Surgery's Surprise: Many Operations May Be Unnecessary

Globally, over 300 million operations are performed annually. However, an increasing number of surgical trials are revealing that many procedures offer no significant benefit over placebo or non-surgical care. For instance, appendectomies and common knee procedures have shown results comparable to antibiotics or sham surgeries. Research indicates that as much as two-thirds of perceived post-operative improvement is due to the body healing itself or the placebo effect of care, not the intervention itself.

This evidence challenges long-held surgical practices, with some procedures like spinal fusions and rotator-cuff repairs showing indistinguishable results from non-surgical options. Worse, some surgeries have been linked to increased complications and no improvement in mortality. The mindset within surgery often resists this data, as surgeons may overestimate benefits based on patients who recover well. Younger surgeons, however, are showing more openness to evidence-based practice.

Adoption of trial findings varies globally. Countries with salaried surgeons, such as Britain and Scandinavia, have seen faster declines in disfavored operations compared to fee-for-service models. Patient demand for quick fixes, often based on scan abnormalities that may not cause symptoms, also contributes to the persistence of unnecessary surgeries. More untested surgical techniques require rigorous evaluation to ensure patient well-being.