The Orthobullets Podcast

Podiums⎪Spine⎪The Moral Hazard of Spine Surgery: Appropriate Use of Surgery

Jan 30, 2025
Dr. Sigurd Berven, a spine surgeon at UCSF, dives into the moral complexities of spine surgery in a fee-for-service healthcare model. He discusses the ethical dilemmas that arise when financial incentives clash with patient care. The conversation emphasizes the importance of patient engagement in decision-making and tailoring treatments to individual needs. Berven also highlights the significance of personalized medicine and the need for collaborative approaches to navigate these challenges, ensuring that the patient's best interests are always prioritized.
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INSIGHT

Defining Appropriate Care

  • Appropriate care means expected benefits must exceed the expected risks.
  • Patients need to be engaged in informed decision making due to the challenge of quantifying risk-benefit ratios.
ADVICE

Assess Surgery Appropriateness

  • Regularly assess if surgeries are appropriate through case conferences.
  • Engage patients in weighing risks and benefits to guide shared decision making.
ANECDOTE

Stephen Jay Gould's Prognosis Story

  • Stephen Jay Gould questioned average prognosis after his mesothelioma diagnosis.
  • Despite an average 8-month mortality, he lived over 20 years, illustrating limits of averages for individuals.
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