How Coronavirus ban on elective surgery is teaching us that many patients need not undergo the knife for common surgeries.
As per the directives from the Indian government in the wake of the Covid 19 pandemic, most of the elective surgeries have been either postponed or cancelled in the hospitals across the country. This situation has compelled many of us to introspect on the surgical need for many of the ailments done before.
It has been observed that around 60% of surgeries in an urban area like Delhi are elective in nature and 80% of them are carried out at private hospitals/nursing homes as per the study stated below
Elective surgeries are those which are planned and does not impose any life threat if not operated immediately. The surgeries we want to highlight are the elective surgeries like joint replacements. These surgeries are non-urgent in nature. As most of the insurance companies provide coverage for these surgeries, they are becoming more common. It may not be entirely because the patients need them but it has become a market driven proposition which is governed by the manufacturers selling the expensive artificial joints. The average waiting time for these elective cases in public and private sector has huge variation from few days to months and that’s the burden it creates on the healthcare system.
According to a study by IKHS (Indian society of hip and knee surgeons) the average age for people undergoing knee replacement was around 55 to 60 years and in 90% of the cases the cause was osteoarthritis (OA). Now considering that OA can be managed very well with other conservative approaches including exercise, weight control, regenerative medicine where one’s own cells and platelets are injected in the knees to help the knees from becoming worse and controlling pain, why this high surgical conversion at an early age is emphasized. It is a known fact that a knee implant too undergoes wear and tear and have a life of around 10 years. On top of it the complication rates from any surgery are in tune of around 20 to 30%. Then why to rush for a surgical option especially when the joints are in a salvageable state? The answer is very simple. The focus of current healthcare system is more surgery centric and neglects on patient education tool, pain management, regenerative medicine, physiotherapy and weight loss programmes. As the companies provide reimbursement /insurance coverages for knee replacements and not for other much more important aspects of the treatment, the medical market is more enthusiastic in getting a surgery done and not pro for more effective conservative approaches.
Studies comparing elective knee replacement surgery with physiotherapy (View Research Report) where a specific group underwent knee replacement and other was managed by exercise and weight control showed that those who did not undergo surgery also improved and almost 2/3 of those patients avoided surgery all together over a two year period.
Similar studies of using one’s own blood products and cell therapy showed good response in patients with knee OA compared to just physical therapy (View Research Report) which makes us conclude that surgery is not the only option when it comes to elective cases for knee pains, shoulder pains, tendonitis, frozen shoulders and rotator cuff tears.
Post covid (corona) era
At Axis Clinic which provides both non-invasive to minimally invasive procedures, we strongly believe that education will be an important tool that has to be used to make people aware of treatments available for joint pains. It is worth important to remember that elective surgical demands peak when surgical consultations are high and they never provide you with an alternative management strategy. In other words the expertise governs the treatment.
Secondly with the shooting costs of healthcare system, people would not be able to afford most of elective surgeries out of their own pockets. Lastly, insurances coverage might take a mighty dip and will not be able to cover a lot many surgeries. Over the time people will also start realising they do not need most of the elective surgeries being offered. This would be the dawn of educating the public in the right direction and giving them an alternate system to take care of their joints, ligaments, tendons and musculoskeletal spine and joint injures.
As we are focused on flattening the curve of corona virus to yield better results in time, we will realise that flattening the curve for elective surgeries is as effective as we don’t need so many surgeries to makes us better. If this curve of elective surgeries could be flattened, it can help billions of rupees which can be saved on unnecessary surgeries and improving the medical health of the population and making them more active without undergoing any open surgeries.