Then why is routine circumcision still covered? And why is unnecessary surgery of all kinds still so big in the US?
“In 2016, the existence of unnecessary surgery remains a daunting reality that continues to expose our patients to an unjustified surgical risk [
18]. For example, multiple clinical trials have shown that spinal fusions for back pain do not lead to improved long-term patient outcomes when compared to non-operative treatment modalities, including physical therapy and core strengthening exercises [
19,
20]. In spite of these insights from high-quality trials, spinal fusion rates continue to dramatically increase in the United States [
18]. Another relevant example is arthroscopic partial meniscectomy, one of the most commonly performed surgical procedures in the world [
21]. This minimally invasive surgery allows treating internal knee damage through small percutaneous skin incisions, with a fast-track postoperative recovery period. In the United States alone, surgeons perform approximately 700,000 arthroscopic partial meniscectomies every year. Strikingly, a recently published prospective randomized controlled trial (“Finnish Degenerative Meniscal Lesion Study”/FIDELITY trial) that assessed patient outcomes after arthroscopic meniscal trimming compared to sham surgery revealed
no benefit for patients from the routine surgical procedure at 12 months follow-up [
22]. Actually, considering the risk for patients sustaining a severe intra- or postoperative complication, no surgical procedure should be considered “routine” from the patient’s perspective [
23]. Yet, until present, a change in practice has not occurred, and arthroscopic meniscectomies continue to be performed on hundreds of thousands of patients in the United States every year [
24,
25].”
I mean what you are saying should be true in theory but for whatever reason it’s just … not.
