Why do surgeons continue to perform unnecessary surgery?
Patient safety in surgery has historically suffered from a lack of physician-driven initiatives aimed at recognizing, preventing and mitigating medical errors and surgical complications. In spite of a multiplicity of global patient safety initiatives, mandatory safety protocols and the introduction of surgical safety checklists, we continue to fall short of protecting our patients from preventable harm. This unrecognized problem has escalated so far that medical errors currently rank as the 3rd leading cause of death in the United States. Strikingly, in the 21st century, we still have to come to terms with the absurd reality that it is significantly safer to board a commercial airplane, a spacecraft, or a nuclear submarine, than to be admitted to a U.S. hospital. What can surgeons do to protect their patients from the hidden dangers of an imperfect health care system? The most intuitive solution is to avoid complications originating from surgical treatment that may not be indicated or beneficial for patients in the first place. In other words, avoiding unnecessary surgery could be considered the most pragmatic approach towards reducing preventable surgical complication rates.