Letters to the Editor
The New York Times
229 West 43rd Street
New York, NY 10036
letters@nytimes.com
This letter is in response to the recent New York Times article by Reed Abelson and Melody Peterson, “An Operation to Ease Back Pain Bolsters the Bottom Line, Too”(December 31, 2003). The article publicly introduces an age-old issue that spine doctors struggle with every day – deciding which treatments will work best for which patients. Despite the article’s impression of surgery-hungry practitioners, statistically, only 10% of the care members of the North American Spine (NASS) Society provide is operative. As a rule, surgery is the last resort after all other treatment options have been exhausted. And contrary to the article’s accusation, surgery is not a bottom line booster. In fact, with recent Medicare reimbursement cuts, it makes it almost impossible for doctors to even cover basic costs.
There are a variety of causes for back pain and treatment options vary from patient to patient. Before any treatments are even considered, the cause must first be determined, and only then can the experienced practitioner offer the optimum treatment option. Doctors, with very few exceptions, have always taken the patient’s best interests into account first and foremost. Patients today have more of a say in their treatment than in years past - and this comes at the encouragement of their doctors. The spine doctor of today has to introduce to his patient the range of options available, risks, benefits and alternatives to every procedure. Not only is this a common practice but it is required as a matter of informed consent law.
True, doctors have varying opinions on the best treatment options for specific cases. In fact, this is a constant debate – but it is a debate over what is best for the patient, NOT what will boost our bottom lines.
Sincerely,
NASS Member