Reasons to Fear the Knife 

 One of the unfortunate outcomes of the Affordable Care Act - and I do believe quality health care should be available to all citizens - is that more of the financial burden of medical treatment is now placed on the insured. This was expected, as it's quite clear from their history that insurance companies are never going miss their healthy fees. The result for physical medicine is that more people will jump to surgery before exhausting all conservative, non-operative alternatives. 

 Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary, according to a review of in-depth studies and data generated by both government and academic sources. In fact, unnecessary surgeries might account for ten to 20 percent of all operations in some specialties, including many spinal surgeries, as well as knee and hip joint replacement surgeries. However, I think the number of unneeded surgeries is even higher. We routinely see patients with painful joints, but only mild actual joint damage, being told they need major surgery; when in fact we get them pain-free and back to their full activities after a few weeks of conservative care. This is not to say all surgeries are unnecessary, but far too many are. 

 Simple physical therapy stretching, strengthening, and ergonomic instructions will resolve the painful tendonitis and bursitis that are common throughout the population, not just those people who show age appropriate joint wear and tear. Assigning one's pain to the joint damage found on x-ray or MRI is bad medicine, unless the clinician matches the diagnostic imaging findings to the findings of a through physical examination. Too many clients tell us that the doctor never touched them, but was ready to march them into surgery on minimal diagnostic findings. 

 Both the medical community and the public share responsibility for the quick-pick surgery options. The fact is that doctors are getting poor insurance reimbursement for simple office visits, and need to do more surgery to preserve the income they were accustomed to before the Affordable Care Act. Patients also will also quickly opt for the surgical route, as too many insurance plans have reduced physical therapy benefits to a point where the cost of patient's co-pay and deductible make conservative care prohibitive, even though they were told physical therapy was covered.

 Ironically, patients think that surgery becomes the cheaper option, but what they don't understand is that quality post-surgical rehab is 50 percent of a good surgical outcome, and post-surgical rehab costs need to be added to the consumer's side of the surgical bill. More importantly, surgeries are not a quick and easy solution to health problems. The best kept secret in medicine is that a full 25 percent of patients entering a hospital will get a hospital-borne infection, and one in ten thousand patients don't wake up after surgical anesthetics. 

 For all these reasons, as well as post-surgical pain, lost income, and surgical complications, everyone should always pursue a second non-surgical opinion with a physical therapist. Every citizen deserves affordable, quality, non-surgical options. 

 Read today's Feature Article about a common spine surgery that can be avoided with physical therapy.

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