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April 11, 1977

After the Dust Settles

JAMA. 1977;237(15):1600. doi:10.1001/jama.1977.03270420068022

Current "revelations" about "millions" of unnecessary operations and "thousands" of resulting deaths must make a surgeon wonder whether he is, in fact, a member of a secret terrorist group. Suspicious glances from patients, sometimes even from members of his own family, must generate self-doubt. Did he perhaps bypass the rigid surveillance of the tissue committee or peer review board to wield the scalpel wantonly? Was it necessary to remove Mrs X's gallbladder only because she had recurrent gallstone colic? Could not Mr Y have done without a hemorrhoidectomy? Did Ms Z really need plastic repair for her Cyranoesque nose? After all, people got along with these miseries, however painfully and precariously, before the age of modern surgery. Would it not be safer to palliate rather than operate? Why invite suspicions and angry accusations?

The storm of the "Report on Unnecessary Surgery" by the Subcommittee on Oversight and Investigation is still