Questions about medical necessity for some surgeries, screenings

The Washington Post looks at the dramatic increase in spinal fusion surgeries and whether all are necessary, while Kaiser Health News examines screenings for stroke and heart disease, some of which are not recommended for healthy people. The New York Times examines how the Food and Drug Administration's recommendation to limit prescriptions for narcotic painkillers was years in the making.

The Washington Post: Spinal Fusions Serve As Case Study For Debate Over When Certain Surgeries Are Necessary
By some measures, Federico C. Vinas was a star surgeon. He performed three or four surgeries on a typical weekday at the Daytona Beach, Fla., hospital that employed him, and a review showed him to be nearly five times as busy as other neurosurgeons. The hospital paid him hundreds of thousands in incentive pay. In all, he earned as much as $1.9 million a year. Yet given his productivity, some hospital auditors wondered: Was all of the surgery really necessary? (Whoriskey and Keating, 10/27).

Kaiser Health News: Prevention For Profit: Questions Raised About Some Health Screenings
For less than $200, Riggs is getting six different screenings for stroke, heart disease and osteoporosis. Life Line says they've checked 8 million Americans this way at churches and community centers, and up to 10 percent of them are found to have some sort of abnormality. But several of the tests performed by Life Line are on a list of procedures for healthy people to avoid (Gold, 10/28).

The New York Times: FDA Shift On Painkillers Was Years In The Making
When Heather Dougherty heard the news last week that the Food and Drug Administration had recommended tightening how doctors prescribed the most commonly used narcotic painkillers, she was overjoyed. Fourteen years earlier, her father, Dr. Ronald J. Dougherty, had filed a formal petition urging federal officials to crack down on the drugs (Meier and Lipton, 10/27).