A recent study shows that South Africa is the country where the most tonsils are removed from children in private hospitals. The rate of tonsillectomy operations on children in SA is twice that of the world average.
The study, done by the University of Cape Town (UCT), claims our rate is double that of the world average and 1 888 tonsillectomies are performed per 100 000 people under the age of 19. The second highest country is Northern Ireland‚ with 850 per 100 000 children.
Dr Martin Young, an Ear, Nose and Throat surgeon (ENT), says the main reason might surprise many parents – financial gain for doctors.
“Where there is a demand for a service, it can be easily done. Many people or parents come to ENTs wanting their (child’s) tonsils out – they have already made the decision. And doctors comply, perhaps more liberally than they should,” Young told Health24.
According to Young there is a dysfunctional relationship between doctors and medical aids, typified by the so-called “designated service provider” agreements, or “network” agreements.
“These are inherently bad for so many reasons. They limit doctors’ fees to well below market-related levels, and are then surprised when doctors over service or do ‘unnecessary’ procedures,” says Young. “Doctors have to survive. It’s just a bad system.”
Still a necessary operation
“Tonsillectomy is a great operation for the patient who ‘needs’ it done. That ‘need’ is actually a ‘quality of life’ decision for parents and patients,” says Young.
“In essence, few people really ‘need’ it done, but the majority will benefit. I can tell you that of many thousands of patients, I have had only one in 17 years of private practice who regretted the operation, and the reason given did not stand up to rational analysis.”
According to Young other “elective” surgeries such as gastroscopies, colonoscopies, hysteroscopies, diagnostic laparoscopies follow suit. “I think the study raises more questions.”