Worse off after surgery: Exposing Australia’s profitable pain industry | Four Corners

everyone feels

pain

, but over 3 million Australians are prisoners of it, desperate for relief, it has spawned an

industry

that has become a breeding ground for exploitation, you are desperate, you need help, you are offered desperate solutions and You accept them, he said, look, we believe that. This would improve your

pain

level by about 60 to 70% and I heard that and thought, Oh my goodness, that's life-changing. We just saw that ray of light and we thought you're beautiful, but it was just a train that came down and hit someone so hard. He appears and says: believe me, I am a doctor, I will take away your pain, would you believe it.

Australians spend more than $3 billion a year trying to treat chronic back pain. It has become an epidemic. The pain

industry

is a huge and

profitable

business that interests everyone. So you have atheist surgeons, pain specialists, GPS, and then you have pharmaceutical companies, you have device companies, it is leaving a trail of misery and some patients end up with worthwhile pain, some suffer paralysis, even death, It was always like this. another

surgery

another

surgery

another surgical surgery I feel like a laboratory if this doesn't work well we'll try this well it didn't work we'll be a little more invasive there is a correlation between the financial reward for performing procedures and the frequency of how those procedures are performed, The pain sector has no idea that we have access to their medical billing data and have sent it to international fraud investigators and a team of leading Australian healthcare experts.

I was so surprised by those findings that it really surprised me that if it was controlled in any way, then you would find an immediate change. What surprised you most was the size of the problem. We will reveal how some medical professionals are straining our healthcare system. There are some obvious attention guys, unfortunately we met. One, we look inside the multi-billion dollar pain industry and expose the ugly side of medicine. Patients' lives are being put at risk and the regulator is not doing its job. This really hits me there. I do not want to be here anymore.

The first words I heard were my specialist standing next to me saying: I'm sorry Teresa, I'm so sorry Theresa, she said it about three times. I'm so sorry, I hit your spinal cord. This is really very tiring. Theresa Burber's minor procedure. it became a major medical incident and I still didn't understand that my leg was paralyzed because no one actually said that, no one told me what was happening every day I wake up and the first thing I see is my chair because it's plugged in next to me bed I open my eyes and it's there and then I recognize the pain and sometimes the pain is the first thing that wakes me up and I look at that chair and I say okay, we have to do this again today Tera had spinal cord stimulator surgery after that she was hit by a car, leaving her with hip pain.

The medical device is implanted in the patients' back. Sends electrical impulses to the spinal cord to relieve pain. Her doctor at a private pain clinic said it would help relieve her pain. The first time I sat in her office and had a consultation, she immediately suggested to me: Have you thought about a spinal cord stimulator implant device? So this was the first consultation, this was the first one and I remember thinking, Oh my God, that life change changed my life. being able to run again, that's me, being able to be completely drug free Theresa says her pain specialist downplayed the risks, she actually told me that nothing goes wrong with this procedure, it's really safe, it's left me with

worse

pain than that I could never feel.

I have imagined that I am left with a constant burning pain in my left leg and left side, so I have a whole new area of ​​pain and it won't stop. I still have that annoying right hip from before, but interestingly that feels like a drop in the ocean these days because the pain in that whole area is like it's on fire now and in terms of before you went to get the stimulator you said you were taking 20 to 30 milligrams of pain relievers, what type of medication? Are you on 100 Mig now just to get through the day?

Nobody tells you that paralyzing means you won't feel anything, you won't feel any temperature, you know, no heat, no cold, no contact, but all you will feel is pain. lose control of your proper bowel functions, you will lose proper bladder function, you will lose sexual function, all those things are gone, where is that in the warnings, where is the information provided, the research on spinal cord stimulators is mixed, is there a lack of credibility? Scientific evidence as a treatment for chronic pain, independent research even describes them as no better than a placebo. Leading orthopedic surgeon Professor Ian Harris agrees that he co-wrote a review on them last year and the conclusion is that they are no more effective than Placebo, so there is uncertainty and when we have uncertainty we have variation in practice practice and the reason there is uncertainty is because there is no good evidence that they actually work compared to not nearly 90% of spinal cord stimulator procedures are performed in private hospitals and can cost up to $58,000 in the private system as it exists at this moment.

I think there's pressure to do that just to keep the wheels of the system turning, so to speak. There is pressure to fill beds and operating lists. The more you are paid for the procedure, the more likely that procedure will be performed. Tens of thousands of spinal cord stimulators are implanted around the world each year. Thousands end up in Australia. Success Stories Drive demand. I can ride it while you slide and slide. They are marketed as safe and effective, but behind the In reality, they described our country as Treasure Island. This is an extremely lucrative procedure for several people in the sector, whether it is the pain specialist, the pain clinic or the large multinational device companies. all the benefits Theresa is one of a growing number of Australians living with spinal surgery gone wrong when I meet people in public and they tell me or outright ask me what happened to you.

I feel a sense of responsibility to share with them the full story, but I'm also absolutely terrified to tell them that a doctor did this, a doctor did this to me and their entire world, their entire belief system collapses. Money and medicines make bed partners uncomfortable, where profits sometimes come before patients Emergency services um, it's my husband, he's in enormous pain, he's 55 years old, he's in terrible pain, this audio It's the ambulance call that Anne Meers made when she thought her husband Gordon was dying, he was like on a roller coaster of pain and would be like that.

Do you know how much pain? I have had to call several ambulances to take him to the hospital because he has had a lot of chest pain. Gordon Myers has been living in hell since a work accident in 2007. What kind of pain are you in? I have nerve pain. and it's every day because I don't know when that pain is going to hit me. I feel a lot of tingling down my spine all the way to my feet. When it gets really bad, my body feels like it's having tremors. The pain specialist recommended a spinal cord stimulator.

When I got home I was in more pain than before, in addition to the medication, and well, the first thing I noticed was that the thing was getting hot inside me when I was charging and it was giving me electric shocks. I woke up flying through the air out of bed and was almost thrown out the bedroom window and had to use all my strength not to go through the glass window. um, he told me many times, he takes a knife and cuts this thing. I can't stand it, yeah, and this is what it did to Gordon's back, it felt like third degree burns on my back, so he took it off.

Corners has obtained exclusive data showing how often spinal cord stimulators require patients to return to the operating room. theater maybe they are saying that Dr Rachel David has access to Australia's private health data as a CEO representing private health funds, so for spinal cord stimulators we looked at 6,000 people and over a period Within 3 years, 41% returned for more surgery, whether it was another implant. or something went wrong with the original procedure, if we compare it to hip replacement, only 2.7% of patients return within a 3-year period. 41% is surprisingly high. It feels like a piece of that is in the dumpster waiting to be picked up.

Garbo drivers don't make you feel very human, that's probably the best way to not make you feel human, if that makes sense, they're not just spinal cord stimulators, spinal fusion is another popular procedure for treating spinal pain. chronic back pain carried out by the private health system. in most of them, that's where the grandmother of three, truly King, came into her own, that's all she wanted to live a pain-free life, which we all want, because the pain and the drugs from taking all those tablets and morphine were too many. the specialist who actually suggested the surgery hello everyone, this is a video taken moments after she woke up from the first surgery in 2021, my ankles are not lifting, I can't lift my feet so you are worried that the nerves are very compressed.

So I'm going to go back for my second take. What was going through your head? I was terrified. I didn't understand why I could move my feet. And no one really. The doctor didn't come to see me, so no one told me. I what was going on there were serious complications totally unconscious I didn't wake up Trudy was in a coma for almost 3 weeks and when she finally left the hospital she couldn't walk and I have three grandchildren under the age of five and I can't play with them like I want and now it's like If the babysitter was always sick or the babysitter was sick, you know, I'm not the healthy babysitter that I always imagined I'd be with them, so I think if I could get my hands on the surgeon, I'd like to just tell him what the hell you did.

Spinal fusion involves joining two or more bones of the spine together permanently to prevent movement between them. Trudy had three bones fused together, she says after scans found degeneration. Professor Ian Harris says an MRI will screen for abnormalities in most people over 40, they will find degenerative changes, dehydrated discs and bulging discs, so there are many diagnoses. The more things you find, the more likely you are to end up with someone who wants to treat or correct that abnormality. Even though correcting that abnormality might not help the patient because it might not be associated with their pain, there is a small place for spinal fusion for people who might. having broken your back or having had a serious congenital deformity where your back simply cannot cope. work properly, but for back pain we say that spinal fusion is a very expensive procedure that for many people simply does not work.

A growing number of health researchers around the world have questioned the benefits of spinal fusion for treating chronic back pain for years. Professor Harris is one of them, there have only been a handful of trials and those trials, when combined , do not show a clear benefit from surgery, some surgeons are very unlikely to recommend the procedure, so when we have variations in practice like telling us that someone is wrong we need more science in medicine unfortunately it is too easy for us, Of course, doctors have been put in a position where we make all the decisions, it is too easy for us to let these other incentives influence our decision making and it is too easy for us to simply rely on our own observation.

Private hospitals perform more than 70% of spinal fusions. Private hospitals literally work on a rotation basis. This is how they make money and many of them are for-profit organizations. So when you say rotation, what do you say? I'm talking about medical activity, so whether it's procedures, drugs, other interventions, push open treatment because that's what's measured, you know how many knee replacements were done last year, that's enough, we should do more. They pay me to do it. an operation um and then there's an incentive for me to do more operations okay I'm in this cycle pain doctors neurologist it's just that it never ends my life it's just a full circle of constant doctors constant doctors it never stops you can say it's me I am

worse

now than before the surgery.

Trudy's doctors charged her private health insurance a fortune. We asked medical billing expert Dr. Margaret Foe to review Trudy's records. I don't have Trudy's complete medical records, but I do. during the period she was in the hospital, those records make it very clearwho was in an intensive care unit on a ventilator for almost 3 weeks, several doctors came to the intensive care unit to provide additional services to Trudy, services that they build. They are services that require the doctor to have a conversation with the patient, not with his family or colleagues with the patient because the treatment must be explained to the patient.

Now I do not understand how it is possible to have a conversation with an unconscious patient who is in a coma with a ventilator, so those records need to be examined the chronic pain industry has become a breeding ground for financial abuse for Corners has obtained one of the largest databases of private health medical bills for surgery analysis column we have access to six Private health funds represent 25% of the industry and the unfortunate reality in the Medicare system is what you did in the operating room and what you pay to Medicare can be two completely different things in Australia medical billing is based on an honor system that doctors will bill. correctly when they file a claim with private health funds and Medicare, they are automatically paid without verifying that services were performed, medical bills are paid on a trust basis, it is a trust.which is not based on reality because After a while, when people realize that they are not being checked, they start first, maybe they start to push the boundaries, there is an interesting trend.

Anesthetist turned medical fraud investigator Dr Simon Peek analyzed data on more than 23,000 anonymous patients with his Cambridge colleagues using his fraud detection software. Well, I'm also interested in seeing the same data. They were also investigated by Sydney-based medical billing specialist registries led by Dr Margaret. Enemy. It is strange that the experts looked for red flags such as inconsistencies in the surgery times recorded by several people in the same operating room, who bill separately, we have not examined the medical records, but there are many red flags in this data, this report suggests that there is a problem with drilling and other things in the data there were enough discrepancies in time and between the data for us to detect the outliers, the findings are the anesthetists who hit Gob, who bill in short periods of time were Of the worst offenders in a health fund, a staggering 87% built an anesthesia time that was much longer than other people in the same operating room.

There are large discrepancies between surgical time and anesthesia time. They found that it was common for each anesthetist to charge for 3 to 6 additional hours and in one case in New York. A South Wales anesthetist spent 14 hours on a surgery that his colleagues said lasted less than an hour. I've looked at data from around the world and I would say that the failed billing indicators in the data they provided us are on the high end of the scale, it gets worse. They were putting these very invasive lines into the major arteries and veins of the body. It's not like a trickle.

They are much more serious. Monitoring lines, they are placing them in very, very young people. You know, 20-year-olds and they're not risk-free, they're dangerous, you know, the incidence of those going to patients was through the roof, the use of invasive monitoring to control blood pressure in patients undergoing to fairly minor procedures, that's not something I do. I've seen it everywhere else without specific medical records, it's impossible to be conclusive, but experts have found that there is a serious fraud waste and abuse problem that requires urgent attention. Its terms are widely used in the industry and can cover conduct ranging from errors to excessive service and fraud.

They discovered widespread problems. Within the pain industry, more than 20% of medical bills for spine surgery raised serious questions and, alarmingly, they found that some doctors were admitting people to the ICU who did not need to be there and this analysis only looks at a area of ​​spine surgery that we show. the findings to a team of leading healthcare experts I'm Dr Chris Hayes I'm a specialist in pain medicine those findings that really surprised me deeply I'm Ian Harris I'm a professor of orthopedic surgery and I've been a surgeon for almost 30 years it's a problem huge, there is certainly a lack of supervision, yes, I mean, if it were controlled in some way, then you would find an immediate change in practice, that's for sure, I mean, it's obvious.

I'm Dr. Rachel David. I'm the CEO of Australian Private Healthcare, which represents health insurance funds in this fairly narrowly defined area of ​​treatment. If we extrapolate to the entire industry, we are talking about 500 million dollars that, as a consequence, are being lost to Medicare and private health insurance. from um from bad billing behavior, are we seeing double exploitation? Yes, we are definitely hitting the patient twice, we are exploiting them clinically by offering them treatments and procedures that can be harmful and then a second time financially and they cannot be turned off. two things because every clinical service that must be provided must be paid for, so you cannot disconnect the clinical from the money, certainly not in a FIFA service system.

Those two things are inextricably linked. I had no sense of direction for almost 12 months. after that I just stayed home I tried to keep the place from the past because that's how the guy liked it um and uh it had nothing to do with pretty much anyone else. Retired police officer David Isard is still coming to terms with the sudden loss of his wife of 43 years, Gail, who died. After major spinal surgery in 2017, his neurosurgeon was Tom Morris, who has since had conditions imposed by the regulator but can still operate. Do you remember when you met Mr.

Morris what he was like? Mr. Morris was like a KN on a silver steed. he was just the light, he was so confident and um, yeah, he made you feel like you'd finally found someone after all these years who would make a difference right away. He told us that he is very good at his job and that for gal to have something. For additional surgery, she would need someone who had done that type of surgery in the past and was competent to do that particular type of surgery and had that experience and if anyone could help her, it would be him, he just swept us away. both. was in a lot of pain constant pain yes, had been in severe pain for many years um in '88 it was debilitating and then became paralyzing Gil and David met Mr Morris for the first time in 2017, he had been Qualified as a neurosurgeon since 2016, We assumed he had been a neurosurgeon for quite some time because we knew the procedure he was talking about was going to be difficult.

Gail was in poor health, putting her at higher risk for surgery. Mr. Morris performed

four

major surgeries. in it for over 7 months, three of them over a period of 8we, which was quite a task because he had from his thoracic spine to his pelvis completely messed up, it's quite a task, something went terribly wrong. I got a phone call from Tom to tell me. that everything had gone well I received another phone call from Tom to tell me that G had had a catastrophic brain injury. Get in here, she won't make it. Former neurosurgical nurse and attorney Allison Spec is pursuing a medical malpractice case against Mr.

Morris. There are two main ones. allegations of negligence, the first being that it was actually unreasonable to recommend that procedure in the first place and perform it on Gale and the second being a matter of consent, multiple hospital records in the days before the surgery show. Gail regretted it hours before the operation. she told a nurse her doubts her nursing staff knows how to vote that Gail has told them words the effect of she is afraid she wants to cancel the surgery she does not want to go ahead she is scared and that they would notify Mr.

Morris that no I don't know if that message It was passed on to Mr Morris, but she then underwent surgery. There is nothing in the notes to suggest that Mr Morris spoke to her or attended because there is nothing in his progress notes in his legal defense of her. Mr Morris says he discussed the risks with Gail and David. He denies medical negligence and says Gail did not withdraw consent. Medical records show that he had explained the risks of the surgery to Gail. Mr Morris says he also received messages of gratitude from David Isard after Gail's death.

Gail was not the only bad outcome for Mr Morris under a 2021 decision by the Victorian vcat court which found he posed a serious risk. VCAT documents show he operated on the wrong part of an 81-year-old at a regional hospital in 2018 and noted 22 patients with surgical complications at EP Worth Richmond between 2017 and early 2018. Worth's notes say he was reluctant to reduce the number of spinal surgeries, as can be seen in the vcat ruling. They believe that Mr. Morris poses a risk to the public as a surgeon and took immediate steps to ensure that there are restrictions on his practicing certificate, essentially what he can and cannot do.

Vcat heard Etworth did not impose any restrictions. Mr Morris, you tried to deal with him internally but he resigned in June 2018, just a few months later, this time there were further complications for patients at St Vincent's, they reported it to the regulator. ARA Atworth declined to answer questions but said patient safety is a priority. I understand that they carried out their own review of her after some pretty significant and terrible results there and that triggered uh area to investigate and therefore impose restrictions. A vcat ruling allows him to continue operating as a surgeon, but under his current restrictions he must consult with a supervisor.

He is also allowed to be a surgical assistant. Mr. Morris declined to be interviewed. There are some obvious cowboys out there. Unfortunately we met one. Mr. Morris's medical billing was also pointed out in the vcat documents by experts he questioned. We asked Dr. Foe to look at Gail. Health Bills Gail's records gave me the most concern, so this included billing for surgical procedures that may not have been performed and billing for hospital visits when there is no evidence in the record that those visits took place. and in fact, on one date, Gail was not even in the hospital yet a hospital visit was built and the pain and needs to be investigated further it's just not the same I'll never be sure I have some friends but I miss my friend we just to see that ray of light and I thought, beauty, there is the tunnel, there is a light at the end, but it was just a train that came down and moved so hard for the last 6 months.

I have been researching the pain industry and what alarmed me most was the slowness of The Regulators who are supposed to keep patients safe The Therapeutic Goods Administration or TGA regulates medical devices runs a database that tracks harmful outcomes and Negatives from patients The TGA says there have been more than 2,000 reports of adverse events related to spinal cord stimulators infection vision paralysis chest pain cerebrospinal fluid leak nerve irritation sepsis recurrent electrical shocks brain hemorrhage in the left side that sounds high to you yeah look it sounds alarming to me the last big scandal we've dealt with in terms of medical implants was the use of hernia mesh for Oran pelvic organ prolapse in women for the mesh during During the same period 224 adverse events were reported and as we now know it was a major scandal in which several patients were harmed, we also discovered a large number of reports about one of the largest device companies, Metronics, had less than 10 adverse events related to their spinal cord stimulators in the database for a decade.

We asked private health funds to crunch the numbers. We examined 764 Metronic generators or stimulators that were implanted and of those, 30%. were revised or acquired some type of premature surgical intervention to reset them within the first 3 years, which would be the device being replaced or a lead being replaced. Australian sponsors of medical devices are legally required to report adverse events to the TGA, but the TGA has never taken any action for failure to report an adverse event related to spinal cord stimulators. Metronics denies this. According to reports and says it follows TGA rules, we can find no evidence that Theresa or Gordon's stimulator horror stories were ever reported, the device companies won.

I don't comment on individual patients, they say their devices are safe and comply with the law. I can't understand why the TGA hasn't done more. I can't understand why companiesstimulated they don't call people like me or even contact me. to their big, elegant officers and they say: well, you know what symptoms you've had, how can we improve this? All that kind of stuff. The regulator's job is to keep people safe when it comes to spinal cord stimulators. It has been appalling their own database is full of people who have been harmed by a device they think is safe the regulator launched a review but that was 2 years ago and we are still waiting we asked the TGA for an interview but they couldn't No took the time in a statement, said approval of a device is based on the evidence available at the time, said patient safety is a priority, no surprise some private pain clinics are making a fortune on stimulators and the funds that pay for them.

I'm not happy that you represent private health funds. Many people would see them as making huge profits. Last year they increased by 110%, while premiums are increasing and people complain that they do not receive as many services as they should. I am absolutely sure that health funds would spend even more money if they knew these were treatments that were working. What we are seeing with what we are spending is that it is simply putting people on a hamster wheel of more treatments Hospital admissions and revision surgeries which are not a good investment in people's care Pain specialist Dr Chris Hayes stopped implanting stimulators 20 years ago I found that people were simply not making good improvements and, in my opinion, nothing There have been substantial changes in the scientific evidence in the last 20 years, as well as reinforcing the view that this has no good supporting evidence and that there is a substantial risk of harm.

Pain in Indry is an interesting place in Australia. a bit like a jungle in some ways I just managed to find a way to look at life without depending on anything to endure my pain my desire was to live with color and joy that had all been eliminated by the spinal cord stimulator the opioids the nerve pain , the injections, the steroids, everything else, so the only way I was going to get out of it was to find a way to leave them behind. Jason Parker felt like a prisoner trapped inside the pain industry for years and he finally got out, so this then, when was the turning point? um, when I took out the machine.

Jason's medical history is heartbreaking. He was in a terrible car accident that left him in agony. He later lost his legs due to an infection. He had a lot of surgeries, stimulators, spinal fusion. of people making tons of money off of people's misery I was just wasting away in a bedroom essentially the financial impact of not being able to work meant you had to go to the doll and I was in my parents third bedroom I lost my house, I left, everything was gone Jason had 10 spinal cord stimulator surgeries over 5 years. He expected me to say, listen buddy, this isn't working, let's leave it and I'm not going to put you through any more, but he was always there.

Another thing I could do to fix it. Do you think it was the worst decision of your life? Absolutely Frankenstein machines are not designed for the human body and sold like a dream. It was sold as the. Now we have your answer. Sometimes. I feel like the response was proportionate because I had the highest medical coverage. It's been a year since Jason's stimulator was removed. I still have pain, but I have learned to live with and understand how my body deals with pain. I hope there's someone out there. Did you know? Maybe don't take that step first.

What is clear is that this industry cannot cure chronic pain, but overtreatment is widespread as the vulnerable seek hope and some unscrupulous professionals see opportunity. There is a big commercial element to this, given that one in five Australians or so experience chronic pain and you could say they walk around with a big dollar sign hanging around their neck and discover that chronic pain is not treated well by cutting off the people and operating on them, so you have to start thinking more scientifically and objectively before offering treatment, but there is no oversight over that. I can offer a spinal fusion to every patient who comes to see me with a degenerative disc in their back, no one is going to stop me from doing that and there is little appetite to change a system. desperate for reform and are you suffering now oh yes, yes, yes, I was always a victim of that?

It's the most horrible thing. The only piece I get is when I'm asleep. It has really destroyed our lives once you get so happy. go there it's extremely difficult to get out don't do it don't do it why does all this matter what's important about it it's important because it depletes our healthcare system of the money it needs and it's a patient safety problem it's both so it's a waste of money funds and you are putting patients at risk, so it is very important if we do not continue to shine a light on this very dark part of the health system, it will soon collapse with waste and abuse, and I think Australians deserve to know the truth, right? is that so?

It has left me in worse pain than I could have ever imagined. It has taken away my mobility, it has taken away my business, it has taken away my career, it has taken away my dignity, at times it has taken away my relationships and it has been the greatest injustice I have ever suffered. ever faced in my life