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Beneath the Surface of Unnecessary Surgery: A Case Study on the Limits of Existing Protections
Journal article   Peer reviewed

Beneath the Surface of Unnecessary Surgery: A Case Study on the Limits of Existing Protections

David Barton Smith
Journal of health politics, policy and law, v 44(2), pp 303-313
01 Apr 2019

Abstract

Biomedical Social Sciences Health Care Sciences & Services Health Policy & Services Legal Medicine Life Sciences & Biomedicine Medicine, Legal Science & Technology Social Issues Social Sciences Social Sciences, Biomedical
Unnecessary surgery has been a focus of health policy concern for decades. Such events are supposed to be prevented by the (a) self-policing of hospital medical staffs, (b) oversight of state medical boards, (c) third-party restrictions on payment, and (d) threat of malpractice lawsuits. While critics may point to failures of will on the part of those responsible for such policing, this case study points to more fundamental problems. The case involved an extension of the diagnosis of Chiari malformation to justify surgery to help relieve symptoms of individuals previously identified as suffering from chronic pain or fatigue syndrome. It illustrates how strenuous efforts to reduce what other members of the medical profession perceived as unnecessary surgery were overcome by (a) uncertainty concerning appropriate diagnosis and treatment, (b) patient desperation-driven self-referrals unrestricted by professional oversight or geographic boundaries, (c) the ambition of a surgeon determined to practice as he or she desired, (d) a business-focused national hospital chain insulated from direct clinical accountability, and (e) the highly profitable nature of the surgery itself.

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Web of Science research areas
Health Care Sciences & Services
Health Policy & Services
Medicine, Legal
Social Issues
Social Sciences, Biomedical
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