Got an aching back? If you live in Bend, you’re more than twice as likely to have surgery for it as the average American is.
That’s the rather startling statistic unearthed by The Bulletin, which published a story this morning addressing the question of why so many back surgeries are done here. According to Medicare records, about 10 out of every 1,000 Bend enrollees receive back surgery – more than double the national rate. Among all American cities, we’re Number Two in back surgeries; only Casper, WY does more per capita.
The reason is hard to pin down. There doesn’t seem to be any basis for assuming that our backs are in horrendously worse shape than those of other Americans.
One factor that does seem to correlate with our high rate of back surgeries is our high number of spine surgeons. According to the American Association for Neurological Surgeons, writes Bulletin reporter Betsy Q. Cliff, nationwide there’s roughly one neurosurgeon for every 86,000 people. In the three counties of Central Oregon there are seven doctors who do back surgery, or approximately one for every 29,000 residents.
More surgeons = more surgeries. It seems pretty logical.
Of course all the local surgeons interviewed by The Bulletin insisted they do back operations only when necessary. But “when necessary” is a judgment call, and a surgeon’s judgment can conceivably be influenced by factors other than a patient’s welfare – such as the need to pay his mortgage.
Unnecessary back surgery has been a problem in American medicine generally for decades. Way back in 1994, the federal Agency for Health Care Policy and Research did a study that found most back surgeries were unnecessary. (An organization of spine surgeons responded by trying to get Congress to kill the agency.)
An article in the current issue of AARP Magazine states that surgery isn’t needed for the vast majority of back pains: “According to the American Association of Neurological Surgeons, 90 percent of herniated discs can be effectively treated with conservative therapies such as limited bed rest, exercise, and anti-inflammatory medications” such as ibuprofen or naproxen.
And in 2006, a study published in the Journal of the American Medical Association found that patients with sciatica – pain in the lower back, hip and leg caused by a ruptured spinal disc – recovered about equally well whether they had surgery or conservative treatment in the form of physical therapy, counseling and anti-inflammatory drugs.
The Bulletin story reports that a committee made up of St. Charles Medical Center medical staff and employees is trying to find out why we have such a high rate of back surgeries. Hopefully they’ll get some solid answers.
Meanwhile, if your back hurts and you’re thinking about going under the knife, you might want to try popping a few ibuprofens first.
This article appears in Jun 18-24, 2009.
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talk about the unnecessary back surgeries,what happens when you need it like i do and they refuse to do it because of medicare and they would rather pump yer body with shots in yer back its pure bullcrap
A Doctor in Bend helped me by ordering an epidural injection in my back instead of surgery. I have a friend who one Doctor recommended back surgery and they switched to another Doctor and they suggested the epidural injection. That indicates perhaps there is a problem with unnecessary surgeries in the Bend area. Second opinions might help but do not go to the same clinic for your second opinion.
CHC inc is not going to release anything that will speak poorly of their prize doctors. Lets all face it to wait until now to look at our monopoly health care system in this region is way to late in the game to do anything to change it.
I agree, i had a friend that had a 10 inch cancerous tumor on her spine! It took doctors 19 years for them to finally find it. When they did find it they refused to perform surgery because of lack of insurance! tell me where is the good in that??? all surgeons are, are money sucking skum bugs that have a degree! Im in the Navy and i would trust a Corpman who has 3 months of traing way more than i would trust a skum bag surgeon! all they are after is money, money, money! They dont care what happens as long as they get a pay check. Dont get me wrong there are a lot of good surgeons out there that do care, however the majority of them are just doing it for the money!
HH: Is it better to cover up the pain with drugs and risk permanent nerve damage or fix the problem so that you don’t need drugs?
Oh, and CHC didn’t cut staff because of construction bonds. They cut staff because less patients were going to the hospital because they couldn’t afford to and the patients who were going weren’t paying their bills so CHC couldn’t afford to keep staffing the way it was.
There’s a good column about health care by Ellen Goodman in the Perspective section of today’s Bulletin. She tells the story of a friend who “had an appointment to consider a rather serious heart procedure. After 15 minutes, the cardiologist stood up to leave. My friend was startled. ‘I have more questions,’ she said. He answered, ‘I have another patient,’ and walked away.”
The friend’s response should have been: “Fine — I’m getting another cardiologist.”
We need to get back to the idea that the practice of medicine is about healing people, not about extracting as much money from them as rapidly as possible.
Re epidurals: The research shows they’re effective only about 50% of the time, and you probably will need repeat ones. But they definitely are cheaper and less risky than surgery.
It seems that you only print the comments that agree with your article and make the Source look good and the Bulletin look bad. How about we give the public actual facts like the Bulletin does? Surgeons aren’t in business to make money and neither is the hospital, they are there to serve their patients and do what is medically necessary.
“It seems that you only print the comments that agree with your article and make the Source look good and the Bulletin look bad. How about we give the public actual facts like the Bulletin does?”
Uh, it was The Bulletin that printed the original story raising the question of whether too many back surgeries are done here.
“Surgeons aren’t in business to make money”
No, of course not, they do it all for charity. That’s why they don’t charge anything.
You’re been watching too many reruns of Marcus Welby.
But seriously, in defense of doctors: I really believe they enter medicine because they want to help people, not mainly to make a buck. If money was their main motive there are lots of occupations (Wall St., for example) where they could make a hell of a lot more faster and without going through the arduous and expensive training a doctor undergoes. But the fee-for-service system of reimbursement, among other things, strongly encourages them to become businessmen first and physicians second. Why see one patient for an hour and make $300 when you can see four an hour and make $1,200?
“Is it better to cover up the pain with drugs and risk permanent nerve damage or fix the problem so that you don’t need drugs?”
The point is (a) that the problem often goes away with treatment with anti-inflammatory drugs, physical therapy, appropriate exercise and rest, and (b) surgery often doesn’t fix the problem, besides being expensive and, like any general-anesthesia surgery, potentially dangerous (ask the late Bill Friedman about that last part).
I am currently experiencing back pain myself and would consider surgery only as a last resort.
Oh, and no matter what you may have been told, there is no risk of “permanent nerve damage” if you delay back surgery.
In the previous post I should have made it clear I was talking about surgery for problems like sciatica, not for back damage due to injury.