Americans frequently undergo unnecessary surgeries

Tens of thousands of patients annually submit to costly operations that could easily be avoided.

By Bruce Kennedy Jun 20, 2013 3:12PM

Medical doctor (© Sean Justice/Corbis)America's broken health care system means patients often need to be both educated and skeptical when it comes to costly, complicated and potentially life-altering medical procedures. That reality was recently underscored by a new USA Today report showing that tens of thousands of people in the U.S. annually undergo surgery that isn't necessary.


The newspaper reviewed government records and medical databases and found that unnecessary medical procedures might make up anywhere from 10% to 20% of all surgeries in some specialties.


It also cited data and research compiled by the Choosing Wisely Campaign, an organization led by the American Board of Internal Medicine and Consumer Reports, outlining some unsettling statistics regarding eight common surgical procedures.


Here are some findings:

  • 12% of all angioplasty procedures, which often include the insertion of stents, weren't medically necessary.

  • In 22.5% of cases in which a cardiac pacemaker/implantable cardioverter-defibrillator was installed, no evidence supported that decision.

  • In 17% of cases in which patients were told they needed back surgery/spinal fusion, no neurological or radiographic findings indicated such an operation was necessary.

  • Among patients told they needed total knee replacement surgery, 38% who received information about joint replacements and alternative treatments decided against the procedure.

  • Similarly, 26% of patients who received additional information about hip replacements decided against them.

  • In 43% of colonoscopies, no clinical indication showed a need for the procedure.

  • A study from earlier this year, looking at data from nearly 600 hospitals nationwide, found the rate of cesarean section deliveries varied tenfold across those hospitals -- from just more than 7% of all births to nearly 70%.

  • 70% of hysterectomies were inappropriately recommended, "often because doctors didn't attempt treatment with non-surgical procedures."

USA Today broke down these unnecessary surgeries into three groups: the immoral, the incompetent and the indifferent.


Some patients, it says, fall victim to predatory doctors who defraud the insurance industry by performing operations that aren't medically justified. But a larger number of people, it adds, "turn to doctors who simply lack the competence or training to recognize when a surgical procedure can be avoided."


Experts and patients alike say questioning a doctor's decision to operate -- by researching the suggested procedure, asking for nonsurgical options and getting a second opinion -- can help reduce the number of unnecessary surgeries.


"We expect the physician to know what's best for a patient," William Root, the 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."


More on moneyNOW

21Comments
Jun 20, 2013 5:24PM
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My late husband several doctors so-called specialists tried to convince him to have major heart surgery, told him he had a 50/50 chance he would survive it, and if he did, the surgery would only correct about half of his multiple problems, he said no, they had some not-so-nice words for me when I supported his choice. the "specialists" told him his failing heart would maybe last another year. He lived about 3 1/2 years after that and cause of death was a rare form of adult onset leukemia.... sometimes they ain't always right,....ca-ching.....

Jun 20, 2013 3:52PM
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One good reason for this: Doctors and for profit hospitals make money based on how much care they give. So they have an incentive to perform extra care for those who have good insurance. This has been occurring for decades and is one of the reasons we pay so much for medicare. 
Jun 20, 2013 3:55PM
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It is doubtful if many of these patients would do those surgeries if insurance would not pay for most if not all of them. Therefore the patient only recognizes their out of pocket expense and ignores the massive expense the insurance companies must take on. This is one of the reasons that insurance premiums are so high
Jun 20, 2013 6:12PM
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look, you have a kid or two in harvard. the tuition is not cheap. they both need a new mercedes which you happily buy them as well as keeping them amply supplied with spending cash. so what do you expect these doctors to do? and dentists are equally drill happy. y'all won't believe this but i have had dentsists i would not send my dog to. and i don't even have a dog.

Jun 20, 2013 4:10PM
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What about the removal of tumors which never existed in the first place followed by long term post operative care?
Jun 20, 2013 6:41PM
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I agree with the findings. I under went a stent procedure last year. The Dr said that I would feel so much better. BULL SH*T. I don't feel better and when I told the Dr he said I could have had a heart attack. I told him yeah and I could get hit by a car too. Now I am on a blood thinner that I call B&B bruise & bleed. It's all about money and how much they can get from insurance companies.
Jun 22, 2013 3:05AM
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This study is crap.  43% of colonoscopies done without clinical indication?  That is a bold face lie.  An insurance company won't pay for a procedure without an indication. Sorry, they won't just take our word for it. And for you guys that think all we do is get rich, try living in the physician's world for a while.  This study is done by a bunch of people out to prove something.  None of the author's are even surgeons.  That's like me saying that "millions of prescriptions of high blood pressure medicine are prescribed but unneeded" It depends on who says they are unneeded.  I never push patients toward a surgery, and I always make a point to make sure that is what they want.  Sometimes I do recommend surgery, but it is up to the patient.  Not to mention that in most literature series,  happiness with the end result of surgery is in the 80-100% range.  I am sorry if the posters on this forum have had bad experiences, but you should discuss this with you doctor, not assume "there was no reason" for the surgery.  And as a note, all of the "alternatives" described above have about a 10% or less success rate.  It's like appendectomy.  Someone comes in with an infected appendix, and I operate within 12 hours to remove it.  They go home usually in about another 12 hours, and are back to work within a week.  Go to Europe, they don't remove the appendix.  They put you in the hospital for a week on heavy does antibiotics(try adding up THAT bill, approx. $15,000), then you MAY go home, and you MAY another round of appendicitis a few weeks alter, and then they MAY take it out, or you may get chronic pain. 

I have to look my patients in the eyes, especially when they get a complication, and I have to go home and look at myself in the mirror.  I have never, ever, recommended a surgery that I didn't think was in the best interest for the patient

Jun 20, 2013 10:35PM
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The are just educated used car salesmen. Greedy, greedy, greedy. And with their noses in the air because YOUR money made them rich. Don't be intimidated by them - question their arrogant @sses every chance you get.

Jun 22, 2013 8:19AM
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Yep Americas broken healthcare system ! <<< That is so true and they are running 150% Above inflation for over 10 yrs now . So Americans this is what is going to bankrupt America . Its plan to see
Jun 22, 2013 3:08AM
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Besides I don't drive a Mercedes, I DO  have a billion dollars in student loans to pay off, and I bought my car and my wife's( a Nissan and a Ford) used like everyone else does.  I also didn't get to start my first job until 14 years after High School.
Jun 21, 2013 11:57AM
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There is a reason both "Dr.s" and "burglars" wear a mask. They have their own best interest in mind when you walk through the door--not yours. They're not your "friend," not "a god,"--they work at the Jiffy Lube and you're the quick oil change. Know that and know what you want from them before you go. Know what you will-and will NOT accept as treatment.  If they're a horse's **** move on. They won't get better--and neither will you.

Jun 20, 2013 5:04PM
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aaaaw come on, who cares as long as the doctors get rich?
Jun 20, 2013 8:49PM
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The Choosing Wisely Campaign, an organization led by the American Board of Internal Medicine appears to be another egghead liberal group with a fancy name.  According to their website, the one doctor on the staff is a Dr. Holmboe who is currently Senior Vice President for Quality Research and Academic Affairs (What a title!  I wonder if he picked it himself) at the American Board of Internal Medicine and ABIM Foundation. He is also Professor Adjunct (not full time) of Medicine at Yale University"  Hmmm ... not a practicing doctor.  I think I would like to hear from the practitioners in the trenches before I reached any conclusions based upon non-original cherry picked data re-hashed by a liberal egghead group.

You know, it seems like more and more of these articles cite some off the wall group of eggheads with a fancy name with no grunts or original work.
Jun 20, 2013 8:32PM
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When studies like this start out to prove something - they can generally find some support for whatever it is they want to prove.  I'm sure that there are unnecessary procedures performed, but, I would rather have a few unnecessary procedures performed than having procedures or drugs denied because a bureaucrat in D.C decides that the overall cost benefit ratio doesn't justify xyz procedure, even if it saves lives or increases the quality of life for some.  I know what its like to live with a bad hip, waiting a couple of months to have it replaced.  Living on painkillers and hobbling on crutches.  I couldn't imagine going through that for years.  Be careful of what you advocate.  You might be the one that needs the procedure or drug that a bureaucrat has has decided does not meet a cost benefit ratio.
Jun 20, 2013 4:40PM
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You think that it is bad now....just wait until we give all of the free loaders free Obama-Care health insurance that we, the working tax payers, will have to pay for. We will get the shaft from both ends....from the ne'erdowells that won't work for their health insurance and the doctors performing the unnecessary procedures for big $$$. 

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