Unnecessary Surgeries Still Being Done at Alarming Rate
Law firms in Jacksonville FL, such as Edwards & Ragatz, comprehend the broad topics that identify as medical malpractice. For instance, did you know that even though a drug has to go through testing to show it is safe before it can be put on the market, surgery is different? Law firms in Jacksonville FL know the FDA regulates drugs, but do not regulate surgical procedures. So my next thought is what happens if there is a procedure that is created to rectify a medical problem but it fails to rectify that problem? I would assume that the procedure would be scrapped and those researchers/physicians would “go back to the drawing board”.
According to a recent article in The New York Times, that is not the case. It looks like it is the responsibility of the patients to ask what evidence, if any, shows that surgery is better than other options. For example: spinal fusions which is an operation that welds together adjacent vertebrae to relieve back pain from worn-out discs. Surprisingly, it was only tested in four clinical trials. The conclusion was dismal: surgery was no better than alternative nonsurgical treatments. Those that opted for nonsurgical treatment had their back pain diminish or actually go away. The studies were completed by the early 2000s and should have been enough to greatly limit or stop the surgery. The Times articles cites to Dr. Richard Deyo, professor of evidence-based medicine at the Oregon Health and Sciences University. Instead of the fusions stopping, the rates for fusions increased. Consequently, the clinical trials had little to no effect. Spinal fusion rates continued to increase in the United States until 2012, shortly after Blue Cross of North Carolina said it would no longer pay and some other insurers followed suit. Consult law firms in Jacksonville FL if you’ve experienced any type of medical neglect or misinformation.
Other operations continue to be reimbursed, despite clinical trials that cast uncertainty on their usefulness. In 2009, the respected New England Journal of Medicine published results of separate clinical trials on a back operation, vertebroplasty, comparing it to a bogus procedure. They found that there was no benefit — pain relief was the same in both groups. Yet it and a comparable operation, Kyphoplasty, continue to be performed. The Times interviewed Dr. David Kallmes of the Mayo Clinic, an author of a vertebroplasty paper. He told them that he thought doctors continued to do the operations because insurers pay and because doctors remember their own patients who seemed better afterward. “Surgery is sometimes no better than alternative nonsurgical treatments. “I think there is a placebo effect not only on patients but on doctors,” Dr. Kallmes adds.
The recent operation and the one that probably has been studied the most in randomized clinical trials — is surgery for a torn meniscus. It’s a condition that often afflicts middle-aged and older people, simply as a consequence of degeneration that can occur with age. The result can be a painful, swollen knee. So many think you must be able to do a procedure to trim / repair the torn tissue? About 400,000 middle-aged and older Americans a year have meniscus surgery. What is surprising is that at one time Orthopedists wondered if the operation made sense because they realized there was not even a clear relationship between knee pain and meniscus tears. When they did M.R.I. scans on knees of middle-aged people, they often saw meniscus tears in people who had no pain. And those who said their knee hurt tended to have osteoarthritis, which could be the real reason for their pain. Added to that complication, said Dr. Jeffrey N. Katz, a professor of medicine and orthopedic surgery at Harvard Medical School, is the fact that not everyone improves after the surgery. As a result, many doctors are split on which is better — exercise and physical therapy or surgery. That led Dr. Katz and his colleagues to conduct a clinical trial comparing surgery with physical therapy in middle-aged people with a torn meniscus and knee pain. The result: The surgery offered little relief to most. Other studies came to the same conclusion, and so did a meta-analysis published last year of nine clinical trials testing the surgery. Patients tended to report less pain — but patients reported less pain no matter what the treatment, even fake surgery.
Then came yet another study, published on July 20 in The British Medical Journal. It compared the operation to exercise in patients who did not have osteoarthritis but had knee pain and meniscus tears. Once again, the surgery offered no additional benefit. An accompanying editorial came to a biting conclusion: The surgery is “a highly questionable practice without supporting evidence of even moderate quality,” adding, “Good evidence has been widely ignored.”
So what should patients be told? Should they even be offered the surgery? Patients should be told that physical therapy is a good first-line therapy for pain relief, Dr. Katz told the Times, but that surgery also relieves pain. Pain relief can take longer with physical therapy, he says. With surgery, he said, patients have to recover from the operation but are likely to be back at work within two weeks. “At the end of the day,” he said, “patients ought to choose.” Of course, how they choose might depend on how the choice is presented.
If you or a loved one has been a victim of medical malpractice and searching law firms in Jacksonville, contact us at Edwards & Ragatz for a free consultation. (904)399-1609 or (866)366-1609. www.edwardsragatz.com
In vertebroplasty, physicians use image guidance to inject a cement mixture into the fractured bone through a hollow needle.
In kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. The cement is injected into the cavity once the balloon is removed.
A meniscus tear is a common injury to the cartilage that stabilizes and cushions the knee joint. The type of the tear can determine whether your tear can be repaired. Radial tears sometimes can be repaired, depending on where they are located. Horizontal, flap, long-standing, and degenerative tears-those caused by years of wear and tear-generally cannot be repaired.