As an intern, I was assigned a rotation, where I prepared patients for surgery.
During this prep process, I asked patients an unexpected but critically important question:
“Do you want to have surgery?”
As it turned out, most of them didn’t want surgery. But they didn’t know they had a choice.
Surgery is usually presented as your only option. But, in fact, it’s just one of many choices available.
The problem is that most specialists and surgeons won’t tell you that – because it’s bad for business.
Thankfully, today we have a superior procedure for “informed consent.” But it’s intended to satisfy the lawyers, not the patient.
Surgeons still try to bully people.
Consider these shocking facts culled from several recent analyses of surgical statistics: 1,2,3,4,5,6
- 70% percent of hysterectomies were prescribed incorrectly;
- 22.5% of pacemakers were inserted without good reason;
- 17% of spinal-fusion back surgeries were performed without medical scans or neurological tests to support the procedures;
- 12% of angioplasties with stents were unwarranted;
- Arthritic knees rarely perform better after arthroscopic surgery to repair the joint’s buffer cartilage.
- Three Pennsylvania surgeons attempted to remove gall bladders from three different patients who had already had the bladder removed!
Raw greed can lead to sham surgeries. So can stupidity and incompetence. But most unnecessary procedures can be blamed on surgeons who just don’t know any better.
The typical surgeon who removes gall bladders doesn’t know what the patient should do to prevent the surgery… or what alternative therapies are available.
He also doesn’t want to appear ignorant for fear that patients will lose trust in him. So he uses his authority to convince them to accept his choice. It’s the only one he knows.
I call this “The Rule of the Hammer” – the psychological phenomenon where people prefer to use the tools that they know.
If you give a three-year-old boy a hammer, everything in the house looks like a nail. The same applies to surgeons. Every medical problem looks like it requires surgery.
But unnecessary surgeries can be prevented if you assert your rights in the decision-making process – and investigate alternatives yourself.
So before you give your “informed consent,” ask the advice of as many experts as you can, including nurses, dietitians, physical therapists, sports physiologists and alternative physicians, like me.
It’s also worthwhile to consult with major teaching hospitals in your area. They often have access to the latest data on the effectiveness of surgical procedures.
Make sure you know:
- Why surgery is absolutely necessary;
- What the surgeon plans to do to your body;
- The chances and consequences of bad outcomes;
- All available non-surgical alternatives;
- What can happen if you refuse the surgery;
- How much it will cost.
I know a woman who avoided back surgery by undergoing special pool therapy. Guided by highly trained professionals, she found relief by performing special exercises in salt water to decompress her vertebrae.
Another woman I know avoided gall bladder surgery through an exercise regimen and by radically changing her diet. She also took regular acupuncture treatments.
These patients took control over their lives. And so should you.
Remember this quote from the philosopher John Stuart Mill: “Over himself, over his own body and mind, the individual is sovereign.”
Those are words to live by.
To Your Good Health,
Al Sears, MD, CNS
1. Eisler, P., and Hansen, B. “Doctors perform thousands of unnecessary surgeries.” USA TODAY. June 20, 2013. usatoday.com/story/news/nation/2013/06/18/unnecessary-surgery-usa-today-investigation/2435009/.Retrieved on 5-14-2015.
2. Eisler,P. “Six common surgeries often done unnecessarily.” USA TODAY.June 19, 2013. usatoday.
com/story/news/health/2013/06/19/surgeries-unnecessary-patients-medical/2439075/. Retrieved 5-14-2015.
3. Eisler, P. and Hansen, B. “Why you should get a second opinion before getting surgery.” USA TODAY. June 20, 2013. usatoday.com/story/news/nation/2013/06/19/surgery-second-opinion-interactive/2439275/. Retrieved 5-15-2015.
4. Sihvonen, R., et al. “Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.” N Engl J Med 2013; 369:2515-2524December 26, 2013DOI: 10.1056/NEJMoa1305189.
5. Mosely, J.B., et al. “A controlled trial of arthroscopic surgery for osteoarthritis of the knee.” N Engl J Med 2002; 347:81-88July 11, 2002DOI: 10.1056/NEJMoa013259.
6. Staff. “Risk of unnecessary gall bladder surgery. Pennsylvania Patient Safety Advisory. PA PSRS Patient Saf Advis 2004 Dec;1(4):3-4. patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2004/dec1%284%29/Pages/03.aspx.