By sheer coincidence a FOUR CORNERS episode was aired at about the time of setting up this site with great relevance - "Wasted" by Dr Norman Swan and Jaya Balendra. The focus of this program was the financial waste and harmful effects of standard management for knee pain and back pain as well as other medical conditions. What wasn't explored was the manner in which these methods not only produced standard complications but also facilitated persistent pain outcomes in vulnerable people.

Furthermore and quite understandably most conclusions were drawn on areas that have been studied for effectiveness via more recent better models eg: sham comparisons, more objective epidemiological outcome data etc. There was no attempt to extrapolate these conclusions to other areas not yet studied with these methods. In these areas interventions are still being implemented on the basis of "best available evidence" using standard, yet now questionable, research techniques. It may be that the findings in this report have only 'scratched the surface'.

http://www.abc.net.au/4corners/stories/2015/09/28/4318883.htm

NB: the background information copied from the program website:

Background Information

"WASTED" KEY FINDINGS

- Four Corners has found that nearly one third of the almost $155 billion spent on health every year is being wasted - about $46 billion

- Since GPs were given permission to order MRI knee scans three years ago, the number of scans has gone from zero to over 150,000 in the last year. It's estimated that at least 50% of them are unnecessary.

- Knee replacements cost up to $23,500 per procedure and last year cost the public and private health systems more than a billion dollars - not far short of an astounding 1% of the national spend on health. About 20% of them may be unnecessary.

- The costs of back pain imaging are extraordinary - about a billion dollars over the last ten years. That doesn't include the costs from public hospitals, but most are done in the private sector.

- At least half of all back scans and X-rays are of no value - that's half a billion dollars that could have been saved in the last 10 years. That could buy a regionally delivered suicide prevention programme, which could save a thousand lives a year.

- Spinal fusion operations, mostly performed in private hospitals, cost about $2.3 billion over the last ten years. It's estimated that 50% of this is needless.