About 6 or 7 years ago, a handful of progressive orthopedic surgeons would ultimately recommend a spinal fusion for a patient after patient had a 2 level disc herniation or multi-level degenerative disc problems along with a herniated disc at one or more levels.
Especially in the workers' compensation field, the insurers would fight “tooth and nail” against such a procedure, labeling the doctors as overly aggressive or imprudent in their radical proposals. There have even been unofficial campaigns, spearheaded by insurers and their legion of insurance defense lawyers to discredit a few orthopedic surgeons and to convince the judges, insurers, law makers and other decision makers that these doctors were far too radical, were harmful to the workers' compensation system and should be avoided at all cost. They won. Many of those surgeons who were really ahead of their peers in ways to treat devastating injuries were marginalized or their practices were greatly reduced in size.
Fast forward to today and you will find that even the insurance oriented doctors are performing these same operations they were railing against only a few years ago.
The change has occurred gradually. The fusion operation has proven to resolve numerous serious back and neck medical problems. And, it is now performed as the first operation, not the operation of last resort.
While I cannot truthfully say what caused the insurers of workers' compensation injuries to drop their general resistance and change courses ever so slowly, I argue that the insurers need to be fought vigorously and at all levels by the workers and their lawyers to obtain the best possible treatment. Patients that were forced into a single level disc excision or partial disc removal 6 years ago, only to need further and major surgery 2 years later due to recurrent, debilitating pain, are the front line testimony of a failed system when the insurers control the doctors.
Let the doctors do what is best for the patient. Keep the insurer's control of the method of medical treatment to an absolute minimum. Until we do so, the workers suffers as the patient and the cost of medical care will increase. Much of my practice of law involves litigation over the most appropriate medical care for my client.