Why does South Africa have the highest rate of tonsillectomies in the world?
A University of Cape Town study claims that South Africa’s rate of tonsillectomies – the surgical removal of tonsils – is double the world average – and the most likely reason has little to do with health.
The study said we have 1 888 tonsillectomies performed for every 100 000 people under the age of 19 years. The second highest country is Northern Ireland with 850 operations for every 100 000 children.
Dr Martin Young, an ear, nose and throat surgeon, said the main reason might surprise many parents: financial gain for doctors.
“Where there is a demand for a service, it will be provided. Many people or parents come to doctors already wanting their child’s tonsils out and doctors comply, perhaps more often than they should,” Young said.
“There is a dysfunctional relationship between doctors and medical aid schemes – typically the so-called designated service provider agreements, or network agreements.
“These are bad because they limit doctors’ fees to well below market-related levels, which is why many doctors over service or do unnecessary procedures. It’s just a bad system and doctors have to survive.
“Tonsillectomies are a great operation for patients who need it done and while only a few people require it for health reasons, most will benefit. Out of the 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,” he said.
According to Young other surgeries such as gastroscopies, colonoscopies, hysteroscopies, and diagnostic laparoscopies also show similar issues. – HEALTH24.COM