1. Provide the title of your story or series and the names of the journalists involved.
Too Much Medicine? Pushing Back On Back Surgery by Janet Moore
2. List date(s) this work was published or aired.
9-Aug-10
3. Provide a brief synopsis of the story or stories, including any significant findings.
One of the mysteries of American medicine is why Americans pay twice as much for health care as consumers in other developed nations while getting outcomes that are no better, and often worse. Simple over-consumption does not explain the numbers: Americans have fewer doctor visits and shorter hospital stays, for example, than patients in many European countries. But, as a team of Star Tribune reporters found, the American health care system is riddled with perverse incentives that can lead doctors and hospitals to recommend too much of the wrong kind of medicine, often the most costly and technology-intensive medicine. The result drives up health care costs and often produces inferior care. These perverse incentives are well-known to health care analysts, but we wanted to make them plain to the general public while giving our readers the tools to be informed consumers in their own care. We focused on three conditions and procedures that millions of Americans encounter each year, that have clear clinical evidence of overuse, and that are amenable to change at the behest of consumers or policymakers: childbirth, back pain and digestive distress.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
For the installment on childbirth, we asked the Minnesota Department of Health to compile a special database of elective induced births and we sorted them by hospital. For the installment on back surgery, we created a database of reports filed by Medtronic Inc. and Boston Scientific Corp of payments to local surgeons, then sorted them by hospitals that perform large numbers of back surgeries. We also used investigative reports compiled by the Finance Committee of the United States Senate.
5. Explain types of human sources used.
The Penny George Institute for Complementary Medicine at Abbott Northwestern Hospital in Minneapolis, a respected clinical research organization, has become a valuable source when we_re trying to find randomized empirical research on nontraditional therapies and medical techniques.
6. Results (if any).
We found that an orthopedic surgery clinic with close ties to Medtronic performs more of a certain type of specialized back surgery than any other practice in the country _ and far more than peer practices. We also found a local HMO that has sharply cut the number of back surgeries simply by requiring surgeons to offer their patients a range of therapies as a condition of reimbursement.
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No corrections or clarifications have followed.
8. Advice to other journalists planning a similar story or project.
Scholarly studies have identified dozens of procedures and pharmaceuticals with clear evidence of over use. But many are rare or obscure. We tried to choose conditions and surgeries that would be familiar to thousands of our readers _ and then to demonstrate why they might be more satisfied with their own care if they challenged the conventional wisdom.