$86 Billion Spent on Back, Neck Pain
Despite Nation's Dramatic Increase in Spending, Little Improvement
Seen in Patients
By Salynn Boyles

WebMD Health NewsReviewed by Louise Chang, MDFeb. 12, 2008 --

More U.S. health care dollars are spent treating back and neck pain
than almost any other medical condition, but much of that money may be
wasted, a new study suggests.

Researchers from the University of Washington, Seattle, found that the
nation's dramatic rise in expenditures for the diagnosis and treatment
of back and neck problems has not led to expected improvements in
patient health.

Their study appears in the Feb. 13 issue of The Journal of the
American Medical Association.

After adjustment for inflation, total estimated medical costs
associated with back and neck pain increased by 65% between 1997 and
2005, to about $86 billion a year.

That is in line with annual expenditures for major conditions,
including cancer, arthritis, and diabetes.

Yet during the same period, patients reported more disability from
back and neck pain, including more depression and physical
limitations.

"We did not observe improvements in health outcomes commensurate with
the increasing costs over time," lead researcher Brook I. Martin, MPH,
and colleagues wrote. "Spine problems may offer opportunities to
reduce expenditures without associated worsening of clinical
outcomes."

(Living with back pain? Is the cost of your treatment becoming more
than you can bear? Discuss it with others on WebMD's Back Pain:
Support Group board.)

The Cost of Treating Back Pain
Low-back pain is one of the most common reasons for doctor visits,
with one in four adults in one survey reporting low-back pain within
the previous three months. Neck pain is also a common reason for
doctor visits.

Over the past decade, diagnostic imaging has become common for
patients with back and neck pain, and the use of narcotics,
injections, and surgery has also increased dramatically.

In an effort to better understand the medical costs and benefits
associated with these interventions, Martin and colleagues analyzed
data from the nationally representative survey of medical expenditures
from 1997 through 2005.

After adjusting for inflation, they estimated individual yearly
medical expenditures among adults with back and neck problems were
$4,695 in 1997 and $6,096 in 2005, compared with $2,731 and $3,516,
respectively, for people without back and neck problems.

Martin tells WebMD that the 65% inflation-adjusted increase in total
costs among adults with spine problems was higher than the increase in
health costs overall.

"We are spending as much on spine problems as we do for cancer and
arthritis," he says. "The only disease category that dwarfs these is
heart disease and stroke. If we are spending more on diagnosis and
treatment, we should expect to see health status changes that are
commensurate with that investment. But that is not what we are
seeing."

Steep Rise in Drug Costs
Some of the largest increases have been in expenditures related to
drug treatments, Martin says.

http://www.webmd.com/back-pain/news/...back-neck-pain

On May 5, 10:33*am, Raymond <Bluerhy...@aol.com> wrote:

Back Pain
Many doctors do not won't to admit that they do not have all the
answers to back pain treatment. Many doctors have taken a
contraindicated medical practice (symptomatic treatment) and turned it
into a very lucrative career

Back Pain
Sensei Adam Rostocki

Back pain articles are all over the World Wide Web on more sites than
can be counted. While some sites present a full and complete picture
of back pain conditions, the vast majority are written by doctors and
therapists trying to sell patients on a specific treatment, product or
“miracle cure”. It is no coincidence that most of these care providers
write articles to support their recommended treatments and in turn,
make vast sums of money from interested patients. While there is
nothing at all wrong with capitalism, even in the medical profession,
there is some ethical problem with giving the potential patient an
incomplete or misleading view of their condition and inflated
expectations for recovery

Truth and True Professionals
Honesty in Medicine:
Should Doctors
Tell the Truth?

Dr. James F. Drane
Profesor Emeritus
University of Edinboro Pennsyvania

If providing truthful information to a patient is a matter of
judgment, mistakes are bound to be made. If the information itself is
limited and the amount to be disclosed must be determined by the
context of each case, then inevitably there will be inadequacies and
failures. It is one thing to fail, to make a mistake, to miscalculate
what should have been said. It is quite another thing, to set out to
lie. It is even worse to adopt a pattern of deception. Failure is one
thing, becoming a liar is quite different, something incompatible with
being a professional.

For a true professional, striving to become an honest person is
important. We have seen the strong stand of Immanuel Kant on this
issue. Now listen to the person against whom Kant was most often
pitted against and with whom he most often disagreed, John Stuart
Mill. In the following quote, he is talking about the feeling of
truthfulness or veracity. He said that his feeling is

"one of the most useful, and the enfeeblement of that feeling one of
the must hurtful, things to which our conduct can be instrumental; and
(..) any, even unintentional, deviation from truth does that much
toward weakening the truth-worthiness of human assertion, which is not
only the principal of all present social well-being but the
insufficiency of which does more than any one thing that can be named
to keep back civilization, virtue, everything on which human happiness
on the largest scale depends.."(11)

For Mill, if someone as much as diminishes reliance on another
persons' truthfulness, he or she is that person's enemy. Why? Because
to lose the trust of others is to lose one's own integrity. A doctor
can do even greater harm because not being honest damages the climate
of trust within the profession. Then, it is not an individual's
integrity, but a whole profession's integrity that is lost. If
patients are habitually lied to or misinformed or deceived, then the
context of medical practice is polluted. The whole profesion is
discredited.

A recent American movie, Liar Liar, attempted to make a comedy out of
the all-pervasiveness of lying in the legal profession. The film
makers seemed most interested in creating laughter but in the process
made a not at all funny commentary on how lying and deceit have become
pervasive among lawyers. Without lying, the main character could not
function in the court system. His lawyer colleagues were repugnant
characters. The comic star of the movie saved his life and his
marriage and his moral integrity by discovering the importantce of
being truthful. Consequently, he had to seek a different type of work.
The image of the legal profession portrayed in this film was
sickening. We cannot let this happen to doctors and medical
researchers.

Something similar must not happen to doctors and the medical
profession. Now, more than ever, patients have to be able to trust
their doctors and to be able to rely on the truth of what they are
told. Since truthfulness and veracity are such critical medical
virtues, doctors have to work to develop the virtue of truthfulness.
This is not an easy task.

To become a truthful person we have to struggle first to know the
truth. Then we have to struggle with personal prejudices which can
distort any information we gather. We have to try to be objective. We
have to work to correct a corrupting tendency to confuse one side of a
story or one perspective of an event with the whole truth. And,
finally, we have to recognize that self-aggrandizement corrupts the
capacity to know the truth and to communicate anything except
pathological, narcissistic interests. Truth for an egoist is reduced
to what promotes his ego. The egoist cannot see the truth and
therefore cannot tell it. The only thing which can be communicated is
his or her own aggrandized self.

Knowing the truth and telling the truth is difficult enough without
shadowing weak human capacities for virtues with narcissistic
pathological shades. If we are self-deceived we cannot hope to avoid
deception in what we disclose. Not to address pathological character
distortions is to make lies inevitable. The classical medical ethical
codes were preoccupied with a good physician's personal character
traits--rightfully so.

http://www.bioetica.uchile.cl/doc/honesty.htm