Physical therapists who support research comparing surgical interventions with physical therapy for chronic, painful spinal stenosis are under attack.
A group of 56 congressmen have written a letter asking President Barack Obama to withdraw the nomination of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS).
Their opposition to Dr. Berwick is based on his support of Comparative Effectiveness Research. The congressmen who wrote the letter are House Republicans not involved in Dr. Berwick's upcoming Senate confirmation meeting. They called Dr. Berwick's beliefs "rationing":
“We believe that Dr. Berwick’s recommendation for the federal government to use ration-based, cost-effective research to restrict patients’ access to medically necessary care is wrong.”...the letter said.
But, according to White House spokesman Reid H. Cherlin,
“The fact is, rationing is rampant in the system today, as insurers make arbitrary decisions about who can get the care they need.The White House continues to support Dr. Berwick who was nominated April 19th. His Senate confirmation hearing has yet to be scheduled.
Don Berwick wants to see a system in which those decisions are transparent – and that the people who make them are held accountable".
There is ample need for head-to-head studies examining both the indications for and the outcomes the following:
Spine fusions alone cost Medicare $575 million dollars in 2007. That money would buy a lot of physical therapy.
Who can think of other, promising areas where PT might compare favorably with dangerous and expensive surgical options?
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