Medical Fads

When was the last time a child you know had his/her tonsils out? How about an adenoidectomy? A study in New York City in the 1930s had over 90% of its children with tonsillitis resulting in surgery or a recommendation of same. Today the equivalent statistic is below 1% (see: The Pediatric Journal).  Of late, I even can’t recall anyone I know getting his/her appendix removed. Yes, I know, the use of antibiotics may have a lot to do with the dramatic reduction in these medical procedures, but it can’t be the total reason. May I suggest that medical fads exist and that this may be one reason for our spiraling health-care costs … particularly when someone else pays for things?

What are the latest oft-expensive medical procedures that deserve to be evaluated for such faddish “crowding in?” Maybe botox injections, cellulite reductions, other vanity plastic-surgeries (Nancy Pelosi per esempio), C-sections, and maybe even some joint replacement procedures (see: Cracked Article). Yes, I know of those people where a knee replacement was a medical necessity, but I still see or hear of others where it may have been palliative or even faddish. (I, myself had been recommended for such an operation.) And, how about those ads on TV that push those fancy self-propelled wheelchairs?

Too often in the news we see of some medical quackery that operate clinics that will perform some expensive Medicare- or Medicaid-paid procedure or surgery over and over again on anyone who is willing to submit to this charlatanism. Why do these patients offer themselves up for such suffering? Often, I think, for bragging rights, borderline masochism, vanity, or even Munchausen’s syndrome.  Estimates of the “waste, fraud and abuse” in our medical system run into the tens of billion dollars per year (see: HHS Testimony), but somehow we can never seem to reduce this number significantly.

May I offer that some targeted and repeated public-service announcements, pointing out these medical fads and their consequences, might be an interesting path to follow? Escalating medical co-pays based upon the degree of faddishness involved might also be tried? These approaches do seem to be working for reducing cigarette smoking.

Afterthought:  I don't know why I didn't first suggest this solution to fix waste, fraud and abuse in the medical system ... reintroduce market forces into medical payments (Ryan's approach).