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Investigate Before They Operate

Because all surgeries involve some form of risk, the decision to operate should never be made lightly. Controversy over physician recommendations for surgical procedures abounds, with several studies suggesting that some patients may not receive vital care, while others are exposed to unnecessary risks.

The Agency for Health Care Policy and Research (AHCPR) sponsored a series of studies intended to improve the quality of patient care, specifically practice guidelines and criteria for surgical procedures. One of these studies, the Women's Health and Hysterectomy Project, focused on hysterectomy because "it is the second most common operation women have, and there are significant concerns among researchers and the public that it might be overused."

Researchers examined 497 women from nine Southern California managed care organizations who had the procedure between August 1993 and July 1995. A staggering 70% of the hysterectomies were judged "inappropriate" based on published criteria.

Hysterectomy involves removal of the cervix, uterus, fallopian tubes, and sometimes the ovaries. Although uterine or cervical cancer, fibroid tumors, and other serious conditions may make this type of surgery unavoidable, the authors of this study note that they found "substantial evidence of underuse of established diagnostic and therapeutic regimens before proceeding to hysterectomy." Before you go under the knife, get a second opinion from a health care professional, and make sure you're fully informed of possible nonsurgical options.


Broder MS, Kanouse DE, Mittman BS, et al. The appropriateness of recommendations for hysterectomy. Obstetrics & Gynecology 2000: Vol. 95, pp199-205.

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