But surgeons are different. They can do pretty much whatever they please. They just "invent" a surgical procedure and keep doing it until someone finally tests it scientifically to see if it really works. And the real kicker is that these procedures are often proven to be completely bogus when patients in the placebo group fare as well as those actually getting the surgery.
That's right-that "dramatic improvement" from an operation can be entirely delusional. In surgical studies, sometimes the patient wakes up from anesthesia symptom-free-completely cured-when the surgeon has done nothing but make a superficial incision then sew it up.
Mind over medical procedure: Placebo surgery produces the same-and sometimes better-results than the "real thing"
One of the biggest surgical scams going on these days is arthroscopic surgery for arthritis of the knee. Don't get me wrong; this type of surgery for knee injuries is nothing short of miraculous: Football players who tear their knee ligaments can usually return to full duty in a matter of weeks with this surgery. But some orthopedist with dollar signs in his eyes got the bright idea that if arthroscopic surgery was good for knee injuries, why not try it out on arthritic knees? Maybe you could diddle around in the joint space, doing a cleanup of whatever trash you could find in there, and, presto, no more arthritis.
It seemed to work dramatically well for Tim Perez. He had such severe arthritis pain in his knee, he'd resorted to using a cane to help him walk. So when he heard about a study going on at the VA Medical Center in Houston, Texas, that was going to test arthroscopic surgery procedure for knee arthritis, he enrolled, hoping for some much-needed relief. Although it was widely used, the surgery had never been tested for efficacy up until this point. But with the results Mr. Perez experienced, who could doubt the effectiveness of the procedure? After three months, he was pain-free and able to throw away his cane. Two years later, he found out that he'd been in the placebo group of the study-the surgeons hadn't done anything definitive to his knee.
The official results of the study revealed that, like Tim Perez, the majority of the patients who went through the dummy surgery fared as well in perceived knee function and pain reduction as those who had real arthroscopic procedures. In fact, in some cases patients who got the placebo procedure reported better results than some of the actual surgery patients. And after examining their knee structure, researchers reported that neither group showed any measurable improvement in actual (not perceived) knee function. So, basically, this study is saying that arthroscopic surgery for arthritis is pure bunk but you can bet surgeons are still going to recommend it and perform it. Why?
The endless profit potential of "voodoo surgery"
Well, 650,000 patients each year undergo arthroscopic surgery for arthritic knees, at a cost of $5,000 each. That's over $3 billion-and insurers routinely reimburse for it. This is only one of many surgical procedures that gobble up billions of dollars in insurance payments yearly with no proof of efficacy. The Wall Street Journal research department uncovered the following medical "profit centers" that may be useless and, in some cases, harmful:
Spinal fusion--no proof of effectiveness
Thymectomy (excision of the thymus gland in the chest for various diseases)--no proof of effectiveness
Arthroscopic shoulder procedure--no proof of effectiveness
Circumcision--not medically necessary
Action to take:
So is arthroscopic surgery worth it? Tim Perez thinks so. But as for you, I suggest that you stay away from voodoo surgery. That means you should assume all new procedures are voodoo until proven otherwise. If you have arthritis, try one of the following alternatives before giving the surgeon the green light to come at you with a scalpel:
(1) Glucosamine/chondroitin capsules--they're available just about everywhere, and you really can't take too much (within reason, of course). Just follow the dosage instructions on the bottle of the brand you choose.
(2) Devil's claw supplements--this herb is available from health food stores and even some pharmacies. Take 2 grams a day. While no major side effects appear to be associated with devil's claw, it may interfere with the action of blood thinning drugs like Coumadin; if you are currently taking such medications, you should not begin treatment with devil's claw. RH
"Common Knee Surgery Is Found to Be Worthless" Wall Street Journal online (www.wsj.com), 7/11/02
"A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee," New England Journal of Medicine 2002; 347(2): 81-88