New Book on Back Pain Can Teach Us Lessons about Medical Technology

Our community deserves less fear and hype and more genuine hope and health improvement, according to this book reviewer

OPINION  -- “Watch Your Back! How the Back Pain Industry is Costing Us More and Giving Us Less – and What You Can Do to Inform and Empower Yourself in Seeking Treatment” is an important new work by Rick Deyo, MD and MPH, that brings together many of his insights based on decades of careful research and investigation about medical technology. In 2005, Deyo and Don Patrick wrote “Hope or Hype – The Obsession with Medical Advances and the High Cost of False Promises.”

In 2009, Deyo in a commentary in The Permanente Journal Spring 2009 wrote “Marketing, Media, Wishful Thinking, and Conflicts of Interest: Inflating the Value of New Medical Technology.” Students in my Linfield College courses in public health and health policy have read and analyzed these remarkably insightful previous works so I was delighted to read what he would say about back pain, an area where we in the public really need better insights to sort out hope versus hype.

Deyo is the Kaiser Permanente Professor of Evidence Based Family Medicine, the initial Director of the OCTRI Community and Practice-Based Research Program at OHSU Oregon Health & Science University, and has long been recognized by many leading physicians as a national expert back pain.

A few excerpts from “Watch Your Back”:

‘Back Pain is among the most frustrating medical complaints for patients and doctors alike. Both expect the usual medical paradigm of diagnosis and treatment to work as it usually does…. Sadly, this paradigm routinely fails us when it comes to back pain”

This book is about “having people with back pain take more control of clinical decisions and more control over your well-being”

“Two-thirds of adults report back pain at some time in their lives”

“Compared with cancer, diabetes or heart disease, back pain may seem trivial to some, but it is costing our society nearly as much as these life-threatening conditions’

“Care for back pain is low-hanging fruit, where we could easily improve care and cut costs at the same time. In fact, it’s the poster child for medical waste”.   

Each chapter has instructive jewels like the excerpts above for you to consider.

   After reading this well written book on the relatively neglected yet enormously pervasive and expensive topic of back pain, here are my take-away observations:

  • Deyo includes in this clear succinct 170 pages the issues, context, and challenges that cause us to focus research primarily on dramatic life and death issues like cancer, heart, AIDS. This well intentioned thinking has unfortunately allowed  us  - the public - to be confused and often manipulated by practitioners and back industry forces that take our money while often providing little value or relief from back pain.
  • I have carefully read Deyo’s 30 pages of logical, relevant notes. They give us a coherent and comprehensive sense of how he as a thinker and researcher has come to understand why we spend more and get less from the back pain industry and why we need to realign behaviors and financial incentives if we are truly to sensibly reform health and health care in America. His thinking and case for change is a model that Accountable Care Organizations, Oregon CCO Coordinated Care Organizations, and those of us interested in implementing better health policy should deeply understand and use.
  • I am so impressed with this short work that I will be requiring it as part of my spring 2015 Health and Social Policy course for my Linfield health administration, global health, and nursing students. We need more articulate, clear, and compelling studies and approaches like Deyo’s “Watch Your Back” and less defensive medicine and rationalizations that do not improve health and waste money.
  • I recommend it to my fellow “Lund Report” readers who want to both better understand and improve health prevention, affordability, quality, and access. I hope our media can give “Watch Your Back” even a fraction of the exposure they are giving to Ebola. Our community deserves less fear and hype and more genuine hope and health improvement.

Michael Leahy, MBA, is a Linfield College Health Administration Coordinator and Visiting Associate Professor of Health Sciences.

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