I’ve recently observed cases where family and friends undertake serious medical interventions with not the best outcomes. These interventions seem well intentioned to rehab issues, but I now wonder if they sometimes are a money grab when potentially better health outcomes might exist. In fairness to the Doctors, we want instant and complete resolution to sometimes niggling health issues – many caused by our own lifestyles or basic aging.
Here are a few observations:
- My uncle had his prostate removed in his late 70’s, and successive complications from the surgery killed him after two years of miserable, bed-ridden life. The typical life expectancy for most prostate cancers is 10-15 years. In fact, some European health organizations eliminate prostate cancer screening after age 70 since studies show no longevity increase with surgical intervention.
- Another relative in her 70’s had major back surgery to cure mild back pain, which persists perhaps worse than before. This individual is sedentary and does not exercise, walk or stretch. No exercise or physical therapy regimes were recommended prior to surgery.
- A friend had a hip replacement in his 50’s to sustain his active sporting lifestyle. Eight years later, he has significant bone-loss damage and other chemical imbalance issues from metallosis poisoning. His prognosis is potentially continued deterioration of these systems.
- Three different acquaintances (60’s) had knee replacements that have not gone ideally – all are hobbling worse and a couple have had multiple surgeries. Two are overweight, and one of these two is relatively inactive. No weight loss or exercise regimes were progressed prior to surgery.
The American medical model seems to be to undertake every possible intervention. In the case of optional surgeries in particular, I just wonder if we sometimes are a defacto 529 Plan for the Doc’s children rather than getting the best outcome.
Do you have further examples where the medical process was not ideally implemented or downsides were not fully explained, or alternatively, do you feel I have it wrong with these examples? The more examples, the better – many of us will face sitting across from our medical professional and wondering whether we should proceed down an uncertain path.
Interesting post! As a PA who has worked in family medicine for 20 years as well as emergency medicine for seven years, I can appreciate many of the comments. To answer your questions in the title of your post, no not all surgeries are necessary in my opinion. I also don’t agree that we have become “the college tuition bank for the Doc’s children.”
One thing that strikes me in these types of discussions is that many people think that medicine is an absolute. There is a reason why it is called “the practice of medicine.” Medical providers try and use the information that we have learned over many years of education and working with patients to help our patients. Unfortunately, there is no such thing yet of “absolute medicine” and 100% positive outcomes.
In all fairness, the main goal of everyone I know and have known in medicine the past 20+ years is to try and help people to the best of our ability. We all have sacrificed in one way or another to get trained in a profession to help people. I never took a class or clinical rotation in my training that taught me how to cut corners, harm people, or rip people off.
People that choose to practice in medicine invest many years and dollars for this training. In the case of physicians, they are required to complete four years of medical school. This is followed by many years of advanced training in whatever specialty they decide to work in. In the case of family medicine and internal medicine, this is usually three years of residency. General surgery or orthopedic surgery requires at least five years of residency. Neurosurgery usually requires 6 to 8 years after medical school.
Based on my experience with a variety of specialists over the years, they all deserve the income they receive based on their level of expertise and the sacrifices they have made to obtain that specialized training.
Someone mentioned in a post that they hated their nephrologist. I would recommend trying a different nephrologist perhaps in consultation with your primary care provider. While nephrologists may not have the best bedside manner, they are some of the smartest people that I have met in medicine.
While non-medical people usually graduate from an undergraduate program and start a career, medical professionals delay their career goals and incomes for many years in some cases. What is the main goal of the majority of these future healthcare providers? Help other people.
I have learned over the years working with patients that not all neck or back pain requires surgery. In addition, not all neck and back surgery cures neck or back pain. This is not due to most specialists doing unnecessary surgery in their professional opinions. The spine is a very complicated part of our anatomy.
It is mentioned in the original post and several other comments that “no weight loss or exercise regimes were progressed prior to surgery.” Do you know for a fact that this was not recommended by the surgeon and his team? Did these people follow all of the recommendations of their physical therapist after surgery?
Do you know how many times I recommend weight loss and exercise on a weekly basis? All I get in response is a glassy eyed stare from most patients. There needs to be a bit of self ownership by the patients and not just blame this on the surgeon or other healthcare providers.
Most patients that I see rave about the results of their knee or hip replacement. Unfortunately, in some cases when they have the second knee or hip replaced by the same surgeon, the recovery is not as smooth and takes longer. No one really knows why this occurs.
Are there mistakes made by medical providers? Yes. Are they intentional or just for the goal of making money in the majority of cases? No.
Do you know that the average cost of ob/gyn medical malpractice insurance can be $46,000 per year (https://griffitheharris.com/cost-of-medical-malpractice-insurance-by-state-and-specialty/)? In addition, neurosurgeons also pay steep annual premiums and nearly 19.1% face lawsuits annually. What happens when these specialists get tired of this and leave the profession?
Imagine sitting in an exam room one-on-one with an obese patient who is in tears about their knee pain. Imaging has revealed bone-on-bone arthritis. They have tried several knee injections with the goal of delaying surgery without any significant relief. They are requesting knee replacement because they are tired of the daily pain. What would you do?
My two cents…
This may be a variation on your question. How well do doctors communicate with us? I’ve hated my nephrologist since first meeting, but how does one select a specialist when it’s not a common problem. He said our goal is to keep my kidneys functioning until one hour after my death (he was unable to provide a date for that). We tried a certain stabilizing drug; he took discontinued it within weeks. Since then, five other doctors, in and out of nephrology have advised me to stay on that drug, and advised on a biopsy to more clearly understand the disease and its damage to date. I’ve followed their advice. I’m quite healthy except for the kidney disease, so I’m exploring transplant. Many of my consults are quite positive about that, but not my original nephrologist. Oh, did I mention he makes money from people being on dialysis?