Ineffective or Needlessly
A minor operation is one that is performed on the other fellow. —Russell Pettis Askue1
FOR MANY people, surgery exemplifies what we mean by high-tech medicine. You might suppose that before doctors start cutting into your body, they're damn sure that what they're doing will work. Most of the time, that's true. But not always. While commercial interests and regulatory practices heavily influence drug prescribing, tradition and authority perhaps more heavily influence surgery. Recently, researchers have looked more closely at some operations that have been done for years. Old practices die hard, and tradition has sometimes overwhelmed convincing evidence. Other research has focused on new operations that seemed to have great promise. The results have occasionally been surprising, and doctors have gone back to the drawing board.
We've already seen how devices used in surgery—like heart valves or spine screws—are sometimes introduced before we understand their limitations. At least devices are subject to FDA review. But a surgeon can perform any new procedure he wishes, assuming he can find a willing patient.