Medical Model in USA Missing the Mark for Treatment of Chronic Back Pain

By Paul Gaspar
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Treatment for chronic low back pain

Healthcare remains the number one concern of Americans, with over 60% indicating it is their primary concern.  Costs and deductibles keep rising, while access to quality care has largely not improved.  Meanwhile, proposals from both sides of the aisle have done little to control costs of care.  It is frustrating that powerful lobbyists within the medical, pharmaceutical, and insurance industries have a large degree of influence on the outcome. 

These special interest groups work hard on Capitol Hill, spending millions to protect their financial interests.  Isn’t it in the interests of all of those groups to increase healthcare spending?  Of course it is!  But who’s looking out for the patients?  And how can we control the real drivers of healthcare costs?  Today’s article will briefly touch on a few of the lead drivers of health care costs, back pain and opioid addiction.

Let’s start with opioids.  There was a multi-million dollar campaign and effort about 20 years ago, focusing clinicians’ attention on pain and even mandating that a pain scale rating be used as a vital sign.  There were strong overtones that refusal to deliver ‘adequate’ pain medications was cruel and insensitive to patients.  Hospitals could actually be penalized for receiving low patient satisfaction scores, which could occur if a patient was refused the amount of pain medications they believed they needed.  The pharmaceutical industry was there every step of the way during this PR campaign and profiting from it in a big way.  What we know now is that it was a VERY bad idea. 

Case in point, in 2015 more than 50,000 Americans died from drug overdoses, more than died as a result of car accidents, gun violence, and wars.  And millions more had a lower quality of life and low productivity, further draining our economy.  Does it make sense that the USA has only 5% of the world’s population, but consumes 80% of the world’s opioids?  Could it be that our health care system is set up to promote medical billing, procedures, and expensive prescription medications?  Does this system not give insurance companies a built in excuse to raise their premiums, which further inflates their record profits?

While some like to brag that the USA has the best healthcare in the world, perhaps it’s time to take a hard look at the actual delivery of health care and the results we are getting, especially in regards to some of the most costly problems, such as chronic lower back pain, which costs hundreds of billions per year.  It’s time that clinicians and patients were more educated about how pain works instead of sticking with a traditional medical approach for treating chronic back pain. 

Perhaps it’s time to concede that a system built around 5-10 minute physician or specialist visits based on a medical model has led to disaster for our patients and society.  And perhaps our system of health care delivery for back pain, based on that model, explains why a patient’s risk of having a risky back fusion surgery is highly related their address (zip code).  Given that lumbar fusions have been reported to have a 50% success rate, should patients have to settle for a coin flip when it come to their care?  Americans deserve better!  Our upcoming posts will show how they can get educated about back pain to make better choices by selecting make smart, affordable, and conservative options to help.

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