finding was that all this spine surgery didn’t result in better outcomes for patients.  In other words, in many cases surgery was not a better answer than non-surgical approaches to back pain but was a much more expensive option and certainly created the possibility of more complications.

The final conclusion was that the deciding factor was what individual doctors believed and that varied from doctor to doctor.  It also meant that doctors either didn’t know what medical science had learned about whether and when back surgery was a good idea or just didn’t care.  Either way, it would be a good idea to find out how often your back (or any other) surgeon’s patients get surgery and how often they do not.  If your surgeon has a high rate of patients who get surgery, chances are you will end up on the operating room table whether you want to or not and whether that is the best thing for you or not.