Tens of thousands of Americans each year undergo surgical procedures that are not necessary because their physicians are “immoral, incompetent and indifferent,” according to a study by USA Today.
“It’s a very serious issue, (and) there really hasn’t been a movement to address it,” warned Lucian Leape, a professor at the Harvard School of Public Health.
The patient-safety expert began studying unneeded surgeries when a congressional report from nearly 40 years ago estimated there were 2.4 million cases each year and 12,000 people died because of those surgeries.
He said things “haven’t changed very much.”
The USA Today study indicates there are tens of thousands of surgeries each year that are unnecessary and, in many instances, dangerous.
According to the USA Today report, it’s mostly a matter of money.
“Doctors who perform needless operations to enrich themselves are the public face of the problem. Lured by the millions of dollars that can be made by billing Medicare, Medicaid and private insurers for expensive procedures that aren’t necessary, they’ve become a top target of investigators who consider this type of health care fraud to be particularly insidious,” the report said.
The USA Today evaluation found that 10 percent to 20 percent of some common surgeries are done unnecessarily, and more than 1,000 doctors already have paid malpractice claims.
The report used Jonathan Stelly, 22, as an example.
He was a semipro baseball player when a fainting spell sent him to the doctor’s office.
Stelly was told if he “wanted to live to age 30 … he’d need a pacemaker.”
He trusted his doctor’s recommendation and had the surgery.
But months later, “local news outlets reported that the Louisiana cardiologist, Mehmood Patel, was being investigated for performing unnecessary surgeries.”
“Stelly had another doctor review his case,” the report said. “Then another. And another. They all agreed: He needed blood pressure medication, but he never needed the pacemaker.”
USA Today said today Patel is in prison on convictions for dealing in unneeded surgeries. And Stelly has lost whatever baseball opportunities he may have had.
“The scope and toll of the problem are enormous, yet it remains largely hidden. Public attention has been limited to a few sensational cases, typically involving doctors who put cardiac stents in patients who didn’t need them,” the report said.
The study said that 10 percent of all spinal fusions funded by Medicare in 2011 were not needed. It also cited a Journal of the American Medical Association report that of 112,000 patients who had an implantable cardioverter-defibrillator, in nearly 25,000 cases there was no medical evidence supporting the use of the machines.
USA Today cited another study, from the Surgical Neurology International publication, that looked at 274 patients with neck and back complaints. More than 17 percent were told they needed surgery.
“The procedures are notoriously tough to identify, even for the victims. If, for example, someone has an unnecessary knee replacement, that person might never know that the pain could have been relieved just as effectively with physical therapy or a less invasive procedure. The symptoms are gone, so the patient suspects nothing,” the report said.
“If we ever learn about it at all, it’s only after the fact, if something goes wrong and the patient sees another doctor, or if Medicare or someone else comes in retroactively and does an audit,”said Rosemary Gibson, an authority on patient safety and author of “The Treatment Trap.”
“The system, in my opinion, doesn’t want to know about this problem,” she said.
The report explained: “Doctors who perform needless operations to enrich themselves are the public face of the problem. Lured by the millions of dollars that can be made by billing Medicare, Medicaid and private insurers for expensive procedures that aren’t necessary, they’ve become a top target of investigators who consider this type of health care fraud to be particularly insidious.”
The study concluded that in most cases of unnecessary surgery, there is no sinister or criminal incentive.
But, said Patty Skolni of the Citizens for Patient Safety organization, don’t take a doctor’s word.
“Research your doctor, research the procedure, ask questions, including the most important one: ‘What will happen if I don’t get this done?’” she said.
“We expect the physician to know what’s best for a patient,” William Root, chief compliance officer at Louisiana’s Department of Health and Hospitals, told USA Today. “We put so much faith and confidence in our physicians, (and) most of them deserve it. But when one of them is wrong or goes astray, it can do a lot of damage.”