Most surgical meniscus repairs are unnecessary. How do you learn about other possibly unnecessary procedures? What is CHOOSING WISELY?

I recall a surgeon telling me many, many years ago he did open hernia repairs, turns out he hadn’t been trained yet to do them laparoscopically.

There is an old phrase in teaching hospitals about learning a new technique: “See one, do one, teach one.” And then some physicians continue to do that forever even as new evidence suggests otherwise. It is the patient’s responsibility to make sure that a procedure is necessary, that it is “state of the art “and that potential gain outweighs possible harm.

For example, It seems everyone I know has had meniscus surgery or been told they need it (like I have!). Have you already had it done? A new study raises questions about the efficacy of meniscus surgery.

“Injury to the menisci, the cartilaginous discs within the knee joint, can be painful when running, and can cause the knee to give way or ‘lock’. Such injuries are troublesome and sometimes painful, and can prevent you from exercising or attending work.

A new study shows that exercise therapy is just as effective for treating meniscus injuries as surgery… lots for treatment with either exercise or surgery. … “Two years later, both groups of patients had fewer symptoms and improved functioning. There was no difference between the two groups.“ (A)

However, those who had exercised had developed greater muscular strength. This is consistent with previous research, which showed that surgery yielded no additional benefits for patients who had had exercise therapy.”

“A 2012 report by the Institute of Medicine estimated that $750 billion—about 30 percent of all health spending in 2009—was wasted on unnecessary services and other issues, such as excessive administrative costs and fraud.” (B)

In 2013, USA Today reported six “common surgeries are often done unnecessarily”: Cardiac angioplasty; Cardiac pacemakers; Back surgery, spinal fusion; Hysterectomy (surgical removal of the uterus); Knee and hip replacement; and Cesarean section. (C)

And more recently the Wall Street Journal reported that” “In the medical community, however, experts are divided on whether there is a benefit to getting an annual exam. Some research has shown regular physicals don’t reduce rates of illness or mortality and are a waste of health-care resources. They also could be harmful, for example, when false positives result in additional, unnecessary testing. Other experts say a yearly checkup is an important part of building a physician-patient relationship and can lead to unexpected diagnoses such as of melanoma and depression.” (D)

WHAT IS ONE TO DO?

CHOOSING WISELY aims to promote conversations between clinicians and patients by helping patients choose care that is: Supported by evidence; Not duplicative of other tests or procedures already received; Free from harm; Truly necessary. (E)

“The goal of the campaign is to reduce waste in the health care system and avoid risks associated with unnecessary treatment. It calls upon leading medical specialty societies and other organizations to identify tests or procedures commonly used in their field whose necessity should be questioned and discussed with patients. The effort has garnered the participation of over 70 medical specialty societies who have published more than 400 recommendations of overused tests and treatments that clinicians and patients should discuss. (F)

Examples of topics include: Treatments and Tests Your Baby May Not Need in the Hospital; Back Pain Tests and Treatments; When It’s Hard to Get Pregnant; Antibiotics for People with Catheters; Clogged Neck Arteries; Neck and Back Pain; Making Smart Decisions About Genetic Testing; Do I Need This Cancer Test or Treatment? ; Colds, Flu, and Other Respiratory Illnesses in Adults; Blood Tests When You’re In The Hospital. And there is a Search Engine to help you find specific areas of interest. (G)

Are you ready to ask your physician to go over CHOOSING WISELY with you when you are deciding whether or not to have a procedure?

EXPECT MEDICARE AND INSURANCE COMPANIES TO START USING CHOOSING WISELY AS A REIMBURSEMENT THRESHOLD!

Note: This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

 

(A) https://www.sciencedaily.com/releases/2016/07/160722093239.htm#.V7mt31UCZ7g.email

(B) http://www.scientificamerican.com/article/medical-procedures-prove-unnecessary/

(C) http://www.usatoday.com/story/news/health/2013/06/19/surgeries-unnecessary-patients-medical/2439075/

(D) http://www.wsj.com/articles/is-an-annual-physical-necessary-1453140799

(E) http://www.choosingwisely.org/about-us/

(F) http://abimfoundation.org/what-we-do/choosing-wisely

(G) http://www.choosingwisely.org/patient-resources/

 

Note: This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

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