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"So 'unnecessary surgery' cannot be defined," said Fran, "without at the same time facing a subversive idea." "Right," I replied, "to define 'unnecessary,' you must first define 'necessary surgery.'" I watched as she finished kneading. The glistening dough would double in size over the next two hours. I was already getting hungry. A moment passed. "That's a concept that would make the physician uncomfortable," she said. "Indeed. Because it raises the efficacy issue for any and every surgical procedure routine as well as experimental." - Gerald E. Markle and Frances B. McCrea, What If Medicine Disappeared? (Get the book.)

"We did not mention the fact that very often people are in hospitals undergoing unnecessary surgery. Surgeons love to operate in the case of back pain, heart or knee problems. And the statistics are rising dramatically. In Germany, 65 thousand patients had surgery in 1998 because of disc-problems. In 2003, 100 thousand. As far as we could research it, there were even more in 2007. And this despite the fact that in 90% of the cases the pain goes away by itself.237 Let us repeat: 90%! Financial interests of the surgeons and/or the hospitals are often the key." - Kenneth W Thomas, Ron Gilbert, Gerd Schaller, Side Effects: The Hidden Agenda of the Pharmaceutical Drug Cartel (Get the book.)

"When several doctors with a particular subspecialty live in a particular region, he says, and they happen to be aggressive, then a lot of unnecessary surgery will be performed, as in Lewiston, Maine, where there were unneeded hysterectomies, and Morrisville, Vermont, where doctors were doing countless tonsillectomies. In other words, he says, the supply of physicians can determine how much surgery is performed, rather than how much surgery patients actually need." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.) "You couldn't say anything to the back surgeon, even though he was doing unnecessary surgery. Nobody wanted to be utilization reviewer because it meant you had to talk to your peers. These doctors did not want to be told what to do. It was worse than telling your three-year-old what to do." Utilization review was an idea managed care had borrowed from traditional HMOs, which routinely monitored the performance of individual doctors, groups of doctors, and entire hospitals." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.) "Time Magazine noted that medicine's new "wondrous machines" were expensive, but in the end they would save billions of dollars by eliminating unnecessary surgery and catching diseases early, when they were easier to treat. Newsweek hailed the new imaging technologies for their ability to render the human body "almost as transparent as a jellyfish." Today's CT scanners, along with MRI (magnetic resonance imaging) and PET (positron-emission tomography), truly are wondrous machines that have made the diagnosis of many conditions far faster and simpler for physicians, and less risky for patients." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"Doctors and hospitals are paid more for doing more, largely without regard for evidence of improved health outcomes (examples are the rapid increase in the number of MRI machines, excess capacity for neonatology and invasive cardiac procedures that lead to excess use, and the approximately 12,000 deaths that occur each year as the result of unnecessary surgery). Health care providers that deliver high quality, efficient care are financially penalized for not delivering a higher volume of more intensive services, beneficial or not (referred to as the "perverse incentive")." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.)

"In the final analysis, it cannot be the patient who has the major responsibility to prevent unnecessary surgery. More recently, some have attempted to distinguish "appropriate" from "inappropriate surgery." According to the RAND Corporation, appropriate surgery is one in which the expected health benefits of doing a procedure (i.e, increased life expectancy, relief of pain, reduction of anxiety, improved functional capacity) exceed the expected negative consequences (i.e., mortality, morbidity, time lost from work) by a sufficiently wide margin that the procedure [is] worth doing." - Gerald E. Markle and Frances B. McCrea, What If Medicine Disappeared? (Get the book.) "Writing about unnecessary surgery reminds me of my tonsillectomy. Proust was right. When nothing else subsists from the past, the smell and taste of things gain entry "into the immense edifice of memory." It was a long time ago, but what I remember so vividly about my tonsillectomy is the smell of the ether. "Just take a deep breath," the surgeon intoned. It was my first disobedient act against the medical community. I held my breath for all I was worth. But within seconds I understood the terrible truth: I had lost. I inhaled the dreadful stuff. Then falling, falling..." - Gerald E. Markle and Frances B. McCrea, What If Medicine Disappeared? (Get the book.) "Since unnecessary surgery is generally defined by incompetence or malfeasance—the deviant case, as it were—it follows from this logic that the great proportion of surgery is necessary. There is nothing new about this kind of reasoning. The medical model routinely defines concepts by their absence. Thus, is the concept of disease carefully considered, but perhaps the more important concept of health is not, except by the absence of disease. It follows that health and its maintenance are understudied and poorly understood." - Gerald E. Markle and Frances B. McCrea, What If Medicine Disappeared? (Get the book.)

"Lyme hysteria," as well as the excesses of the drug companies and why medicine's approach to saving women from breast cancer was an unconscionable overreach.. I highly recommend Disease Mongers as a template for print and media medical journalists. Shannon Brownlee needed no such template. Her Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (2007) picks up where Payer left off and does so brilliantly. Lynn left me with memories and lessons, lessons that relate to the difficult task faced by journalists attempting to make sense of "health care" in the United States." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.)

"When several doctors with a particular subspecialty live in a particular region, he says, and they happen to be aggressive, then a lot of unnecessary surgery will be performed, as in Lewiston, Maine, where there were unneeded hysterectomies, and Morrisville, Vermont, where doctors were doing countless tonsillectomies. In other words, he says, the supply of physicians can determine how much surgery is performed, rather than how much surgery patients actually need." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"Occasionally, the result has been unnecessary surgery. An example: the patient was a woman who had been successfully treated previously for back pain. She called and said that pain in the right shoulder had been diagnosed as a torn rotator cuff; surgery was performed, with relief of the pain (excellent placebo). When the same pain began in the opposite shoulder a few weeks later her suspicion was aroused; she called and asked if it could be TMS." - John E. Sarno, M.D., The Divided Mind: The Epidemic of Mindbody Disorders (Get the book.)

"How could mammography lead to unnecessary surgery? Ductal carcinoma in situ is a common lesion that is believed not to become a cancer in many cases. It has become four times more common in recent years, largely, but not entirely, because of increased mammo-graphic screening. When it is found nowadays, DCIS is removed surgically, often with a procedure that leaves the breast intact but not without scars, and sometimes with loss of feeling in the nipple. Some young women with DCIS choose to have both breasts removed as a precaution." - Devra Davis, The Secret History of the War on Cancer (Get the book.)

"People ask me why there's so much unnecessary surgery, and I tell them there are more reasons why there should be than there are that there shouldn't be. The only reason why there shouldn't be so much unnecessary surgery is that it causes suffering and loss of life, health, and expenses that do not have to be. That consideration alone has never had much effect on the workings of the Church of Modern Medicine. On the other hand, the reasons why there should be unnecessary surgery are legion, and quite compelling within the ethical framework of the Church." - Robert Mendelsohn, Confessions of a Medical Heretic (Get the book.)

"You couldn't say anything to the back surgeon, even though he was doing unnecessary surgery. Nobody wanted to be utilization reviewer because it meant you had to talk to your peers. These doctors did not want to be told what to do. It was worse than telling your three-year-old what to do." Utilization review was an idea managed care had borrowed from traditional HMOs, which routinely monitored the performance of individual doctors, groups of doctors, and entire hospitals." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.) "Time Magazine noted that medicine's new "wondrous machines" were expensive, but in the end they would save billions of dollars by eliminating unnecessary surgery and catching diseases early, when they were easier to treat. Newsweek hailed the new imaging technologies for their ability to render the human body "almost as transparent as a jellyfish." Today's CT scanners, along with MRI (magnetic resonance imaging) and PET (positron-emission tomography), truly are wondrous machines that have made the diagnosis of many conditions far faster and simpler for physicians, and less risky for patients." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"These delays led to unnecessary surgery or death for millions of women. • Some of the first modern studies on workplace causes of cancer, the dangers of medical and environmental hormones, and the cancer-causing properties of tobacco were carried out and published by scientists around 1936, including many who worked in Nazi Germany. In June 1945, Robert R. Kehoe, an Army captain who was a member of the Office of Strategic Services, traveled throughout Germany gathering information on chemical and hormonal hazards for the U.S. Army Field Investigations Unit and the British Secret Service." - Devra Davis, The Secret History of the War on Cancer (Get the book.)

"The amount of unnecessary surgery is high. As early as 1953, Dr. Paul Hawley, director of the American College of Surgeons, stated matter-of-factly in an interview in U.S. News and World Report, "You'd be shocked, I think—we are—at the amount of unnecessary surgery that is performed." The reason, according to Hawley? "Money."26 "In the United States today," Moss wrote in The Cancer Industry, "the direction of cancer management appears to be shaped by those forces financially interested in the outcome of the problem." - Kenny Ausubel, When Healing Becomes A Crime: The Amazing Story of the Hoxsey Cancer Clinics and the Return of Alternative Therapies (Get the book.)

"Secondly, he has probably been given huge cash incentives from the drug companies to prescribe drugs, or he needs to make a payment on his yacht and needs the money that he will get from the insurance company or the government by performing the unnecessary surgery. Please pay attention to this because this is exactly how doctors operate. This is the insider's secret that they don't want you to know." - Kevin Trudeau, Natural Cures They Don't Want You to Know About (Get the book.)

"Both concluded that these testing methods have done nothing to reduce mortality, but a lot for increasing unnecessary surgery and radiation because of the frequent false positive results. The evidence also has considered undeniable that radiation exposure from repeated mammography causes breast cancer. These studies are challenging a multi-billion dollar industry." - Helke Ferrie, Dispatches From the War Zone of Environmental Health (Get the book.)

"Things like unnecessary surgery, medical errors, negative effects of drugs, etc., cause almost as many deaths as heart disease and cancer. Over 250,000 people in America alone die each year from physicians' activity or therapy. These account only for the deaths; they do not include people who are permanently maimed, injured, or develop serious other medical conditions due to drugs and surgical procedures." - Kevin Trudeau, Natural Cures They Don't Want You to Know About (Get the book.)

"It's very difficult to obtain accurate statistics when studying unnecessary surgery. Dr. Leape in 1989 wrote that perhaps 30% of controversial surgeries are unnecessary. Controversial surgeries include Cesarean section, tonsillectomy, appendectomy, hysterectomy, gastrectomy for obesity, breast implants, and elective breast implants.74 Almost thirty years ago, in 1974, the Congressional Committee on Interstate and Foreign Commerce held hearings on unnecessary surgery. They found that 17.6% of recommendations for surgery were not confirmed by a second opinion." - Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD., Death by Medicine (Get the book.) "Researchers performed a very similar analysis, using the 1974 'unnecessary surgery percentage' of 17.6, on back surgery. In 1995, researchers testifying before the Department of Veterans Affairs estimated that of 250,000 back surgeries in the U.S. at a hospital cost of $11,000 per patient, the total number of unnecessary back surgeries each year in the U.S. could approach 44,000, costing as much as $484 million.75 The unnecessary surgery figures are escalating just as prescription drugs driven by television advertising." - Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD., Death by Medicine (Get the book.)

"The authors were pleased with the low unnecessary surgery rate, pointing out that patients with less severe heart disease are now being treated medically. The low rate of unnecessary surgery, they concluded, was greatly achieved by the oversight and feedback of the Cardiac Advisory Committee and the Department of Health of New York State, which played a major role in improving the situation. Solutions io I lie Surgical Crisis Overall, how many patients undergo unnecessary operations each year in all forms of surgery?" - Martin L. Cross, The Medical Racket (Get the book.)

"Although some potentially curable cancers and other disorders are occasionally found by such scanning, many findings are difficult to interpret, and as a consequence they may lead to attendant anxieties, unnecessary additional testing, and even unnecessary surgery. As with most tests, they have to be applied to the right populations to yield meaningful results, and we are not yet certain for which group the body scan would be most useful (if any). Despite these cautions, some physicians have promoted body scanning to the public." - Jerome P. Kassirer, On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health (Get the book.) "Some performed unnecessary surgery. Some sold drugs and alternative medicine potions directiy to patients. Some brought patients back for office visits more often than medically necessary. Some worked the system to get the highest possible return from drugs that they bought at wholesale and sold at retail. Cardiac procedures were easily abused. Some doctors performed electrocardiograms and billed for them at every office visit even when the test was unnecessary. (One cardiologist estimated that a busy practitioner could perform as many as 70 to 80 in his office in a busy week." - Jerome P. Kassirer, On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health (Get the book.)

"Greed plays a role in causing unnecessary surgery, although I don't think the economic motive alone is enough to explain it. There's no doubt that if you eliminated all unnecessary surgery, most surgeons would go out of business. They'd have to look for honest work, because the surgeon gets paid when he performs surgery on you, not when you're treated some other way. In prepaid group practices where surgeons are paid a steady salary not tied to how many operations they perform, hysterectomies and ton- sillectomies occur only about one-third as often as in fee-for-service situations." - Robert Mendelsohn, Confessions of a Medical Heretic (Get the book.) "The only reason why there shouldn't be so much unnecessary surgery is that it causes suffering and loss of life, health, and expenses that do not have to be. That consideration alone has never had much effect on the workings of the Church of Modern Medicine. On the other hand, the reasons why there should be unnecessary surgery are legion, and quite compelling within the ethical framework of the Church. The simplest reason is that surgery can be put to many uses besides the stated purpose of correcting or removing a disease process." - Robert Mendelsohn, Confessions of a Medical Heretic (Get the book.) "There's no doubt that if you eliminated all unnecessary surgery, most surgeons would go out of business. They'd have to look for honest work, because the surgeon gets paid when he performs surgery on you, not when you're treated some other way. In prepaid group practices where surgeons are paid a steady salary not tied to how many operations they perform, hysterectomies and ton- sillectomies occur only about one-third as often as in fee-for-service situations. If we had about one-tenth as many surgeons as we have now, there would be very little unnecessary surgery." - Robert Mendelsohn, Confessions of a Medical Heretic (Get the book.)

"When doctors find such discs in people with back pain, the discs may be irrelevant, but they are likely to lead to more tests, patient anxiety, and perhaps even unnecessary surgery. In fact, back surgery rates are highest where MRI rates are the highest.24 In a randomized trial, we found that doing an MRI instead of a plain x-ray led to more back surgery but didn't improve the overall results of treatment.23 Because we see more things on these scans, certain medical problems seem to be becoming more common year after year." - Richard A. Deyo M.D. M.P.H., Donald L. Patrick, Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises (Get the book.)

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