SURGERY: CONSUMERS BEWARE

This issue was one of the most data packed Health Perspectives. It is worth reading and then rereading because it had a significant impact on the practice of surgery, and in many cases, it was just that: practice.

The text is accompanied by four tables that speak for themselves. The data is real and convincing. While critical of the delivery of surgeons to perform the surgery and the performance they delivered, there is also explanation of the conditions that placed surgeons in the difficult position of recommending questionable surgery and the success of second opinion programs initiated by two courageous unions; one mandatory and one voluntary. Many surgical procedures are questionable because reasonable questions could be raised about their need and outcomes. Many persons experiencing surgery, questionable or not, die. That is a fact of life and the operating theater. But unnecessary deaths associated with questionable surgery died unnecessarily. And those deaths could be avoided or delayed.

The issue covers costs, insurance payment options, location of the surgery, the need for independent opinions (aka ‘second opinions’), and the board status and type of practice of doctors performing surgery, the oft occurring ‘ghost’ surgeons, the dangers associated with over extended surgical residents and the role of hospitals in encouraging surgery. Comparative data showing ratios and rates within America and across the globe are also included.

At the end of this issue there are fifteen (15) recommendations many of which still need to be acted upon.