A handful of back surgeons in Flanders perform unnecessary operations to make money. This is evident from a study by the VRT program ‘Pano’. Patients describe how they were pressured to undergo surgery quickly, sometimes even without the doctor first performing a physical examination. “Criminal,” responds pain specialist Bart Morlion (UZ Leuven).
Lore Vanhaelewyn
Journalist at HLN
For the report, ‘Pano’ spoke to dozens of patients and doctors. They outline how some surgeons are very quick to resort to surgery for back problems, while other treatments or a wait-and-see approach are often indicated. “We see patients every week and we really wonder why on earth they had surgery,” says Morlion, head of the pain clinic at UZ Leuven.
A reporter from ‘Pano’ also went undercover to consult a back surgeon who, according to colleagues, operates quickly. During that conversation, the doctor reportedly asked hardly any questions and immediately started talking about an operation with screws in the back. A physical examination did not take place.
With the same scans, the reporter subsequently went to another specialist: back surgeon Geert Mahieu from AZ Monica and chairman of a professional association for back surgeons. After a traditional physical examination and viewing the images, he came to a completely different conclusion: surgery will not help much and is therefore not recommended.
Doctor Geert Mahieu also knows the stories about back surgeons who perform unnecessary operations. Yet he emphasizes that it is a minority. According to him, most back surgeons do act in the interests of their patients.
As in any professional sector, there are people who think they can circumvent the rules for profit
According to him, financial motives can play a role in exceptional cases. “Are there individuals who operate to make money? That could be,” he says. “As in any professional sector, there are people who think they can circumvent the rules for profit.”
For Mahieu, such practices have no place in medicine. “If you would even destroy a life for an amount in your bank account, that is distasteful. If it is proven that someone knowingly harms a patient, then that is criminal.”
Little evidence for injection treatments
In addition to operations, back patients are increasingly receiving injection treatments to relieve pain. Yet evidence for their effect is limited. According to a large 2024 review study in the medical journal ‘BMJ’ (British Medical Journal), there is little convincing evidence that such injections help long-term chronic lower back pain.
Patients should realize that sometimes low-value treatments are offered because they are more financially attractive to doctors
These injection treatments do make a difference for doctors and hospitals: a consultation yields approximately 33 euros, while injections easily yield ten to twenty times more. “Patients must realize that low-value treatments are often offered because they are financially more interesting for the doctor in question than standard care according to current guidelines,” Morlion warns.
