Articles by JCS
Medical Mistakes Part III
White Collar Crime
Why Surgeons Wear Masks
Once again one of my former patients got railroaded by her attorney into having back surgery. Apparently some of these predatory personal injury attorneys aren’t satisfied that chiropractic care gets people well without surgery because it lowers their settlements. Since chiropractic care is so effective and inexpensive, these sharks lie to patients about the mistaken belief that chiropractors are not expert witnesses, thereby ushering these naïve patients to their local knife-happy back surgeons.
Linda was involved in a MVA—low-speed, minimal damage accident which left her with a mild neck strain. I placed her on a Grade 1 program of spinal manipulation along with anti-inflammatory therapy, then rehab exercises to strengthen her neck. I dismissed her from active care one month later with flying colors. I recall she was ready to go play tennis and was wearing a cute little tennis outfit, looking like a 30 year old woman instead of her real age of 50+ years.
Over a year later, the attorney from the other side came to talk with me about her, wondering why she had had three back surgeries since she had left my office. Bewildered myself, I had no explanation since she left my office looking and feeling great. His side was being sued for $250,000, and he didn’t understand why she had three surgeries since the accident was only a "bump" and she sustained minimal damage. Neither did I, other than suggesting these were unnecessary surgeries.
The next day I phoned her attorney to ask why. Of course, initially he side-stepped the real reason of money, and told me that he wanted a second opinion from a "real" back doctor who discovered that she had degenerative disc disease in her neck and low back.
"Mr. Nixon," I said, "you and I both know disc degeneration had nothing to do with her pain, nor was it a result of this accident because it takes years to develop disc degeneration. Besides that, she had no complaints about her low back."
"Well," he responded, "the orthopedist said she had degenerative disc disease, and who am I to argue with him?"
"Like I said before, her disc degeneration has nothing to do with her neck pain. The MRI research has shown that fact repeatedly. Her pain came from joint dysfunction and associated soft-tissue damage. Plus, she was perfectly fine when she left my office, ready to play tennis as a matter of fact."
Finally he opted to tell me the truth. "Look, Dr. Smith," he admitted, "do you want 33% of $10,000, or a third of $250,000?"
I was shocked that he admitted his hidden agenda, knowing how some attorneys railroad their clients into the surgeon’s office to increase their settlements. While most every attorney does this, few are willing to openly admit it.
"So you’re willing to sacrifice this patient to unnecessary back surgery just for the sake of money?" Why did I feel totally naïve in asking that question? Of course he is willing since it’s her back and life that’s permanently messed up forever, not his.
He simply responded, "You got that right." End of discussion.
Coincidentally, I saw Linda in the grocery store a few weeks later. Instead of a young 50 year old with great legs, now she looked like a 90 year-old, using a walker to assist her as she limped around the store.
"Linda, how are you doing?" I asked.
"Well, I can get out of bed now, but only if I use this walker. Since I saw you last, I’ve had three back surgeries. They found out that I had degenerative disc disease, but fortunately, the surgeon got it all."
Apparently this unscrupulous surgeon had given her the voodoo diagnosis—"If you don’t have my surgery, you’ll only get worse." He implied to her that her disc disease was like a cancer spreading throughout her spine, and if he didn’t cut if out, she would worsen. What a lie.
Rather than telling her the truth and making her feel worse about her dire situation—that she had been lied to and ripped-off by her attorney and surgeon—I just left knowing she was just another victim of white collar medical crime. Incidentally, the other attorney phoned me later to tell me that they settled out of court for only $90,000 because I was willing to testify that these surgeries were unnecessary. Through the patient grapevine, I later learned that her attorney got his $30,000, the surgeon got even more, and the balance that she got went to her husband who bought himself a new truck. All Linda got out of this was three failed back surgeries, and a future lifetime of misery.
To make matters worse, Linda’s Snake Farm insurance company didn’t pay her bill with us entirely, citing their IME determined it was "excessive." Excessive, I queried? What about 3 failed back surgeries that left her on a walker? Weren’t those unnecessary and excessive? While they gladly paid the surgeon’s bill, they balked at paying all of her bill to us.
After her bill was finally sent to the collection agency, her husband hired another attorney to fight our bill. Their attorney decided that the reason Linda needed those 3 surgeries was supposedly due to some fault of mine, apparently because I failed to refer her after discovering the degenerative discs. Forget that she was better after leaving my office, they needed an excuse and found me as their answer. His ploy was obvious: If I sued her, then they would sue me.
I couldn’t believe it. Here is a clear case of unnecessary back surgeries that were unsuccessful, leaving the patient on a walker for the rest of her life. Fortunately, her Oswestry indexes indicated her improvement in my office went from initially 40% impairment to 20%, indication in her own words of her improvement. As I previously mentioned, she was ready to go play tennis the last time I saw her in my office.
But the implication that I was responsible for her demise still sticks in my craw. She was clearly the case of three greedy men—her attorney, her surgeon and her husband. She was clearly misdiagnosed, mistreated and ill-informed by them all, yet her chiropractor had become the scapegoat for her total disability now? Go figure.
How often does this same scenario play out daily throughout our country? Too often, that’s for sure. But the entire system of medical greed feeds into this sad situation. As long as attorneys make more in settlement due to back surgeries, they will continue to railroad patients into the surgeon’s office. And the naïve patient will do as told by these ill-guided, greedy mentors.
As long as insurance companies accept without question the old "disc degeneration" as a cause of back pain, we’ll continue to see more mis-diagnosis and mis-treatment. MRI research repeatedly has shown disc abnormalities exist in the majority of patients with no back pain, disproving the belief that discs are the cause of pain. As one researcher said, "finding disc abnormalities is like finding grey hair—everyone has them, but it doesn’t mean it the cause of their pain."
Indeed, you don’t slip discs as much as you slip joints. Considering there are 137 joints in the spinal column, the possibility of joint problems is very great. Unfortunately, research be damned. Consequently, mechanical back pain and joint dysfunction remain alien terms to these people looking for bigger fish to fry.
Imagine the cost-savings if every back surgery victim was treated first by a chiropractor, preventing 90% of these unnecessary surgeries as many experts believe. Imagine how many people wouldn’t be left in walkers or wheelchairs because some greedy attorney wanted to make more money off their case.
Since money is the steam behind the engine of modern medicine, I doubt this scenario will ever change. Oddly, while much of the public thinks the insurance companies want to reduce costs, the opposite seems to be true. If payers pay out more, they can charge more, so there’s more money for everyone. Hospitals also dislike chiropractic care because it’s too cheap—filling beds and price-gouging is the name of their game, not price-reduction via better patient treatment like spinal manipulation for back pain or chelation therapy for clogged arteries. Since back surgeries and bypass surgeries are the second and third-leading hospital procedures, there's a lot of money at stake here. And hospitals and doctors have no interest in referring these high-priced items to "alternative" practitioners.
So, don’t think for a moment that white collar crime is limited just to crooked bankers, attorneys or stock brokers. Think of the millions of patients left in the wake of medical mistakes, which now are considered the third-leading cause of death behind heart disease and cancer, killing 3,000 each week. Considering experts state that 78% to 90% of all surgeries are unnecessary, white collar medical crime accounts for an astronomical number of damaged or dead patients.
All too often we’ve heard their explanation, "The operation was a success, but the patient died. And here’s a bill for $50,000." Surgeons know full well in many cases that they are predating upon naïve patients. Just talk with their operating room nurses and they’ll tell you the shameless truth of the situation. Nurses see it all. As one OR nurse for the local back surgeon told me recently, "I’d hate to be a patient in my own hospital because they just don’t care about people."
But, as the late Abraham Maslow, Ph.D. once said, "If your only tool is a hammer, everyone looks like a nail." How prophetic—surgeons are in business to do surgery, not referring patients to chiropractors. And it appears that too many are willing to do unnecessary surgery because it’s so profitable and the insurance system gives them a green flag. Perhaps this explains the real reason why surgeons wear masks. But in this case, this thief is stealing your good health as well as your money.