Generally surgeons aren’t pain management specialists and as a result may recommend operations that aren’t necessary.
Washington, D.C. (PRWEB) December 27, 2013
While new federal data questions increases in costly back fusion surgery, early referrals to board certified pain management specialists could eliminate many operations saving trauma and money.
A Washington Post investigation found some experts fear “as many as half “ the procedures weren’t justified.
“Generally surgeons aren’t pain management specialists and as a result may recommend operations that aren’t necessary. Since we take a multidisciplinary approach, we can often find a solution that doesn’t require an operation,” says Reza Ghorbani, MD, ABIPP, FIPP, Ghorbani, MD, ABIPP,FIPP.
Dr. Ghorbani is president and medical director of the Advanced Pain Medicine Institute of Greater Washington, DC. He is also the author of the new book, “Secrets to a Pain Free Life” which stresses the importance of mainstream medical treatments combined with natural, alternative remedies shown to be safe and effective over time.
In his pain management practice, Dr. Ghorbani sees many failed back fusion patients who wind up in even worse pain.
“I wish they’d come to me first, but often a primary care physician will refer his patient directly to a surgeon without giving a pain management specialist a chance to make a difference. That’s an aspect of medical culture that needs to change,” says Ghorbani.
When physical therapy or drugs don’t work, doctors can fuse two or more bones in the spine to prevent painful movement. However, the procedure may ultimately weaken the area around the injury leading to further complications.
This problem even has a name, “Failed Back Surgery Syndrome.” However, it can be treated with an implantable device called a spinal cord stimulator—similar to a cardiac pacemaker. It sends an electronic message to the brain through the spine that eases pain.
“Many of my patients are asking for this device as a result of other treatment failures,” says Ghorbani.
An aging population of Baby Boomers hoping to stay active and better surgical techniques may be trends underlying the bone fusion boom, but skeptics say the real rationale is compensation, not compassion. In the current “fee-for-service” environment, the more procedures a doctor does, the more he gets paid.
From 1993 to 2011 the number of US spine fusion procedures increased from 60,973 to 465,070 and the commensurate cost ballooned from $24,045 to $100,785, according to an analysis from the Agency for Healthcare Research and Quality.
Appropriate or not, these operations have proven increasingly lucrative for doctors with financial interests in companies that sell plates, screws and rods--devices that can add up to $11,000 or more per procedure.
However, Dr. Ghorbani says the fix isn’t just on the doctor’s side. As more patients gain coverage under the Affordable Care Act, they will need to be more proactive about their own health so the system won’t be overburdened.
“We can’t be all things to all people, particularly with younger patients coming into the system and older patients needing more care. If people would just follow common sense lifestyle guidelines, it’s possible to keep pain in check. That’s one of the secrets to a pain free life,” says Dr. Ghorbani.