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The problem with our health care system

Posted on: November 18, 2011   by  John Cannell, MD

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Millions of Americans undergo surgery every year, from minor wart removal to the complex surgery for pancreatic cancer. Thousands of surgeons get rich on the surgery. Slowly, very slowly, a few surgeons are beginning to realize that they get better results if they operate on vitamin D sufficient patients than on vitamin D deficient patients. However, when they realize the full potential of vitamin D to relieve pain, I suspect some physicians will have a harder time running their business, like so many bakers. That’s right, bakers, who are reducing prices and are having a hard time making it in this financial downturn.

The scientific paper in question, presented on October 3, 2011 at the North American Spine Society annual meeting by Dr. Jacob Buchowski (an associate professor of orthopedic and neurological surgery at Washington University), indicated a few in the surgical field are beginning to wake up.

Lower levels of vitamin D may put spinal fusion patients at risk, study finds By John Fauber of the Journal Sentinel

Says Dr. Buchowski,

“It was alarming to see that so many patients have inadequate or deficient vitamin D levels, especially when vitamin D is so readily available and inexpensive.”

Yes, that’s why the Vitamin D Council was formed almost 10 years ago, and it’s why we keep at it.

Dr. Buchowski presented research involving 313 adults undergoing spinal fusion surgery at Washington University in St. Louis in 2010 and 2011. He tested their vitamin D blood levels before spinal fusion, a common surgery for intractable back pain. Most had very low vitamin D levels. He then gave virtually everyone 50,000 IU of D2 or Drisdol (that’s right D2, not D3) every week for eight weeks and then he operated.

However, the first thing he should have done, with any kind of pain (including back pain), is to treat their vitamin D deficiency, and they are virtually all deficient, with D3, not D2. Treatment entails giving human vitamin D (D3) at physiological doses, like 5,000 IU per day. Unless there is a clear anatomical anomaly clearly causing their pain, surgeons should delay surgery until patients have vitamin D levels of about 50 ng/ml to see if their pain goes away.

What I think the surgeons will find, perhaps to their chagrin, is that some of the back pain will go away and their surgical candidates will disappear. What would you do if you were the surgeon? You could correct the vitamin D deficiency with an office call or two and risk losing a surgical candidate ($150) , or do the surgery ($3,000).

When you think about the medical system we have, it is like having the baker tell you how much bread you need to buy. I often don’t know what medical procedures I need, and I’m a physician. What about health care consumers who are not physicians? When you think about it, we have a system in which the baker (surgeon) decides how much bread (medical care) you need. I bet the bakers would love to be in the surgeons’ shoes.

2 Responses to The problem with our health care system

  1. JBG

    The surgeon-author in question has had the crucial “light bulb go off” and has taken favorable action (treating his patients and publishing the article) within his current knowledge. Does it make strategic sense to take pot shots at him and at the subprofession that he and we would like to influence?

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