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Unnecessary surgery exposed! Why 60% of all surgeries are medically unjustified and how surgeons exploit patients to generate profits Every year millions of Americans go under the knife, but many of them are enduring great pain and shelling out thousands of dollars for surgeries they don't really need. In fact, the only people who seem to really benefit from these unnecessary medical procedures are the medical professionals who stand to make exorbitant amounts of money from performing them. An estimated 7.5 million unnecessary medical and surgical procedures are performed each year, writes Gary Null, PhD., in Death by Medicine. Rather than reverse the problems they purport to fix, these unwarranted procedures can often lead to greater health problems and even death. A 1995 report by Milliman & Robertson, Inc. concluded that nearly 60 percent of all surgeries performed are medically unnecessary, according to Under The Influence of Modern Medicine by Terry A. Rondberg. Some of the most major and frequently performed unnecessary surgeries include hysterectomies, Cesarean sections and coronary artery bypass surgeries. Coronary bypasses are the most common unnecessary surgeries in
America Women are at an especially high risk of unnecessary surgery Women are also frequently subjected to Caesarean sections they don't really need. With an estimated 920,000 Cesarean births performed each year, the Cesarean has become the "most common major surgery in America" and it is four times more likely a woman will give birth via cesarean section today than it was in 1970, according to The Medical Racket by Martin L. Gross. Women are also at special risk for receiving unwarranted surgeries because of the results of a mammogram, since the high rate of false positives in mammography often leads to invasive procedures. Women who do not even have cancer to begin with are treated for breast cancer, Goldberg writes. That's right: These women's bodies are carved up and altered and they aren't even sick. So why does this happen? Needless surgeries mean higher profits for doctors and hospitals When it comes to heart surgeries, Heart Frauds author Dr. Charles T. McGee writes, "As Harvard professor Braunwald predicted, a financial empire has developed around surgical procedures on the heart. With so many powerful vested interests involved, it will be difficult to change how American doctors treat patients with coronary artery disease. No one who is currently gaining from the system has any incentive to try to stop the unnecessary costs and suffering." In other words, surgery makes money and surgery is what medical professionals are trained to do, so rather than exert the time and energy to try more conservative treatments that could threaten their very careers, medical professionals often turn to surgery as their most immediate and financially logical avenue. "The economic incentive for a physician to operate on you is great. Surgeries make doctors a lot of money. Doctors are human beings and they are not immune to the lure of bigger profits," according to Prescription Medicines, Side Effects and Natural Alternatives by American Medical Publishing. One extreme case involving a doctor knowingly reaping the financial benefits of unnecessary surgeries occurred in California, where an ophthalmologist managed to bill Medicare $46 million over four years for unwarranted operations he performed on his patients. "According to the government, he created a 'surgery mill,' in which he falsified patient records to justify numerous unnecessary cataract and eyelid operations. In addition to this wholesale theft, he put his patients through unneeded pain and worry," writes Gross. It is also important to note in all of this that unnecessary surgery is not considered medical malpractice, according to Rondberg in Under the Influence of Modern Medicine, which makes it even more important for patients to protect themselves by looking into all possible avenues before going under the knife. If you imagine for a moment being knocked out, sliced open and having a part of your body removed for no logical reason, it sounds more like a nightmare than a visit to the hospital. But that's what is happening to millions in American hospitals every year. We are having organs and body parts removed without reason, and for what? Why are we so willing to give our bodies over to a person wielding a very sharp knife and some very strong drugs? Maybe it's because we trust that our doctors will do what is best for us, since, after all, we don't have the medical training they do. But when it comes to your body and your health, it's okay to be skeptical and to want all the information you can get. The bottom line is: Surgery is not something to be taken lightly. When confronted with the suggestion that you need to go under the knife, it's important to remember that you have a choice. Don't just trust one doctor to know what's best for you. Get a second opinion. It could mean the difference between life and death. The experts speak on unjustified surgery: A definitive review and close reading of medical peer-review journals,
and government health statistics shows that American medicine frequently
causes more harm than good. The number of unnecessary medical and
surgical procedures performed annually is 7.5 million. The number
of people exposed to unnecessary hospitalization annually is 8.9
million. Annually, between 20 million and 25 million surgical procedures
are carried out among all the specialties except plastic surgery.
This study determined that between 15% and 29% were unnecessary.
For example, 27% of the women who had hysterectomies, the second
most common surgery, didn't need the operation! Despite what appears to be an attempt by the medical profession
to keep that kind of information from the public, a few reports
have surfaced which show clearly that the problem with unnecessary
surgeries is not a thing of the past. In a 1995 report issued by
Milliman & Robertson, Inc., titled "Analysis of Medically
Unnecessary Inpatient Services," researchers David V. Axene,
FSA and Richard Doyle, M.D., concluded that "the level of
medically unnecessary use may actually be closer to 60%" (than
their previously projected 53%). This included a variety of surgical
procedures as well as associated services. That same year, the
federal government's Agency for Health Care Policy Research (AHCPR)
concluded that most back surgery was unnecessary. Back surgeons
immediately began a campaign to abolish the agency. Other reports
confirm this frightening statistic. Women with urinary incontinence are often advised to get bladder
surgery, even hysterectomies. But this drastic approach may be
completely unnecessary, according to Dr. Hufnagel, who says that
women need to be educated about more conservative treatments for
this common everyday occurrence. The Harvard University School of Public Health estimates that
as many as 1.3 million Americans suffer disabling injuries in hospitals
yearly, and 198,000 of those may result in death; 7 out of 10 of
which were preventable (48% from faulty surgery), and 1/3 from
negligence. Almost thirty years ago, in 1974, the Congressional Committee
on Interstate and Foreign Commerce held hearings on unnecessary
surgery. They found that 17.6% of recommendations for surgery were
not confirmed by a second opinion. The House Subcommittee on Oversight
and Investigations extrapolated these figures and estimated that,
on a nationwide basis, there were 2.4 million unnecessary surgeries
performed annually, resulting in 11,900 deaths at an annual cost
of $3.9 billion. One surprising discovery in recent research is that smoking is
the cause of 28 percent of urinary incontinence in women. Studies
indicate that surgery and the use of pharmaceuticals are often
unnecessary; other methods that have proven effective are behavioral
techniques and biofeedback, Kegel exercises, which strengthen pelvic
muscles, electrical stimulation of the pelvic floor, and acupuncture.
A natural treatment, according to one study, can be extracted from
the plant marshmallow; this helps incontinence by treating inflammation
of the genito-urinary tract. Unfortunately for millions each year, this may not be the case.
They may instead be victims of powerful medical propaganda that
makes every operation seem essential. But the reality is that unnecessary
surgery, whether performed by doctors who operate out of ignorance,
self-delusion, or simple greed has long plagued medicine and today
still reaches epidemic proportions. The unnecessary surgery figures are escalating just as prescription
drugs driven by television advertising. Media-driven surgery such
as gastric bypass for obesity "modeled" by Hollywood
personalities seduces obese people to think this route is safe
and sexy. There is even a problem of surgery being advertised on
the Internet.76 A study in Spain declares that between 20 and 25%
of total surgical practice represents unnecessary operations. In his book, "Health Shock," journalist Martin Weitz
reported that a 1974 Senate investigation into unnecessary surgery
found that "American doctors performed 2.4 million unnecessary
operations, causing 11,900 deaths and costing $3.9 billion." In
1982, Robert G. Schneider, M.D., calculated that between 15 and
25% of all surgeries were unnecessary — with that figure
rising to 50-60% with some types of operations. In the case of
tonsillectomies and hysterectomies, the percentage was as high
as 40-80%. Some studies suggest that almost 40 percent of surgical operations
in the United States are unnecessary. A 1987 JAMA study found the following significant levels of inappropriate
surgery: 17% of cases for coronary angiography, 32% for carotid
endarterectomy, and 17% for upper gastrointestinal tract endoscopy.
Using the Healthcare Cost and Utilization Project (HCUP) statistics
provided by the government for 2001, the number of people getting
upper gastrointestinal endoscopy, which usually entails biopsy,
was 697,675; the number getting endarterectomy was 142,401; and
the number having coronary angiography was 719,949.13 Therefore,
according to the JAMA study 17%, or 118,604 people had an unnecessary
endoscopy procedure. Endarterectomy occurred in 142,401 patients;
potentially 32% or 45,568 did not need this procedure. And 17%
of 719,949, or 122,391 people receiving coronary angiography were
subjected to this highly invasive procedure unnecessarily. These
are all forms of medical iatrogenesis. Your best defense against an unnecessary hysterectomy? Information—and
a second opinion, says Nora W. Coffey, president of Hysterectomy
Educational Resources and Services, an educational organization
in Bala Cynwyd, Pennsylvania. Educational organizations can supply
information about the surgery. Overlapping of statistics in Death by Medicine may occur with
the Institute of Medicine (IOM) paper that designates "medical
error" as including drugs, surgery, and unnecessary procedures.
Since we have also included other statistics on adverse drug reactions,
surgery and, unnecessary procedures, perhaps as much as 50% of
the IOM number could be redundant. However, even taking away half
the 98,000 IOM number still leaves us with iatrogenic events as
the number one killer at 738,000 annual deaths. When in doubt about the diagnosis or recommendation, don't hesitate
to get a second opinion —or a second diagnostic test. Your
best defense against an unnecessary hysterectomy is obtaining information
before you meet with the doctor. Read books, find people who've
had the surgery (or the alternatives), contact support groups,
locate medical literature. And then show them to your doctor, says
Nora W. Coffey, president of Hysterectomy Educational Resources
and Services in Bala Cynwyd, Pennsylvania. "That's the way
to get a doctor's cooperation, and not hostility." And take
control in making the decision, she encourages. Get comprehensive
information about the condition you have, your options and the
risks and dangers of the options. Stressors create a field of disturbance in the energetic web of
the body. These fields of disturbance are most often in the head,
because the mouth is where we most readily allow thoughtless or
unnecessary surgery, excessive procedures, and implantation of
foreign materials. The results of the disturbance can be felt anywhere
in the body and can virtually block any treatment's effectiveness. Unwarranted Surgery and Heart Related Problems: YOU DON'T HAVE TO DIE: Angioplasty and coronary artery bypass
surgery are frequently unnecessary and produce no benefit to the
patient at all. Some people endure multiple operations (one patient
whose case is discussed in this book underwent 14 angioplasties)
without result or their condition returns later. In addition, bypass
surgery is dangerous, many people suffering strokes or other damage
to their brain as a result of the operation. The bottom line is this: when patients are advised to have a coronary
angiogram, chances are eight out of ten that they do not need it.
The critical factor in whether a patient needs coronary artery
bypass surgery or angioplasty is how well the left ventricular
pump is working, not the degree of blockage or the number of arteries
affected. The left ventricle (chamber) of the heart is responsible
for pumping oxygenated blood through the aorta (the large artery
emanating from the heart) and to the rest of the body. Bypass surgery
is only helpful when the ejection fraction (the amount of blood
pumped by the left ventricle) is less than forty percent of capacity.
Up to ninety percent of all bypass procedures are done when the
ejection fraction is greater than 50 percent, which is adequate
for circulatory needs. In other words, as many as 90 percent of
all bypass procedures may be unnecessary. Dr. Whitaker views most of the current therapies available to
heart disease patients as needless and unjustified. Most are ineffective
in terms of actually stopping and/or reversing the deterioration
that has begun by the time the patient seeks treatment. Catheterization,
for example, has insufficient scientific basis in Dr. Whitaker's
opinion, yet thousands of catheterizations are done almost routinely.
Catheterizations are used to detect arterial blockages and to open
them up, often in conjunction with a balloon angioplasty or a bypass.
The angioplasty technique, as explained earlier, is an invasive
method of trying to force open blocked spots within the arteries,
while bypass surgery involves severing the artery before the blockage
and rerouting the blood flow through an unblocked vein taken from
the leg. Recent clinical and laboratory studies have seriously questioned
the validity of the theory that a blocked coronary artery is the
primary cause of a heart attack. The angiogram, an invasive test
to evaluate coronary artery blockages, poses significant risks,
and has often been discredited. In many cases, bypass surgery is
considered unnecessary and dangerous. A team of conservative cardiologists in Brigham Hospital, Boston,
evaluated 88 patients that had been scheduled for cardiac bypass
surgery. They advised against surgery for 74 of the 88. Among those
74, 60 accepted a second opinion and didn't have the operation.
These patients were followed for a period of two years plus. Only
two had minor attacks that could be treated conservatively, an
outcome comparable to that of the 14 (scared not to take the advise
of the conservative specialists) patients that underwent open-heart
surgery. In short, a vast number of patients are submitted to unnecessary
procedures by cardiologists. A second opinion clinic was opened in Boston in 1982. The first
published study from the clinic involved 88 patients who had been
advised to have cabbage surgery elsewhere on the basis of ordinary
angiograms. Some had been referred by insurance carriers who were
hoping to get out of paying some large bills. Large insurance companies
are well aware that about 85 percent of cabbages are unnecessary,
and teach this fact during private seminars for their executives.
However, they don't make this public. On the brighter side, several studies have confirmed it is possible
to evaluate heart patients with non-invasive means and identify
people who will do well with medical management alone. In the best
of all worlds, this should become the wave of the future. But this
will never occur as long as these crises situations remain under
the control of people who are becoming rich by doing unnecessary
surgical procedures. Three of these studies were published in leading medical journals.
No efforts were made to attract media attention to the embarrassing
results. If the media had picked up the story they could have accurately
reported, "The diagnostic test used to scare the pants off
heart disease patients and coerce them into billions of dollars
of unnecessary surgical procedures is a scam." The information
was ignored by physicians and never picked up by the press. I have attacked myths about heart disease that cost Americans
billions of dollars per year in unnecessary surgical procedures,
as well as untold suffering. The list of abuses can start with
the widespread use of inaccurate angiograms that are used to plan
surgical procedures. People are conditioned to expect to live longer
if they have cabbage surgery, but survival rates are not improved
with surgery. The system encourages doctors who are learning to
do balloon angioplasties to practice on people who don't need any
surgical procedure. Long term survival after balloon angioplasty
has never been studied. The cholesterol theory is an empty shell.
These approaches to our number one killer disease represent a fraud
against the people more often than not. For example, bypass surgery for heart disease, at an average cost
of $44,000 per operation, is "one of the most unnecessary
operations of all," says McTaggart. Heart surgeons have known
since the 1970s that bypass does not improve survival except for
patients with severe left ventricle coronary disease, while U.S.
government statistics state that about 90% of patients receive
no benefit. The "miracle cure" of beta blockers to lower
high blood pressure (hypertension) also evaporates when you look
at the outcomes, McTaggart says. A British study of 2,000 patients
with high blood pressure showed that in barely 50% of the cases
blood pressure dropped to a moderately healthy level as a result
of taking hypertension drugs. Yet when faced •with heart disease, doctors recommend a
bypass. By so doing, we think, they bypass the real problem. Bypasses
are the single most commonly performed unnecessary surgery in the
country. Only two groups have been shown to benefit from bypass
surgery: one, those whose arteries are so badly clogged that the
heart can no longer beat adequately, and two, those with severe
blockage in the main artery to the heart and signs of resulting
poor blood flow. Pierce now knew the research in the field of nonlocal medicine
inside and out. She was amazed that many physicians ignored the
evidence. Their reasons, she suspected, were rooted in the tendency
of humans to hang onto what is familiar and comfortable. Many physicians,
for example, continued to do coronary bypass surgery the old way,
opening up the chest cavity, instead of using the new percutaneous
fiberoptic methods that made open-chest surgery unnecessary. The departments of health of each state should conduct a study,
at least every two years, on the success of such common operations
as bypass surgery and angioplasty, as does New York State. In addition,
they should publish risk-adjusted figures on breast cancer recovery
and other common illnesses, along with the rates of unnecessary
surgery as compiled by an independent board of surgeons. Unnecessary Bypass Operations Coronary cirtery bypass operations
have had a better record than the neck artery surgery. Earlier
studies of the heart operation—in 1979,1980, and 1982—also
showed some evidence of surgical mayhem. Fourteen percent of the
surgeries were "inappropriate" or unnecessary, defined
as "performing the procedure under circumstances where the
medical risk exceeded the medical benefits." The fourteen
percent was high, but much less than the carotid surgical extravagance.
But the unnecessary rate for bypass operations has now been reduced
considerably by new techniques and better choices by patients. An outspoken critic is Thomas A. Preston, professor of medicine
at the University of Washington, Seattle. Preston claims fully
one half of all cabbage surgeries performed in the United States
are unnecessary. He says that survival rates are basically the
same as with medical management, except for a well-defined minority
of patients, and in most cases cabbage surgery is no more effective
than a placebo. Race has been found to play a role in who gets cabbaged and who
does not. Nationally the rate of having a cabbage surgery runs
27.1 per 10,000 whites per year, and only 7.6 per 10,000 blacks.
Hospital admission rates for coronary artery disease for the two
races are the same. The authors concluded that racial prejudice
appears to influence cabbage surgery rates. There is another way
of viewing this study. Black people with coronary artery disease
are being spared a lot of unnecessary heart surgery because of
racial discrimination. These unusual treatments may make open-heart surgery unnecessary
for many heart patients. If your doctor recommends angioplasty
or bypass surgery for your angina, ask him about these new options
before making a decision. Unjustified Surgery - Hysterectomy: Hysterectomy: A hysterectomy (removal of the uterus) is another
risk factor for early osteoporosis, even if the ovaries are still
intact. "This is because anywhere between 16% and 57% of all
women who undergo uterus removal suffer from premature loss of
ovarian function with its associated rapid bone loss," explains
Dr. Brown.24 Unfortunately, this surgery, a conventional medical
solution for uterine fibroids and endometriosis, is all too common
among premenopausal women. Every year in the U.S., 750,000 women
undergo hysterectomies (many including ovary removal); about 90%
of these are unnecessary. Hysterectomy may also be performed after cesarean section in cases
of complications such as uncontrolled bleeding, gross infection,
or cancer of the cervix. Once misused in the belief that removing
the uterus (and often the ovaries) would control what were considered
inappropriate sexual urges and ambitions, it is still the most
common unnecessary surgery. Nearly half of all hysterectomies performed in the United States
are medically unnecessary. According to the People's Medical Society,
in 1970 one in twenty babies was delivered by Cesarean section
rather than normal vaginal childbirth. Today, one in four babies
is delivered by Cesarean section. (Interestingly, both surgeries
are performed on women.) Many people question the fact that over 650,000 hysterectomies
are performed in the United States each year. Very few of these
operations are performed because of a life-threatening situation,
and it is likely that many of them are actually unnecessary. Per
capita, half as many hysterectomies are performed in Great Britain
as in the United States, and, statistically, American women show
no health benefits for their higher incidence of surgery. Outside
the United States, very few hysterectomies are performed for what
doctors often term "quality of life" reasons. Obviously, despite the shortage of reports from the medical profession
itself, the problem of unnecessary surgeries is still a serious
one. Yet, ironically, unnecessary surgery normally is not considered
medical malpractice. According to "Medicine on Trial," a
People's Medical Society book: "When greed controls the impulse
to operate when an operation is not called for, as is often the
case in unnecessary surgery, such an operation is certainly a grossly
unethical and immoral act, but not a medical mistake per se." The
ultimate solution is prevention. But when, as a last resort, surgery
must be considered, patients need to have full and honest information
about the risks and benefits involved in the procedure. UNDER THE INFLUENCE OF MODERN MEDICINE lions of unnecessary hysterectomies
yet it is still the most frequent surgical procedure inflicted
on females. She also found that patients play a part in unnecessary surgery.
When they voiced objections to a hysterectomy for such conditions
as painful fibroids, doctors tended to change their opinion that
the operation was necessary. One of the most outspoken critics of unnecessary surgery is Dr.
Sidney Wolfe of Public Citizen. "If a doctor immediately says,
'Have a hysterectomy/ shop for a new physician," he suggests. "You
need tests to write off all the alternatives." Unwarranted Surgery – Cesarean Section: In 2001, Cesarean section is still the most common OB/GYN surgical
procedure. Approximately 4 million births occur annually, with
a 24% C-Section rate, i.e., 960,000 operations. In the Netherlands
only 8% of babies are delivered by Cesarean section. Assuming human
babies are similar in the U.S. and in the Netherlands, we are performing
640,000 unnecessary C-Sections in the U.S. with its three to four
times higher mortality and 20 times greater morbidity than vaginal
delivery.105 Research has indicated that cesarean sections, as well as being
associated with greater risks to mother and infant, are often unnecessary. Unnecessary surgery referred to the modern rash of cesareans as
a "surgical epidemic." Calling on understatement, the
American College of Obstetricians and Gynecologists admits that
C-sections "are more common than they should be." An
actual estimate, made by the Centers for Disease Control, says
that 349,000 of the cesarean surgeries were unnecessary. This is
a serious situation. The operation is major surgery, and when inappropriate,
carries two to four times greater risk to the mother than normal
vaginal birth. This is a serious situation. The operation is major surgery, and
when inappropriate, carries two to four times greater risk to the
mother than normal vaginal birth. Public Citizen, which puts out
a regular report on the rate of C-sections, believes the surgery
is done almost twice as often as medically indicated, at a cost
of an extra $1.3 billion and unnecessary pain and injury. Just as one surgical operation—like tonsillectomy—is
shot down by intelligent criticism, another, like C-section, rises
to take its place in the inventory of often unnecessary surgeries.
It is now up to the profession—or if forced, the states—to
stop the excess cutting stimulated by either greed, medical fashion,
or ignorance. That is the only way to protect the unknowing patient
public. Chapter VI Women who have their babies without CNMs are also more likely
to be denied room to walk around during labor to ease their discomfort,
more likely to be denied the use of a bath or shower during their
labor, and more likely to undergo unnecessary cesarean surgery. Multiple Types of Surgery Mentioned: In 1985 the U.S. Senate's Special Committee on Aging found that
unnecessary operations (most for hernias, hemorrhoids, gallstones,
enlarged prostates, heart disease and similar conditions), far
from helping patients were actually shortening their lives and
wasting money — billions of dollars. The committee found
that operations increased 130 percent after Medicare went into
effect. The American College of Surgeons and the American surgical
Association suggested that 30 percent of the millions of operations
being performed each year were unnecessary with 50 percent of the
remaining procedures beneficial but not essential to save or extend
the patient's life. In all, it was thought that the needless and
dubious operations were causing an unnecessary thirty thousand
deaths per year. The unnecessary expenses and deaths become noticeable
when doctors are in short supply or go on strike. In such cases
the death rate in an area can drop remarkably — much to the
embarrassment of the medical community (when the facts can't be
covered up). 1974: 2.4 million unnecessary surgeries performed annually resulting
in 11,900 deaths at an annual cost of $3.9 billion. 2001: 7.5 million
unnecessary surgical procedures resulting in 37,136 deaths at a
cost of $122 billion (using 1974 dollars). It's very difficult
to obtain accurate statistics when studying unnecessary surgery.
Dr. Leape in 1989 wrote that perhaps 30% of controversial surgeries
are unnecessary. Controversial surgeries include Cesarean section,
tonsillectomy, appendectomy, hysterectomy, gastrectomy for obesity,
breast implants, and elective breast implants. Myriad of reasons—mix-up of X rays and patient charts, surgeons'
haste to "beat their time" doing a procedure, poorly
trained surgeons, and unnecessary surgeries, especially hysterectomies
(nearly half are unnecessary), coronary bypass operations (one
out of every three may be unnecessary), and Cesarean sections.
In addition, the area of the country in which you live plays an
important part in the type of surgery you will undergo. Hysterectomies. American Health also reported in April 1993 that
the chance that a woman in Maine will undergo a hysterectomy varies
from 20% to 70%, depending on where in the state she lives. Local
preference, not science, explains the disparity. In general, the
reason for most hysterectomies is to resolve symptoms related to
benign uterine fibroids. New studies show that if they aren't causing
any serious and immediate symptoms, surgery is unnecessary. Cesarean
sections. The U.S. Centers for Disease Control reported that in
1991 some 349,900 unnecessary cesarean sections were performed,
at a cost of more than $1 billion. The rate skyrocketed from 10.4%
of births in 1975 to 24.5% in 1988. Again, the issue isn't just
money, although $ 1 billion would pay for a lot of health care
for those who don't have it. Surgery can lead to infections and
longer hospital stays. On the other hand, studies show that particular areas of the country
as well as specific hospitals within a community often are more
likely to perform operations that may be unnecessary—such
as tonsillectomies, hysterectomies, and cesareans—than others.
If you're assigned to a particular physician's group or hospital
where the standard of care mandates surgery rather than more conservative
treatment, demand a second opinion. Myringotomies are currently being performed on nearly 1,000,000
American children each year. It appears that the unnecessary surgery
of the past, the tonsillectomy, has been replaced by this new procedure.
In fact there is a direct correlation between the decline of the
tonsillectomy and the rise of the myringotomy. Over 2 million myringotomy
tubes are inserted into children's ears each year, along with 600,000
tonsillectomies and adenoidectomies. These surgeries are unnecessary
for most children. Unjustified Surgery due to Back Pain: Unnecessary surgery waxes and wanes. First one operation, like
tonsillectomy, is in fashion, then another, like C-sections. The
most recent "in" technique is "back surgery." A forceful critic of much back surgery is Dr. Richard A. Deyo,
professor at the University of Washington School of Medicine. He
points out that most low back pain is caused by a simple muscle
strain, which over time heals itself. It is not, he says, usually
caused by herniated disks in the spine, which are the target of
most surgeries. Dr. Deyo estimates that "diskectomy," the
name of such surgery, is performed on 300,000 people a year, and
is often a wasteful, unnecessary activity. A diskectomy involves
cutting through the bony parts of the vertebrae to remove the jellylike
substance inside. The reason is that in herniated disks, the substance
protrudes, putting pressure on the nerves. Dr. Deyo, writing in the journal Spine, says America is undergoing
an unnecessary back surgery epidemic of such proportions that surgeons
here perform diskectomies forty percent more often than other Western
nations and five times more often than in England and Scotland.
It also appears that the number of back surgeries relates directly
to the number of appropriate surgeons available in the nation according
to population. In the same publication, Dr. Deyo and others also
studied hospitalization for back pain and found that from 1979
to 1990, nonsurgical hospitalizations decreased dramatically. Meanwhile,
admissions for surgery increased. Orthopedic doctors, who specialize in injuries related to the
muscles, joints, bones, tendons, and ligaments, are often inexperienced
with conservative methods of treatment and are sometimes too willing
to engage in unnecessary surgery. The problem is that surgery has
limited long-range benefits and is completely unnecessary for many
lower back pain sufferers. When confronted with pain caused by
a factor that does not show up on an X ray, an orthopedist will
generally refer the patient to another professional. If you are
going to an orthopedic specialist for advice on back pain, it is
recommended that you see one who does not reflexively advocate
surgery or prolonged reliance on prescription drugs. In 2001, the top 50 medical and surgical procedures totaled approximately
41.8 million. These figures were taken from the Healthcare Cost
and Utilization Project within the Agency for Healthcare Research
and Quality. Using 17.6% from the 1974 U.S. Congressional House
Subcommittee Oversight Investigation as the percentage of unnecessary
surgical procedures, and extrapolating from the death rate in 1974,
we come up with an unnecessary procedure number of 7.5 million
(7,489,718) and a death rate of 37,136, at a cost of $122 billion
(using 1974 dollars). Researchers performed a very similar analysis,
using the 1974 'unnecessary surgery percentage' of 17.6, on back
surgery. In 1995, researchers testifying before the Department
of Veterans Affairs estimated that of 250,000 back surgeries in
the U.S. at a hospital cost of $11,000 per patient, the total number
of unnecessary back surgeries each year in the U.S. could approach
44,000, costing as much as $484 million. They studied the surgical treatment for the common complaint of "low
back pain," and concluded that most of the operations were
unnecessary. In fact, says the agency, the less treatment for these
pains, surgical or medical, the better. A report in the New England
Journal of Medicine, for instance, decried the use of corticosteroids
as risky and of little value. The evidence, says the federal agency,
shows that regular activity rather than bed rest reduces the chances
of developing a chronic condition that leads to surgery. The findings of the MRIs are often misleading and lead to "unnecessary
surgery and the results are not very good," Froymeyer said.
Another expert, Robert Boyd, M.D., an orthopedic surgeon at Massachusetts
General Hospital in Boston, said, "surgery doesn't put new
backs in and it doesn't give better long-term results. It is indicated
when pain doesn't respond to conservative treatment and is clearly
associated with nerve root compression. Then the results of surgery
are excellent." But only a small percentage of people with
back pain fall into this category, according to Boyd. Unwarranted Surgery due to Results of Mammography: Mammograms Add to Cancer Risk—Mammography exposes the breast
to damaging ionizing radiation. High Rate of False Positives—Mammography's
high rate of false-positive test results wastes money and creates
unnecessary emotional trauma. A Swedish study of 60,000 women,
aged 40-64, who were screened for breast cancer revealed that of
the 726 actually referred to oncologists for treatment, 70% were
found to be cancer free. According to The Lancet, of the 5% of
mammograms that suggest further testing, up to 93% are false positives.
The Lancet report further noted that because the great majority
of positive screenings are false positives, these inaccurate results
lead to many unnecessary biopsies and other invasive surgical procedures.
In fact, 70% to 80% of all positive mammograms do not, on biopsy,
show any presence of cancer. According to some estimates, 90% of
these "callbacks" result from unclear readings due to
dense overlying breast tissue. High Rate of False Negatives—Mammography
also produces a high rate of false-negative test results. While
false Breast Cancer type of abnormality found and the age of the woman.
Usually the follow-up tests begin with the least invasive methods,
such as an ultrasound or second mammogram, and progress, if necessary,
to the more invasive methods, such as a needle or surgical biopsy.
A biopsy should spare the tissue, removing just enough tissue to
make a diagnosis without being unnecessarily invasive. A woman
should not rush from one abnormal screening mammogram or clinical
breast exam to a major, invasive surgical procedure or to treatment
for breast cancer. Following the series of tests outlined below
can ensure that the diagnosis is correct and assist in avoiding
unnecessary procedures. Early detection is currently one of the primary strategies for
prevention and successful treatment, which is why the breast self-exam
is so important. The benefits of mammography are still a subject
of debate. Questions that are still present include whether low-level
radiation used in the test can contribute to cancer, whether equivocal
results lead to unnecessary surgery, and the accuracy rate of test
results. Equivocal mammogram results lead to unnecessary surgery, and the
accuracy rate of mammograms is poor. According to the National
Cancer Institute (NCI), in women ages 40-49, there is a high rate
of "missed tumors," resulting in 40% false-negative mammogram
results. Breast tissue in younger women is denser, which makes
it more difficult to detect tumors, and tumors grow more quickly
in younger women, so cancer may develop between screenings. Corruption and Unjustified Surgery ($): Doctors and hospitals are paid more for doing more, largely without
regard for evidence of improved health outcomes (examples are the
rapid increase in the number of MRI machines, excess capacity for
neonatology and invasive cardiac procedures that lead to excess
use, and the approximately 12,000 deaths that occur each year as
the result of unnecessary surgery). Health care providers that
deliver high quality, efficient care are financially penalized
for not delivering a higher volume of more intensive services,
beneficial or not (referred to as the "perverse incentive"). We could do much more to lower costs, such as practicing scientifically
based medicine, but it's like combating an epidemic. There is such
a strong incentive, as with the pharmaceutical industry and surgical
subspecialists, to keep prices—and profits or incomes—high.
It will likely require a major change in how we organize health
care in America to effect any meaningful change. If we were really
to practice scientifically based medicine, the cost savings would
be great. We order and do so many unnecessary tests and procedures,
and our prescribing patterns are illogical and expensive. Most health problems are not emergencies. To treat them as though
they were chronic, recurrent emergencies, which is the way medicine
is often practiced today, is costly, time consuming and generally
ineffective. It causes many problems, often more than it relieves,
and these are sometimes deadly. Side effects of medications kill
more people annually than automobile accidents. Unnecessary surgery
(heart disease and other conditions) has significant mortality
while it also drives up health care costs. This approach to health
care also takes the power and responsibility for your health out
of your control. Clinical care, which was improving, is now being subject to new
rules, systems, and regulations from the outside, which punish
both good medicine and good doctors. Surgery is still too often
unnecessary. Medical fraud, always a small problem, has become
near epidemic. American hospitals are adrift, struggling against
empty beds, fierce competition, and massive confusion. Surgery is similarly a vastly lucrative practice, acting as the
third financial mooring in the tripod of cancer treatments. The
more radical the operation, the more costly. Since surgeons are
rewarded monetarily for the magnitude of their handiwork, excess
becomes a perverse incentive for financial success. The amount
of unnecessary surgery is high. As early as 1953, Dr. Paul Hawley,
director of the American College of Surgeons, stated matter-of-factly
in an interview in U.S. News and World Report, "You'd be shocked,
I think—we are—at the amount of unnecessary surgery
that is performed." The reason, according to Hawley? "Money." This truth has been deliberately concealed from the general public.
According to Dr. Gould, the reason for this conspiracy of silence
is money. The public must continue to see the cancer establishment
as a winner to continue providing money. One of the quoted scientists
said that, with tens of thousands of radiologists and millions
of dollars in equipment, one still gives radiation treatment even
if study after study shows that it does more harm than good. Dr.
Gould says patients who could be comfortable without medical treatment
until their inevitable death are made miserable with medical treatment
in a pointless attempt to postpone death for a few unhappy weeks.
Of course, that is when most of the money is being made. Dr. Gould
says doctors poison their patients with drugs and rays and mutilate
them with unnecessary surgery in a desperate attempt to treat the
untreatable. Unnecessary surgery: With appendicitis produced only two "false
positives," patients who did not have the disease. This is
in contrast to the twenty percent proven to have healthy appendixes
after surgery. The technique, called "Focused Appendix CT" or
FACT, could eliminate this type of unnecessary surgery—at
least in the hands of honest surgeons. Unlike other doctors, surgeons
are not content to live on forty dollars per patient visit. Many
still see the operating table as a chance for the brass ring—the
new SL600 Mercedes coupe for $139,000, or even the down payment
on a piece of land in Southampton or Malibu. Miscellaneous (tonsils/adenoids, prostatectomy, cancer, carotid endarterectomy, mastectomy etc): Rufer and her husband sued Abbott Laboratories, UWMC, and the
cancer specialist who treated her. UWMC and the doctor argued that
they had relied on the Abbott test results. Abbott denied all responsibility,
even though the literature distributed with its tests made no mention
of the potential for false positives. What's more, according to
a court opinion, it turned out that "Abbott also had access
to reports that false positive results on its assay led to unnecessary
cancer treatment before 1998. It received over forty complaints
of false positives, including multiple complaints of unnecessary
chemotherapy and surgery before Jennifer Rufer's first treatment
in April 1998. Although it embraces new technology, the medical profession has
a tendency to reject new ideas. Surgeons are willing to learn new
ways of performing operations, although few seem eager to examine
possible alternatives to surgery. Much of this can of course be
explained by the fact that research into surgery is normally performed
by surgeons. Their training and experience does not lend itself
to looking into other options. Cardiac surgeons, for instance,
would be unlikely to work at a project that would prove that most
heart operations are unnecessary or dangerous. That conclusion
would not only put their livelihood at risk, but also invalidate
their entire vocation. The only people in the operating room who
have a clear reason for wanting the truth are the patients on the
tables. But if we wait until that moment to learn the truth, it
might be too late. Anesthesiologists benefit from bypass surgery. In medical slang
anesthesiologists are called gas passers. Anesthesiologists use
measured amounts of poisons to put surgical patients to sleep and,
hopefully, wake them up. They bill patients by the hour. Each cabbage
case may take about two to three hours of their time. They have
nothing to do with the decision to do surgery, but you don't hear
any of them making waves by complaining about unnecessary surgery.
To do so would jeopardize their standing in the anesthesia department
and their livelihoods. About 300,000 men per year have surgery to correct enlarged prostates,
but many of those surgeries may be unnecessary. There are many
natural remedies that you can find in health food stores that will
shrink your prostate, if BPH is the cause. (Note: Only a doctor
can tell the difference between BPH and prostate cancer, so get
a firm diagnosis before you go ahead with natural remedies). But religious considerations aside, circumcision has caught on
among non-Jews in the United States. The operation has been the
center of a medical debate: Does it provide health benefits, or
is it unnecessary surgery? Surgery has come under increasing criticism in recent years for
a number of other reasons. Some doctors and patients hold that
much cancer surgery is either unnecessary or excessive in its scope.
The fiercest argument has taken place over the question of breast
cancer, but the issues raised in this debate appear applicable
to other forms of cancer as well. Surgery is unnecessary when the risk is greater than the benefit,
or when there is no strong evidence that the surgery will benefit
most of the people operated on. Going under the knife. One explanation for high U.S. medical costs
is that so much surgery is unnecessary. Ask for a plain-English
explanation of the need for and alternatives to any surgery. The innocuous behavior of recurring tumors is a mystery. Some
surgeons think that leaving a few cancerous cells to roam about
after surgery is a deadly mistake. Others believe that these cells
simply turn into tumors that can be removed without threatening
the life of the patient. Still, many leaders in the field of oncological
surgery, either out of fear or arrogance, continue to demand that
more studies be conducted before modifying the traditional treatments.
How many patients will become the innocent victims of this irrational
posturing? The same tendencies have also been observed in other
types of tumors. For example, sarcomas are tumors that generally
form from muscle or fat in the extremities. Treatment of them always
consists of an extensive amputation followed by radiation therapy,
with the object of reducing the incidence of recurrence. After
reviewing the experiences of numerous hospitals, one concludes
that "a reduction of local recurrence does not mean a betterment
of average life expectancy in the long run." In other words,
the frightening mutilations are entirely unnecessary. The same
conclusions can be applied to melanoma a very aggressive skin cancer,
which is generally treated with excessively radical surgery. The indiscriminate, and often unnecessary, surgical removal of
these glands does not solve the underlying immunological problem
that caused them to be swollen and diseased in the first place.
Often, after a short period of improvement, it leads to chronic
allergy problems. If the microorganisms get past the tonsils and
adenoids, ciliated microfilaments lining the upper passages of
the lungs remove them in secreted phlegm; they do this in a wavelike
fashion, much like firemen of an earlier time on a bucket brigade. The common carotid endarterectomy surgery is designed to prevent
a full-fledged stroke. But is it often overused and unnecessary,
especially when there is insufficient diagnosis. In fact, because of the high potential for false positive readings—where
people are told they have cancer when they don't—screening
may only be increasing the number of patients mutilated through
unnecessary drug treatment or surgery. Doctors differ considerably in their approval of this "nontreatment." Naturally
the more surgery-prone physicians lean in the direction of early
removal of the prostate, while the more conservative ones tell
us that for any man whose life expectancy is less than 10 years,
the surgery may offer only unnecessary discomfort and incapacity. Alvsborg County Council felt the costs of a mass-screening program
far outweighed any benefits, and that the money saved could be
better spent helping those diagnosed with cancer. The council voted
for the ban, following advice from the county's chief physician,
Dr. Christer Enkvist, who felt that the advantages of screening
are "extremely marginal" and can lead to unnecessary
surgery. |
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