One more thing about that review of knee arthritis treatments: it challenges the common belief that doctors are only in it for the money. In that report, surgeons officially tipped over one of their own cash cows. They denounced one of the most common and profitable knee surgeries (athroscopic lavage and debridement, polishing joint surfaces basically). They “cannot recommend” it, because the data clearly shows that it’s ineffective. (And that writing has been on the wall for a while. For example, see Moseley — a fascinating study.) Certainly there are still way too many surgeries that aren’t evidence-based, and probably unnecessary (spinal fusion comes to mind). But AAOS doing the right thing … well, it’s a big ethical deal, a Good Thing. Dr. Hall again:
Critics who claim doctors are just out to make money, take note: if they were the evil money-grubbers some make them out to be, wouldn’t these surgeons want to promote income-generating arthroscopic lavage and debridement? Wouldn’t they want to suppress information about conservative treatments and keep patients in pain until they were desperate enough to consent to expensive joint replacement surgery? Gee, do you suppose maybe they really are just trying to do what’s best for their patients?