It’s no secret, the FDA is a dysfunctional cesspool of mediocracy and double standards. And it baffles me how many harmful drugs make it through the agency’s regulatory process.
But here’s something a lot harder to swallow…
There is no regulatory process required to determine the safety and effectiveness of surgical and medical procedures before turning them loose on the public.
Years ago, the U.S. Congress’ Office of Technology Assessment (OTA) evaluated modern technologies. It also evaluated unregulated surgical procedures and medical practices.
In fact, during the 1970s and 1980s, the OTA found that 80 to 90 percent of standard medical practices were not supported by clinical trial evidence.
Needless to say, the OTA did not survive the century to make it into the new millennium.
What did survive are the useless medical procedures and screening tests…
For example, for the past 50 years, routine colonoscopy has never been tested in a direct clinical trial comparison against other, safer techniques used to screen and prevent colon cancer.
No. 1 procedure to avoid at all costs
The situation with dangerous and expensive colonoscopies has become so alarming, I launched a new citizen campaign called the Safe Colon Cancer Screenings Initiative to increase public awareness of the safe and effective alternatives. The first part of this initiative is a petition we intend to send to the U.S. House of Representatives Committee on Oversight and Government Reform. Please consider supporting this important movement — and adding your name to this petition. You can read more about the Safe Colon Cancer Screenings Initiative and sign the petition here.
Back surgery is another disastrous example…
The surgery more likely to fail than succeed
Ten years ago, when I was running the Center for Integrative Medicine at Thomas Jefferson University in Philadelphia, “failed back surgery” was a huge problem. It was so common, insurers even stopped offering malpractice insurance to surgeons in Pennsylvania who performed certain risky spinal procedures.
Spinal fusion was a huge red flag. For this procedure, the surgeon welds together vertebrae located next to each other, supposedly to relieve back pain associated with degeneration of spinal discs.
When researchers finally tested this surgery in clinical trials, they found it worked no better than non-surgical treatments, including directed exercise and physical therapy. Of course, many other clinical trials show the benefits of acupuncture, massage, spinal manual therapy, and even herbal remedies as well. In fact, I testified in front of a Congressional panel with then-Pennsylvania Governor Ed Rendell about all the safe, effective, non-surgical alternatives to back surgery.
Unfortunately, this new evidence still fails to make its way to patients. And they accept the doctor’s word that they “need” surgery.
Non-surgical treatments are safer and just as effective
Dr. Richard Deyo at Oregon Health Sciences University has been evaluating back pain treatments for decades. I began reporting on Dr. Deyo’s research on back pain 25 years ago in my medical textbooks. His research shows that non-surgical treatments for back pain are safer, more effective, and more cost-effective than surgery.
The Annals of Internal Medicine even invited me to write an editorial about this kind of research in 1989 while I was director of the College of Physicians. At the time, I thought access to this research would help doctors finally realize the futility of back surgery.
In a recent article, Dr. Deyo told The New York Times that all the studies completed by the early 2000s (more than 10 years ago) should have been sufficient to stop or greatly restrict this dangerous, ineffective spinal fusion surgery. Instead, the rates of spinal fusion surgery continued to increase for the next decade until 2012, despite the clinical trial evidence. How’s that for the importance of evidence in the era of so-called “evidence-based” medicine?
Plus, insurance companies — meaning you, the consumer — kept paying for it. And you the patient kept suffering from a surgery known to be “next to useless” for another 10 years. Money talks, scientific evidence walks.
Finally, in 2012, Blue Cross of North Carolina said it would no longer pay for this surgery and other insurers followed suit.
But surgeons simply turned to performing other types of back surgeries.
Two more procedures to avoid
Today, because spinal fusion is off the (operating) table, back surgeons turn to two similar procedures called vertebroplasty and kyphoplasty. In these procedures, doctors inject a type of cement into the spine.
Clinical trials show no evidence to support performing either of these surgeries. Yet doctors still perform both them nationally — again, despite the evidence. Instead of following natural approaches to heal bones and joints, these surgeons figured they could just pull up the cement truck for a quick and lucrative “fix.”
- When it comes to colon cancer screenings, skip the “routine” colonoscopies. Instead, opt for widely available Cologuard that detects fecal DNA in the stool. Evidence shows it’s even more sensitive and accurate than other proven “alternatives.” You can even ask for the camera pill, if your doctor will agree to it.
- For back pain, try spinal manual therapy provided by a licensed chiropractor and physical therapy before considering any kind of surgery.
- For joint pain, try the ABCs of joint health — ashwaganda, boswellia and curcumin (400 to 500 mg each daily). Research shows they are highly effective at relieving pain (and avoiding surgery), especially when used in combination.
I also encourage you to check out my online Arthritis Relief & Reversal Protocol. It offers step-by-step details on the natural, non-invasive ways to alleviate all kinds of pain.
“Why ‘Useless’ Surgery Is Still Popular,” The New York Times (www.newyorktimes.com) 8/2/2016