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BackPage Online, April 2023

BackPage Online, April 2023 THE BACKLETTER Vol. 38, No. 4, April 2023 Widespread Mistreatment of Patients at For-Profit Addiction Centers? The overuse of opioids in the management of chronic back pain led many patients—and members of the general public—down an unfor- tunate path to addiction. A large addiction treatment industry—much of it financed by private equity—has quickly grown up to provide addiction services to these individuals. However, there are now widespread accusations that addiction treatment centers are milking patients, families, and assorted payers by offering addiction treatment services that don’t find support in the scientific evidence. Kaiser Health News recently published a series titled “Patients for Profit: How Private Equity Hijacked Health care.” The latest article in that services bears the title “Some Addiction Treatment Centers Turn Big Profits by Scaling Back Care.” Here is a link to the free article: https://khn.org/news/article/some-addiction-treatment-centers-turn-big-profits-by-scaling-back-care Inferior Care at Exorbitant Prices The United States continues to lag other affluent countries in the quality of its medical care, according to a study by the Commonwealth Fund. Yet, it spends exorbitant sums of money to deliver subnormal care. The management of low back pain is an excellent example of poor-quality care at high prices. It is one of the two or three most expensive areas of U.S. medical care—and an area with stagnant treatment outcomes. The prevalence of chronic pain and disability both appear to be rising despite an investment of well more than $100 billion per year in medical care alone. Here are four sad facts about the U.S. healthcare system: • Healthcare spending, both per person and as a share of GDP, continues to be far higher in the United States than in other high- income countries. Yet, the United States is the only country that doesn’t have universal health coverage. • The United States has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates. • The United States has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the average of other countries in the Organization for Economic Co-operation and Development. • Americans see physicians less often than people in most other countries and have among the lowest rate of practicing physicians and hospital beds per 1000 population. Here is a link to the entire report: https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022. Doctors Inundated With Guidelines: Not Enough Hours in the Day to Follow Them Observers often ask why physicians and other healthcare providers don’t follow evidence-based guidelines on the management of low back pain. There are several potential reasons. As the cover story of this issue of the BackLetter documents, healthcare providers, like patients, don’t have accurate views about the nature and course of low back pain. In addition, the entire spine and back pain fields are organized in silos—that hold disparate views of the evidence on back pain and rarely communicate among themselves. And one of the most important reasons for a lack of guideline-adherent care is that physicians, particularly primary care physicians, are inundated with guidelines—and simply don’t have enough time to use them to improve care. A recent article in the New York Times by Gina Kolata pointed out that following all the major guidelines in primary care would require physicians to work 27 hours per day. Here is a link to the full article: https://www.nytimes.com/2023/02/14/health/doctors-medical-guidelines.html The BackLetter e1 Vol. 38, No. 4, April 2023 BBLv38n4-Online.indd 1 BBLv38n4-Online.indd 1 3/7/2023 9:50:27 PM 3/7/2023 9:50:27 PM http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png BackLetter Wolters Kluwer Health

BackPage Online, April 2023

BackLetter , Volume 38 (4) – Apr 1, 2023
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Wolters Kluwer Health
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© 2023 Wolters Kluwer Health, Inc. All rights reserved.
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0894-7376
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2161-5179
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Abstract

THE BACKLETTER Vol. 38, No. 4, April 2023 Widespread Mistreatment of Patients at For-Profit Addiction Centers? The overuse of opioids in the management of chronic back pain led many patients—and members of the general public—down an unfor- tunate path to addiction. A large addiction treatment industry—much of it financed by private equity—has quickly grown up to provide addiction services to these individuals. However, there are now widespread accusations that addiction treatment centers are milking patients, families, and assorted payers by offering addiction treatment services that don’t find support in the scientific evidence. Kaiser Health News recently published a series titled “Patients for Profit: How Private Equity Hijacked Health care.” The latest article in that services bears the title “Some Addiction Treatment Centers Turn Big Profits by Scaling Back Care.” Here is a link to the free article: https://khn.org/news/article/some-addiction-treatment-centers-turn-big-profits-by-scaling-back-care Inferior Care at Exorbitant Prices The United States continues to lag other affluent countries in the quality of its medical care, according to a study by the Commonwealth Fund. Yet, it spends exorbitant sums of money to deliver subnormal care. The management of low back pain is an excellent example of poor-quality care at high prices. It is one of the two or three most expensive areas of U.S. medical care—and an area with stagnant treatment outcomes. The prevalence of chronic pain and disability both appear to be rising despite an investment of well more than $100 billion per year in medical care alone. Here are four sad facts about the U.S. healthcare system: • Healthcare spending, both per person and as a share of GDP, continues to be far higher in the United States than in other high- income countries. Yet, the United States is the only country that doesn’t have universal health coverage. • The United States has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates. • The United States has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the average of other countries in the Organization for Economic Co-operation and Development. • Americans see physicians less often than people in most other countries and have among the lowest rate of practicing physicians and hospital beds per 1000 population. Here is a link to the entire report: https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022. Doctors Inundated With Guidelines: Not Enough Hours in the Day to Follow Them Observers often ask why physicians and other healthcare providers don’t follow evidence-based guidelines on the management of low back pain. There are several potential reasons. As the cover story of this issue of the BackLetter documents, healthcare providers, like patients, don’t have accurate views about the nature and course of low back pain. In addition, the entire spine and back pain fields are organized in silos—that hold disparate views of the evidence on back pain and rarely communicate among themselves. And one of the most important reasons for a lack of guideline-adherent care is that physicians, particularly primary care physicians, are inundated with guidelines—and simply don’t have enough time to use them to improve care. A recent article in the New York Times by Gina Kolata pointed out that following all the major guidelines in primary care would require physicians to work 27 hours per day. Here is a link to the full article: https://www.nytimes.com/2023/02/14/health/doctors-medical-guidelines.html The BackLetter e1 Vol. 38, No. 4, April 2023 BBLv38n4-Online.indd 1 BBLv38n4-Online.indd 1 3/7/2023 9:50:27 PM 3/7/2023 9:50:27 PM

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BackLetter – Wolters Kluwer Health

Published: Apr 1, 2023

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