In 2012 medical guilds began to release lists of unnecessary or untested services. Because patients often undergo costly procedures without seeing any measurable health benefit, experts believed it would be possible to crunch the numbers and come up with a list of procedures for doctors to avoid. Hospitals could then scale back these procedures, and patients could be more wary about undergoing them.But as Kaiser Health News’s in-depth study of these lists shows, things didn’t quite work out as planned. For some specialist fields, the no-go lists seemed to do some good, but in other fields, the lists only included services that aren’t very profitable for specialists. The articles gives joint surgeons as a representative example:
The American Academy of Orthopaedic Surgeons discouraged patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery. The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline.“They could have chosen many surgical procedures that are commonly done, where evidence has shown over the years that they don’t work or where they’re being done with no evidence,” said Dr. James Rickert, an assistant professor of orthopedic surgery at Indiana University. “They chose stuff of no material consequence that nobody really does.”
Others took a different route than the joint surgeons, choosing to list procedures performed by other specialist doctors. Kaiser:
“They were willing to throw someone else’s services into the arena, but not their own,” said Dr. Nancy Morden, a researcher at the Dartmouth Institute for Health Policy & Clinical Practice in New Hampshire.
Medical opinion is legitimately divided about the usefulness of certain treatments; reasonable doctors could decide to provide services that others might fight superfluous. But this report is a good indicator that there are indeed medical guilds out there that are more concerned with protecting their members’ income than with cutting back on waste in the U.S. health care system. We’re sure everyone is shocked—shocked—by this news.