Back Surgery Marketing

The Wall Street Journal did a nice piece about how a small California hospital is cranking out the back surgeries for profit.  It is such a black eye for doctors but it needs to be exposed. Tri-City Regional Medical Center billed workers’ compensation insurers $65 million in 2010, up from less than $3 million three years earlier.    The story is a sad tale of marketing, greed, shady salesmen, kickbacks to doctors and chiropractors, and price gouging.   Healthcare has enough problems.  Being a doctor is a noble cause.  These kind of stories need to continue to clean out the bad apples who make us all look bad.   And I am not sure that the tag line for Tri-City works for them so much anymore.   I think I they broke their promise.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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6 Responses

  1. Nesher Asner says:

    Anywhere I can read the full article if I’m not a subscriber to the Wall Street Journal?

  2. John Difini, MD says:

    Unfortunately, the amount of damage this type of behavior does to our profession overshadows the innumerable instances of behind-the- scenes charity work most of us do, and of course is reflected in the media attention as well. Our public persona suffers immeasurably.

  3. Dear Dr. Doug,
    Unfortunately, I cannot read the whole WSJ article since I don’t have a subscription but I suspect it was similar to a article that appeared at the end of 2010 on spinal fusion. I am attaching a copy of my response to the bloomberg article that you and your readers might find of value.
    Please keep up the good fight.


    Dear Mr. Waldman and Mr. Armstrong,

    I want to thank you very much for the fine article revealing how useless and dangerous spinal fusion surgery is. I found it very interesting and will use it with my back pain patients. In fact, I have already mailed a copy to a patient of mine who just last month was asking me for my advise on spinal fusion. I am a family doctor who also specializes in the treatment of chronic pain.

    If you are at all interested in learning more about back pain and why your article is so correct, I would refer you to my website and to the books by Dr. John Sarno MD, Professor of Medicine at NYU Medical School. He has been treating back pain since the late 1960’s as strictly a psychosomatic disorder. He has treated over 11,000 chronic pain pts (mostly back pain) and has an 85 to 90% cure rate including myself in 1987 as well as Howard Stern and John Stossel. Dr. Sarno has written 4 books on the subject (all available through Amazon). He was never able to publish in the medical journals due to the extreme prejudice against assuming a psychosomatic basis for chronic pain. He identified the pain as a result of what he called TMS (Tension Myositis Syndrome). There are a number of MDs including myself as well as psychologists who now follow Dr. Sarno’s work and are very successful helping these patients.

    Essentially what Dr. Sarno teaches us is that the brain (not our conscious brain – but the part that controls the autonomic nervous system) creates the pain by creating a mild lack of oxygenation to the muscles, nerves or tendons in order to DISTRACT us from thinking about the things we don’t want to think about. Patients with TMS tend to be perfectionists, goodists (need to do good for others and seek others approval) and tend to have had difficult childhoods. I use these 3 traits to quickly screen a pain patient for TMS after first ruling out fracture, malignancy and infection.

    If a patient can accept the diagnosis, then it is relatively easy to cure them of their chronic pain. I do it with a two hour lecture and a homework assignment. If you have read this far into this note, then you may be interested in going to my website and clicking on the back pain button at Please consider looking into one of Dr. Sarno’s books. I would recommend The Mindbody Prescription.

    I am always interested in teaching this medicine to others, especially those who might be able to better spread the word. You are also welcome to attend one of my lectures at no cost. A few months ago, I had an orthopedic surgeon attend my lecture and he commented at the end that he believed 100% of what I taught was correct. He had long ago given up trying to help back pain patients and for good reason. Back pain as well as most other chronic pain is due to psychosomatic causes and not physical causes. It is not an accident that the medical community does such a poor job with these patients.

    Thank you again for the great article.

    Paul Gwozdz MD
    Somerset, NJ

  4. Ken says:

    Workman’s comp back surgery–the country’s most expensive placebo

    • steve says:

      The WSJ, NY TIMES, and Washington Post have all done stories about Urologist-owned IMRT set-ups and self referral abuse which touch on similar problems.
      When is the Medicare OIG going to look into this issue and the loss of money it generates it generates before going ahead with the drastic cuts proposed for honest and hard working doctors?

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