Behind Upper Respiratory Infections, Back problems account for the most visits to the Doctor. Brook I. Martin, M.P.H., of the University of Washington, Seattle, and colleagues conducted a study to examine changes in expenditures and health status related to spine problems from 1997-2005.
"These data suggest that spine problems are expensive, due both to large numbers of affected persons and to high costs per person. We did not observe improvements in health outcomes commensurate with the increasing costs over time. Spine problems may offer opportunities to reduce expenditures without associated worsening of clinical outcomes," the authors conclude.
Ouch! doesn't look good for back specialists. I know Chiropractic hasn't gotten fat off of Insurance over the last 10-12 yrs.
Now, not everyone believes outcomes are getting worse with modern treatment. At the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) three studies were presented outlining protocols for lumbar disc herniation, surgery for seniors with spinal conditions and compression fractures.
Interesting assessment regarding lumbar disc herniation.
"The bottom line is patients who seek treatment, whether it is surgical or non-surgical, during the first six months of symptoms will respond better to treatment,"
Admittedly, I did not read these studies for myself, but I would bet a pretty penny that the majority had not received what I would consider adequate conservative care. In our microwave society, most patients in moderate pain will jump from doctor to doctor and modality to modality seeking the PAIN FIX. That doesn't mean that patients should be suffering for months on end before seeking alternate care. But putting trust in the Doctor's skills and professional opinion would surely reduce costs and increase outcomes.
Hinted at but not specifically stated in the first article Expenditures Rising For Back And Neck Problems, But Health Outcomes Do Not Appear To Be Improving is the liability issues facing doctors in today's litigious environment. Many Physicians will run additional testing despite feeling confident in their clinical assessment because of fear of law suits. Hey, we are all human and errors and omissions are made, but if you have the tests to document your diagnosis and treatment protocols you are better off. So when you request more tests next time you are dis-eased remember MRIs are great but they never directly got anyone better.
Work Smarter Not Harder!
Dr. David Marcon
Cincinnati, Ohio
drdavidmarcon.com
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