It was only a matter of time. With The Wall Street Journal uncovering eyebrow-raising increases in spinal fusion surgeries in its “Secrets of the System” series of investigative reports, and The New York Times running stories on back surgeons receiving kickbacks from medical device manufacturers, sooner or later an orthopedic surgeon was going to be disciplined as a result of malfeasance uncovered by great investigative journalism.
And it has apparently finally happened. The Wall Street Journal is reporting that Dr. Vishal James Makker, a Portland, OR-based neurosurgeon has had his admitting privileges suspended by the hospital he worked at after the Journal ran a March 29 story showing that Dr. Makker performed ten times as many spinal fusion surgeries as the national average. According to the WSJ, in 2006 the Oregon board of medicine ordered Dr. Makker to undergo remedial training for what it called “unnecessary surgeries.”
(All of which makes you wonder, if Dr. Makker was a guy who the board of medicine five years ago determined was performing unnecessary surgeries, why is he still licensed to practice?).
Dr. Makker’s case is just a single illustration of a larger back-and-forth in the medical malpractice debate. Tort reformers claim that medical malpractice lawsuits drive up health care costs by encouraging doctors to practice “defensive medicine” – ordering unnecessary tests and procedures merely to provide cover in the event of a lawsuit. Patient advocates, citing a growing body of data, say that the performance of unnecessary tests and procedures is driven by the financial incentives doctors face in a world of fee-for-service medicine: more tests and procedures mean more money for doctors and their hospitals. Many doctors, whether consciously or unconsciously, are responding to those incentives.
We need to rearrange those incentives. We need to reward doctors financially for preventative care and the money they save and stop paying them for each cutting-edge procedure that they perform.
When we have a system that enriches people like Dr. Makker, we should not be surprised that there are Dr. Makkers out there.

This blog in maintained by the Boston medical malpractice lawyers at The Law Office of Alan H. Crede, P.C.