I had a patient who came in to see me about treatment for a meniscus tear in his knee. He was a personal trainer, so being able to get back to using his knee at as close to full capacity as possible without pain and discomfort, was important for his business. He had been to a respected orthopedic surgeon, who was recommending surgery to repair the tear and was almost ready to have that done. Fortunately for him, one of his friends had told him about our clinic and the stem cell and PRP treatments we perform, as a way of avoiding surgery.
After evaluating his knee injury, we determined that he would be a good candidate for PRP (Platelet-Rich Plasma) therapy. This is where samples of the patient’s blood are taken, and the platelets growth factors and plasma are separated from the red blood cells through centrifugation. This platelet-rich plasma is then injected into the site of the patient’s injury, promoting healing of the injury whether it is for tendons, ligaments, muscles, or joints.
When this particular patient went back to the orthopedic surgeon for a last consultation before deciding which treatment he would have, he told the doctor that he had been to see me and asked what he thought about PRP treatment. To his credit, the doctor wasn’t negative about it. He told our patient that he had heard about the treatment, and that he should choose which one he thought was best for him. He also told our patient that if he chose to have the PRP treatment done, but wasn’t happy with the results, he could always come back and do the surgery.
So, why didn’t the doctor mention this non-surgical option in the initial consultations? There are usually 3 main reasons why doctors may not tell you about these two alternative treatments.
Let’s look at what they are:
Lack of Time to Keep Up on New Treatments
Today’s doctors are extremely busy. Even with the use of technology, the endless stream of patients they have to see means lots of medical notes and reporting for insurance purposes.
According to a recent study in the Annals of Internal Medicine of 57 U.S. physicians in family medicine, internal medicine, cardiology and orthopedics , “For every hour physicians were seeing patients, they were spending nearly two additional hours on paperwork.”
All of this paperwork limits the amount of time that doctors have available to keep up on new research and treatments, which can be substantial.
According to Nate Gross, MD and co-founder of Doximity, “Medicine has a TL;DR problem (Too Long; Didn’t Read). It would take 20 hours of reading each day for the average physician to comb through everything published in their specialty.”
So, if doctors haven’t spent time on learning new information about treatments or don’t feel comfortable with their knowledge on a new treatment, you aren’t going to hear about it.
Medical Practices are a Business
While medical practices treat patients for illness and injury, they are also in the business of making money.
According to Medical Group Management Association’s 2015 Provider Compensation and Production Survey Report, general orthopedic surgeons make an average of $421,000 per year. If the orthopedic surgeon specializes in joint replacement, this number goes up to $563,890. And, if they specialize in sports medicine, the average is $549,048.
So, if you go to an orthopedic surgeon for an injury or condition that can be treated with surgery and they perform that surgery, is it surprising that they are going to recommend surgery as your treatment?
Insurance Companies are Slow to Catch Up to Alternative Treatments
The most basic concept in the world of healthcare and insurance is the provider network. Provider networks are made up of the doctors, hospitals, clinics, and other healthcare professionals and facilities that a health plan contracts with to offer services at reduced costs.
It is important to remember that provider networks are an integral part of managed care plans. They are systems that have been put in place by health insurance companies to help manage the quality and costs of medical services that their members receive.
Traditional medical procedures are the hallmark of these systems, so sometimes it can take ten years or more for the insurance companies to catch up to alternative treatments. They typically want to see ten years of proven results before they will cover a new treatment, even if it would save them money in the short run.
What does this mean for you?
If the insurance company hasn’t approved a procedure yet, you will be referred to a specialist within their network who will most likely recommend surgery.
Research Optional Treatments
Knowing these three things about the medical industry, it is up to each of us to be our own advocates when it comes to our health care.
There are alternative treatments available that can replace some surgeries, don’t require joint replacements or invasive procedures and mean quicker recovery time. But, if you don’t do your own research, you may never know about them. So, it is important to get another opinion and do your due diligence. Also, don’t forget ask to speak to past patients who have had the procedure from the doctor you are considering. A quality doctor will be only too happy to refer someone to you.
In the case of the patient we mentioned in the beginning, PRP treatment worked very well for him. He could already do more with his knee shortly after his first treatment, and it got better from there. And, he never did go back for surgery.
You can read more about how PRP treatments are gaining popularity with pro athletes here.
As with any form of medical treatment, you should consult with your physician before embarking on any treatment plan. The information contained in this article is for informational purposes only and should not be deemed accurate for the purposes of diagnosing your particular medical condition