The roundtable sent out a reference to an article about how doctors treat themselves when they are faced with end-of-life decisions.  Often, what a doctor chooses for himself is not what he would choose for a patient.  The majority choose to forego intensive treatments that have a marginal chance of success.  Their time is spent with friends and family, avoiding the medical system as much as possible. However, when their patients face similar illness, doctors frequently recommend medical treatment.

A similar behavior occurs in spine surgery.  I know of only two spine surgeons in my 25-year career who have undergone a spine fusion for LBP.   One was an older surgeon who did pretty well.  The other committed suicide two years later.  I don’t know how much of his ongoing pain contributed to his emotional state.

Whenever I give a lecture to a group of physicians, I usually ask the question “how much lower back pain would they have to experience before they would undergo a spine fusion?”  I have not ever seen one person ever raise their hand.  This includes surgeons who routinely perform these surgeries.

There was a survey done through one of our national spine societies a few years ago asking surgeons about the use of an artificial cervical disc.  Although 75% percent would recommend it for their patients, only nine percent would have one performed on themselves.

I gave a lecture, “Low Back Surgery—The State of the Union.”  I first covered what we knew versus what is currently being done.  There is almost a complete disconnect.  The upshot is that Surgical Results are Overly Optimistic.  Somehow we have to figure this out.

NH, BF