The researchers emphasize they are not suggesting that physicians are just trying to generate income and volume, although that may, in some cases, underpin the rationale behind a more aggressive course of care.
Rather, they say, it's about making sure the patient is fully informed of all the pros and cons of every treatment option – surgical and non-surgical—and they are fully informed about the benefits and risks, recovery periods, perforations, risk of stroke and even death from having an invasive procedure versus taking drugs and changing their lifestyle.
For instance, a patient might not realize that surgery for back pain would require a two-month convalescence with limited mobility, whereas with a non-surgical option such as physical therapy, medication and exercise they may have a similar outcome.
One of the authors, Michael Barry, MD, explains the issue as one that is at the epicenter of patient safety and quality and reducing medical errors.
"The patient safety movement in the last decade has worked very hard to make sure that the wrong patient doesn't get surgery, that Mr. Jones doesn't get taken down to operating room for surgery that was scheduled for Mr. Smith, and that's really important," Barry says.
"But if Mr. Smith were fully informed, and would then decide he would neither need nor want this surgery, then taking him to the operating room is like operating on the wrong patient as well."