Health Coverage Fellowship
Every year, reporter and author Larry Tye, gathers together ten healthcare journalists from TV, radio and print and exposes them to all things health-related in Boston. Larry was a health and environmental reporter for the Boston Globe from 1986 to 2001. Included in this week of total immersion is an opportunity to experience a variety of complementary health modalities like acupuncture, reiki, and posture-based therapies. 360 NMT was proud to introduce the scribes to neuromuscular therapy, manual and needle-assisted trigger point therapy.
After we worked on the journalists, we were plied with a delicious dinner at Babson College and observed a debate between two guest speakers with opposing views on complementary therapies (where have I heard this before?). One was a doc from Dana Farber who was promoting integrative medicine. The other was a neurologist from Tufts Medical Center who boldly stated that anything not backed by proven medical science was mere placebo. The latter wanted everything in medicine to be evidence-based, laboratory tested, and proven. (Placebo and chiropractic were quoted to be the enemy.) How is this rigid system working to relieve pain in America?
Well, it got me to thinking. To locate the source of pain a doctor commonly orders an X-ray, CT scan or MRI. These tests are pretty expensive, involve exposure to radiation and generally always find something wrong. Subsequently, the patient develops a hard and fast attachment to the resulting diagnosis. But do these abnormalities account for the pain? My latest metaphor could be an image of a telephone. You know it’s a telephone, but do you know if it’s ringing, or if it’s even plugged into the wall. I have previously described a presentation that I attended last year where the surgeon showed an MRI of a patient’s left and right hip; one good looking the other one a mess. Guess which one he replaced?
In a 2010 paper published in the J Occup Environ Med, BS Webster concluded that those who had an early MRI (< 1 month) for back pain were eight times more likely to have surgery, had a five-fold increase in medical costs, and had increased disability rates. This population didn’t recover any faster than those who had no testing. Last year, I was fortunate to study with world-renowned lumbopelvic pain expert, Andry Vleeming. He introduced the acronym ‘VOMIT’. VOMIT stands for ‘Victim Of Medical Imaging Technology’. Love it. He convinced us that there was no gold-standard imaging test and that there was no evidence to support the use of MRI, CT scan, X-ray, scintigraphy, SIJ injections or external frame fixators for diagnostic purposes. So how do we reduce the vomit? Well, there is a group of physicians who are choosing their diagnostic testing wisely. Click.