NCPA - National Center for Policy Analysis

Doctors Perform Thousands of Unnecessary Surgeries

June 24, 2013

Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary. Some fall victim to predators that enrich themselves by bilking insurers for operations that are not medically justified. Even more turn to doctors who simply lack the competence or training to recognize when a surgical procedure can be avoided, either because the medical facts don't warrant it or because there are non-surgical treatments that would better serve the patient, says USA Today.

The scope and toll of the problem are enormous, yet it remains largely hidden. Public attention has been limited to a few sensational cases.

  • In fact, unnecessary surgeries might account for 10 percent to 20 percent of all operations in some specialties, including a wide range of cardiac procedures as well as many spinal surgeries.
  • Knee replacements, hysterectomies and cesarean sections are among the other surgical procedures performed more often than needed.

Since 2005, more than 1,000 doctors have made payments to settle or close malpractice claims in surgical cases that involved allegations of unnecessary or inappropriate procedures. About half the doctors' payments involved allegations of serious permanent injury or death, and many of the cases involved multiple plaintiffs, suggesting many hundreds, if not thousands, of victims.

The costs of unnecessary surgeries touch consumers and taxpayers in ways most never imagine. Medicare, Medicaid and their private insurance counterparts spend billions of dollars on operations that shouldn't be done, draining health care dollars that could go to far better use.

  • About 10 percent of all spinal fusions paid for by Medicare in 2011 were not necessary, either because there was no medical basis for them or because doctors did not follow standards of care by exploring non-surgical treatments.
  • A 2011 study in the Journal of the American Medical Association reviewed records for 112,000 patients who had an implantable cardioverter-defibrillator (ICD), a pacemaker-like device that corrects heartbeat irregularities. In 22.5 percent of the cases, researchers found no medical evidence to support installing the devices.

The fee-for-service nature of U.S. health care essentially rewards those that put more patients under the knife. The 2010 health care law, still being implemented, promises changes in the payment system that may pressure health care providers to cut unnecessary surgeries, but the key is to redefine the doctor-patient relationship.

Source: Peter Eisler and Barbara Hansen, "Doctors Perform Thousands of Unnecessary Surgeries," USA Today, June 20, 2013.


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