Insurance companies spend vast sums of money on paying for spinal operations for their policy holders which are in the main entirely unnecessary from a medical point of view. In the USA alone, 400,000 back operations are performed annually.
The reason why these operations are carried out is chiefly because a great deal of money (from medical insurance companies) follows the patient to the operating theatre - it is not because the operations themselves are medically necessary. In the vast majority of cases spinal operations are not only unnecessary and ineffective, but they are debilitating and crippling for the patient.
Why are spinal operations carried out if they are not medically necessary?
In order to answer this it is necessary to understand how the patient is 'directed' along the surgical route.
The GP - Consultant - Surgery process.
1. The patient attends their local GP (doctor) complaining of back or neck pain. Pain killers and 'bed rest' are usually prescribed on a first visit. If these don't help, the patient is referred to the local physiotherapy unit attached to the GP's clinic or Health Trust. If the local physiotherapist cannot solve the patient's problem (which they cannot do when the condition requires specialist knowledge of the spine) then the patient is referred to an orthopaedic or neurosurgical consultant attached to a hospital.
2. Hospital consultants are generally given free access to consulting rooms and hospital facilities, but they are expected in return to refer patients to the hospital for treatment (i.e. surgery). The consultant's fees and the earnings of the hospital depend on the patient being admitted to the hospital (empty beds don't pay the bills) and so there is a great resistance to the idea of considering a specialised form of physical therapy for the spine even if the treatment is well known.
3. Insurance companies rely upon the recommendations made by the patient's GP or consultant in deciding whether to meet a claim for health cover. NHS GPs do not however refer patients to non-NHS organisations such as ours, and hospital consultants do not refer patients to us for the reasons already given. Conversely, we have only had to refer patients for surgery on two occasions during the last 35 years, which shows us that surgery is just not necessary.
The result of this administrative and 'financial' process is that thousands of patients end up having totally unnecessary and expensive spinal operations paid for by medical insurance companies.
Our Services to the Medical Insurer
We will provide a free examination for any patient referred to us by an insurance company. Insurers are entitled to 'shop around' for treatment options other than surgery for their policy holders. We will advise the insurer as to whether a patient really needs surgery as a form of treatment (herniated discs for example do not generally require surgical treatment). The initial treatment we provide will also be free in order for the patient to report back to the insurer as to their improved condition. If the patient wishes to continue with the non-surgical treatment that we offer, our agreed fees of £500 per hour will need to be met by the insurer up to a limit of £12,000, depending on the complexity of the case. We have never had to charge more than this level of fees in order to treat a patient.
The average cost of treating a herniated disc condition at our clinic is for example starting from £7,500 which usually requires some 8 - 14 treatment sessions. We provide the patient with a specific follow-up exercise program to prevent recurrence of the condition. Our costs can be compared with surgical treatment, although the difference between our form of treatment and surgical treatment is that our patients are left with their backs intact while facing a healthy future, whereas patients who have undergone surgical treatment are invariably disabled sooner or later as a direct consequence of the operation (rather than as a consequence of their original condition).
The next time your claims department is considering underwriting a policy holder's hospital bills, please let us know so that we can examine the patient without charge and provide a "second opinion".