This recent article in the New York Times (Read the Full Article) raises some very interesting questions about healthcare in our country. Tens of thousands of procedures are done for which there is no real evidence to show they are effective at treating the particular condition at issue. The concerns about costs are obvious and very serious, but there is also the concern about tens of thousands of people being put at risk when they undergo these surgeries.
Medicine is a risk benefit process. You weigh the risk of a treatment against the potential benefit. Sometimes this is quite obvious – stopping a major bleed is something about which there would be no issue. Sometimes it can be a hard or very close call as is often seen with regard to debilitating cancer treatment which have limited chances of success. Sometimes there is not much solid information as the condition is a relatively rare one. However, with common conditions such as knee and back problems we have lots of data and that data leads to the clear conclusion that many very common procedures are simply not effective.
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