It is shocking to continually read articles about doctors performing unnecessary surgeries. The most recent story involves Sacred Heart Hospital and some of its doctors. According to The Bloomberg News, a pulmonologist at the hospital kept patients too sedated to breathe on their own, and then ordered unnecessary tracheostomies so that the hospital could reap huge profits.
USA Today recently published a story about a study they conducted, reviewing government records and medical databases. They found tens of thousands of patients undergo unnecessary surgeries every year. These surgeries include unnecessary cardiac stents, angioplasty and pacemaker implants; unnecessary spinal surgeries; unnecessary knee replacements; and unnecessary hysterectomies and cesarean sections.
Academic studies have been following this problem as well. In 2011, the Journal of the American Medical Association published a study that found that 22.5% of implantable cardioverter debrillators (ICDs) were placed in patients who did not meet the medical criteria set forth by practice guidelines. These patients also faced significantly higher risk of in-hospital death and post-procedure complications.
Also in 2011, the journal, Surgical Neurology International, reported the findings of a senior neurosurgeon at the Albert Einstein College of Medicine in New York who saw patients in the office for consultations, including second opinion consultations. In just a singe one year time period, of the 274 patients seen, 47 of them (17.2%) were told they needed spine surgery when, in fact, surgery was unnecessary. These patients had no neurological deficits and had no significant abnormal findings on radiology studies. These patients included both cervical pain patients and lumbar pain patients. The planned operations included anterior diskectomy/fusion, laminectomies/fusion, posterior cervical diskectomy, and single and multilevel posterior lumbar interbody fusions. The author felt that the 17% was a significant underestimate of the true number of patients undergoing unnecessary, very invasive and risky surgeries.
What conclusions can we reach from this? I think the best one is that second opinions are a really good idea, especially if a major surgical procedure is recommended. The various studies support this. When patients were required to obtain a second opinion, such as pursuant to Medicaid regulations, a large percentage of them did not require the surgeries that had been recommended. I think second opinions are also good so you can do a little surgeon comparison shopping. Who do you like? Who do you feel comfortable with? Confident with? Get a second opinion from someone who practices at a different hospital. Look them up, get information, ask questions.