The process by which medical procedures become established medical practice makes the drug-approval process look good. Before the FDA will approve a new drug, the pharmaceutical company must demonstrate that it does something better than the competition’s, inspiring a lot of statistical ingenuity.
“We have a saying in research medicine,” Roberts says. “If you torture the data long enough, it will confess to anything.”) But a new medical device has to clear a lower regulatory bar – only that it’s not dangerous – before it can be introduced to the public. The procedure itself is rarely systematically evaluated: A few influential doctors bring out something new, it catches on, and in a few years we have procedures like cardiac stenting to reduce heart attack risk or spinal-fusion surgery to relieve back pain that become institutional cash cows with little scientific evidence that they work as advertised.
Once a procedure becomes established, it’s protected by a phalanx of moneyed interests. In How We Do Harm, Brawley recounts the tale of a fledgling federal agency, now called the Agency for Healthcare Research and Quality, which was created to review how well common medical treatments actually work. In 1995 it reported that the research on spinal-fusion surgery for back pain was unequivocal: It produced results that were no better or not much better than doing nothing. Outraged, the North American Spine Society convinced a group of Republican congressmen that the agency was wasting taxpayer money on shoddy research. After nearly losing its funding, the agency limped away from the inquisition with a 21 percent budget cut. “The self-serving surgeons were saying the hell with what the science says,” Brawley wrote, “and everyone else was apathetic or worse.”
Read the full report here.
It’s important to keep in mind that while we criticize and critique our health care system, we should not minimize the value of the persons who have dedicated themselves to the study of medicine. When we or one of our love ones are sick we are often beholden to the artful and skilled physician. However, as a patient or concerned loved-one asking good questions should always be encouraged.
The Men’s Health article Surgeries You May Be Better Off Without is worthy of your review.
Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.
