While doctors are supposed to recommend treatments that are in the best
interests of their patients, some are more interested in their own financial
gain. Because of the way certain procedures are billed to Medicare and
private insurance, doctors can benefit from performing surgeries that
are not medically necessary and may even do more harm than good.
According to a
report by USA Today, unnecessary surgeries might account for 10 percent to 20 percent of all
operations in some specialties, including a wide range of cardiac procedures
and spinal surgeries. “It's a very serious issue, (and) there
really hasn't been a movement to address it,” Lucian Leape,
a former surgeon and professor at the Harvard School of Public Health, told
USA Today. Leape, a renowned patient safety expert, started studying unnecessary
surgery after a 1974 congressional report estimated that there were 2.4
million cases a year, killing nearly 12,000 patients. In his opinion,
"Things haven't changed very much.”
Patients are often unaware that unnecessary surgeries can be grounds for a
medical malpractice claim and fraud claim. Like all medical malpractice cases, in order to
be successful, a patient must show that his or her doctor was negligent.
This means that the doctor’s actions failed to meet the standard
of care set out by state statutes, as well as what a reasonable doctor
would do in the same situation. Examples might include performing a procedure
absent any medical need or obtaining a patient’s consent to a procedure
under false pretenses.
Patients that are able to prove that a surgery was medically unnecessary
may be able to collect damages from the doctor who performed the surgery
as well as the medical center where it occurred. Surgery often involves
rehabilitation, costly medical bills, and missed time from work, all of
which may be recovered if the procedure is found to be unnecessary.
These types of medical malpractice cases can be complex and difficult to
prove. Therefore, it is important to speak with an attorney who specializes
in this area as soon as possible.