Wellness Industry Has Us On Our Knees

At a time when Australians, especially older Australians, are under financial pressure, helping them and the government cut unnecessary health cost is especially important.

So it is depressing that the Royal Australian College of General Practitioners had felt moved to issue a warning about the waste of public and private money on a range of useless treatments for the scourge of knee pain.

Chemists, supermarkets, Big Pharma and Big Health are pushing people who suffer from osteo-arthritis, an increasingly common knee condition, to buy pharmaceuticals with dangerous side-effects, such as opioids, or else fad winder products such as Vitamin D or glucosamine.

Yet, after exhaustive study, the GPs say there is almost no evidence that these treatments are effective. The only recommended remedies are cheap ibuprofen rom a chemist, weight loss and psychological pain management techniques known as cognitive behavioural therapy.

The GPs also warn that several common surgical techniques, including know arthroscopies and meniscectomy, also do no good. It has been known for 15 years that these expensive and painful interventions bring no benefits but physicians continue to perform about 40,000 each year.

As Australia ages and more people suffer from bad knees and other chronic pain conditions for which sadly there are few quick, effective treatments, GPs will have to tell their patients not to waste their money.

It is a hard message to sell to patients desperate for a cure and the GPs’ work is made all the more difficult by the weight of disingenuous advertising by the wellness industry. The Australian Competition and Consumer Commission should be vigilant about any false claims.

Orthopaedic surgeons have recently accepted that arthroscopy is largely  ineffective and reduce the annual flow of operations by about two-thirds. Yet that raises the question of why they were carried out hundreds of thousands of operations over the past 10 years. It is hard to resist the conclusion that many doctors wee just happy to accept the fees or they were too lazy to tell their patients the truth.

The broader point is the need to demand value for money from the health dollar. Individuals can buy whatever therapies they like provided they are not actually dangerous. But taxpayers should not be footing the bill.

There should be more scrutiny of how private health funds use the public subsides they receive via the health insurance rebate. Clearly many funds pay for unnecessary arthroscopies or other quack treatments.

The federal government has, from time to time, tried to curtail ineffective treatments but the private health lobby has resisted and argued its customer demand them. The government should have a more rigorous process.

This issue is much broader than sore knees. The Grattan Institute has warned tat surgeons continue to conduct unnecessary operations such as spinal fusions for osteoporotic fractures or removal of healthy ovaries during hysterectomies.

The GPs are to be commended on highlighting useless treatments but all medical colleges should make this a focus, even if it reduced their incomes. The Choosing Wisely guidance that is being issued by some specialist groups is a positive step in this direction.

The big message is for patients who are all too inclined to listen to lifestyle and wellness bloggers and believe the lie that there is some quick fix. The treatments might have some placebo effect but patients should ask whether it is worth spending money.

–              Sydney Morning Herald August 30th 2018

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