Do you know that some people have surgery that they don’t even need?
I find it hard to believe too, but it really happens. A man came in scheduled for a vasectomy. He is nearly 50 years old, has no children and to his knowledge (his words) never conceived any. My question to him was, “How do you know you need a vasectomy?”
We discussed doing a semen analysis to make sure that he needed the procedure, but that would mean rescheduling. His response was, “But, I’m here already, so I just want to do it.” I reviewed the risks, bleeding, infection, chronic pain and failure of the procedure. I REALLY went into the chronic pain aspect of it explaining that if it happened there was not much to do about it: it was something that he would have to learn to live with. He responded that he knew a lot of people who have had vasectomies and they had no problems. I re-reviewed the risks, asking if he was willing to accept these risks for a procedure that he did not know if he needed. He said, “Yes!” and in my head, I said “WHAT?!!”
As you might guess, this puts me in quite a tricky situation. Medicine these days seems to be more about patient satisfaction and what the patient feels is right than what is medically appropriate. I know that other surgeons would go ahead and do the vasectomy in this situation; I did it. I don’t feel good about it. It makes no sense to me. Hopefully he does well.
This is not the only case of this type of thing that I know of. A man who had back pain, evidently severe enough that he thought he needed surgery. He went to a back surgeon, who told him that he didn’t think back surgery would help him. The man was angry, he went to several other doctors until he found one to operate on him. Even that doctor did not operate on his low back where he was having the pain. He had he surgery and continued to have pain after “recovery.” He had another surgery on his back later, then his knees. He continues to have pain today.
I once had a patient with a small mass on her kidney. Now, don’t get me wrong, that can be scary. I reviewed her x-rays and thought it would be best to watch it. We discussed that the mass could be removed, but it was probably not a cancer (everyone’s fear) and one of the numerous risks of the surgery was that she could loose her kidney. She told me that a friend of hers, a retired doctor from some other specialty, told her to have it removed. I said to her, “I get paid to operate on you, it should mean something when I am advising you not to have surgery.”
All of these examples are true. I do not know the motivations of any of these patients. Yes, we all have motivations that drive us to do things, even things that may not be in our best interest. When it comes to our bodies and health, things can get scary, because you think that you do not understand.
I’ve said this more than once; your health is not rocket science. What is happening with your body can be explained in words that you can understand. If the person in front of you cannot help you understand, find someone who can.
It is your responsibility.
